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Q:  Over the past 18months I have experienced difficulty looking into the distance, watching TV and latterly even walking around outside. My left eye closes regularly. My sight is OK.  Recently I have also noticed my lefthand side of my face is slightly distorted. I have had several eye tests all confirming that. I have received Botox for bletherspasm which has helped with the left eye closing but nothing else. I have had an MRI scan which all came back normal. I wondered if acupuncture could be something that could help?

A:  We are very sorry to hear of your experience. It must be rather unnerving to have had all the relevant tests and still have neither a formal diagnosis nor an effective treatment for your problem.

On the assumption that the MRI and other tests rules out any neurological problems, we do have to say that what is happening to you is suggestive of some form of energetic blockage on one side of your face not dissimilar to Bell's Palsy, which as our fact sheet shows we do treat with some cautious claims for success

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/bellas-palsy.html

The reason for mentioning this is not because it is Bell's Palsy, but because in Chinese medicine the understanding and treatment of the problem readily lends itself to other problems which manifest as one-sided disturbances. As you have probably read on our website, traditional acupuncture is based on theories of a flow of energy called 'qi' and its rