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Ask the Expert
Q: I've had five sessions with an acupuncturist for neck pain, which worked. Better with less needles than more. I have complete confidence in the acupuncturist, although the needles hurt going in.
A: There are sometimes reactions to treatment, especially in the treatment of neck and back pains, which are quite severe. This is not an uncommon reaction, and it is not unique to acupuncture; we often get feedback from patients who have osteopathy and chiropractic that they feel the pains and discomfort intensify for a couple of days before the symptoms they came with start to subside. We routinely (well, this 'expert' anyway) warn patients with neck and back pains that there may be a reaction for 48 hours, after which matters should start to improve.
In your case we wonder whether the fact that you were feeling run down and have now come down with a virus just sensitised the whole system a little more, which has meant that the reactions to treatment have been a little more intense and the pain itself has now increased a little. We often find that the manner in which a cold or virus is understood in Chinese medicine could easily make musculo-skeletal pains a little worse.
We are not in the business of trying to persuade people who feel reluctant to go back for further treatment. We often find out that there were other concerns and the reaction to treatment was simply a tipping point. However, if it is simply the reaction and the intensity of the needles, this is something which a responsible practitioner should and will take into account. The best course of action, rather than cancelling now, is perhaps to talk to the practitioner himself or herself to explain what happened and ask their opinion based on case notes which we, of course, do not have. If you don't feel reassured by what they say then by all means cancel. We believe, however, that will be very concerned to hear of your experience and very keen to make sure that your condition continues to improve comfortably, especially since you appear to have been making good progress.
Q: I had surgery for a disc bulge at S1 level a year ago as I was having fasciculations in my lower limbs and pains in my buttocks. I also had nerve conduction tests before surgery which were fine. The sensations in my lower limbs continue and although not painful they are constant and irritating. My consultant thinks the damaged nerve has not recovered. Is there any possibility that acupuncture could help with the uncomfortable sensations in my lower limbs?
A: Cases like your are always interesting from a Chinese medicine perspective because they highlight the different approaches take by a conventonal medical practitioner and a Chinese medicine practitioner.
Conventional medicine rests on a very clear commitment to establishing patterns of causation, and very successful it has been too. For the western medical practitioner the presence of discomfort and fasciculations, together with a disc bulge in an area associated with the dermatomes in which the sensations appeared, would be a no-brainer, a very clear case of pressure on a nerve which surgery on the disc would relieve. It may well be the case that the process of recovery still continues, but after twelve months it may start to seem less likely.
From a Chinese medicine perspective such symptoms reflect a disturbance in the flow of energy, and the art and skill of the practitioner lies in determining whether these sensations are indicative of a local blockage or are evidence of a much deeper systemic problem of which these are the surface manifestations. The nub of the issue, however, is that these might have arisen independently of any physical damage which has occurred in the area, and might be addressed by the use of needles and moxibustion while leaving the damage untouched.
In most cases like yours, however, the two systems of medicine overlap, and our way of explaining what has happened would probably take the form of suggesting that the disc bulge not only caused possible nerve reactions from a conventional perspective but also caused a blockage in the energy of the area which, while it remains untreated,will continue to generate the same type of symptoms. In your case it may be we have that most interesting of cases, physical damage understood in western terms causing energetic disturbance understood in Chinese medicine terms, especially since the nerve conduction tests showed no problems. There is also the possibility that the surgery itself, by cutting into tissue in the area from which small amounts of scar tissue are inevitable may be a contributory factor.
The best advice we can give you is that you visit a BAcC member local to you for a brief face to face assessment of whether they think they can help you. Because your symptoms are well-defined, it should be a relatively simple matter, should you decide to have acupuncture treatment, to set measurably outcomes which will enable you to determine whether there has been any improvement. We always recommend in these cases that people set a review period for four or five sessions. Our belief is that problems like this start to respond quickly or not at all. If there is no evidence of improvement after five sessions we would always explore other treatment options with a patient.
We always take great care in answering questions about conditions such as motor neuron disease. From a conventional medical point of view the term 'motor neuron disease' covers four or five distinct variations of disease, but what is common to all is that they are all progressive and deteriorating, and most people survive onky three to five years from the point of first diagnosis. There are some exceptions, the most notable being Stephen Hawking, the scientist, who has had the disease for over fifty years.
From a Chinese medicine perspective, a great deal depends on how the disease first presents. The ancient Chinese had a far greater understanding of anatomy and physiology than is often recognised in the West, but diseases of the nervous system such as this would have been a mystery to them. They would have looked at the symptoms as they presented, and tried to make sense of these within a framework which was underpinned by the concept of 'qi', a form of universal energy, whose flow, rhythm and balance are seen as integral to health and well being. If there was a weakness in an arm or leg, often an initial symptom in MND, it would be seen as an impairment in the flow of qi and the practitioner's aim would be to identify whether this was a loca problem or a wider systemic problem and use needles and moxibustion to restore flow and balance.
Anecdotally we hear stories about people for whom treatment with acupuncture appears to arrest the speed with which symptoms get worse, but such is the unpredictability of the course of the disease there is no way of knowing whether the treatment has done this or not. There are forms of the disease where after the initial symptom appears nothing else seems to happen for many years, and this is unpredictable and difficult to measure. We would like to think that acupuncture treatment can delay more severe symptoms, but there is no evidence to suggest that it can do this. Acupuncture treatment will certainly not do any harm, and may even help with some of the anxieties and stress which accompany the condition, but more than that we could not claim.
Q: My Dad suffers from severe dry mouth after mouth cancer operations and radiation. Is there an acupuncturist who specialises in this?
A: As this extract from our factsheet on palliative care shows
Dry mouth (xerostomia)
A systematic review found possible benefits with acupuncture for radiotherapy-induced xerostomia (O’Sullivan 2010). Not all the inter-group differences were significant but this is typical in trials comparing acupuncture with sham acupuncture, for the latter is commonly viewed as being an active treatment itself, not a placebo, and hence may underestimate the effects of the therapy (Lundeberg 2011; Sherman 2009; Paterson 2005).The RCTs to date are few in number and small in size. Although they have produced encouraging results, and are supported by observational studies (for example, Meidell 2009), larger trials are required to achieve more robust evidence. Acupuncture may also help with xerostomia dysphagia (swallowing difficulty) in late-stage palliative care (Filshie 2003).
there is some evidence for the value of acupuncture treatment for dry mouth after radiotherapy, and the two studies below certainly seem very positive.
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Clearly there is a considerable difference between the kinds of functional disturbances caused by disruption of the balance of the body's energies through normal wear and tear and the kinds of damaged brought on by injury or accident. This does mean that it is more difficult to predict whether acupuncture treatment might be of benefit. Treatment of the kind used in the studies tends to be localised or precisely targeted, and this can mean that it does not really conform to the patterns of treatment which a Chinese medicine practitioner would employ. In broad terms, however, acupuncture treatment is aimed at putting the whole system back in balance with the underlying belief that a body in balance tends to deal with symptoms itsef, and on this basis it may well be worth talking to a BAcC member local to your father to see if a combination of systemic and local treatment may, in their view, be of benefit. Most BAcC members are more than happy to give up a little time without charge to give a face to face assessment of whether treatment would help.
We do not have any members of whom we are aware who specialise in this field of treatment. From our perspective all of our members are sufficiently skilled to be able to handle the vasy majority of conditions with which they are confronted, and know when to refer on if they feel it is beyond their limits of competence. In cases such as your father's, which are relativey infrequent in day to day practice, most members would as a matter of course undertake their own research to be au fait with the most recent research findings if presented with an unusual condition.
Q: I am not sure if acupuncture would have any chance of helping with this, but I suffer from bad acne around my chin area - and I'm pretty sure this is related to hormones. I am 29 years of age, and female.
A: There is some evidence that acupuncture can help acne, as out factsheet shows:
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However, we are interested that you think there is a hormonal connection because in someone your age acne is very often a symptom of polycystic ovary syndrome, for which there is some, if conflicting, evidence about the value of acupuncture treatment, as our factsheet shows
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There is every reason to seek further conventional medical assessment to establish whether this is the case, because it can add to the understanding of the condition from a Chinese medicine perspective. Any accumulations of fluid in the body have significance from a Chinese point of view, and if there are other linked symptoms this will suggest possibilities for treatment.
If the problem is simply a local one, we believe that there may be some value in seeking acupuncture treatment, but we would also probbaly recommend that a prospective patient visit someone who is also trained in Chinese herbal medicine. Using herbal medicines can often offer daily treatment of a problem which in the case of skin problems seems to provide a better chance of 'breaking through' the pattern. Mist members of the RCHM are also members of the BAcC, so finding someone who uses acupuncture and herbs is not difficult.
However, any of the BAcC members local to you will be able to offer you honest advice and a brief face to face assessment of your problem to make a more informed recommendation than we can make remotely.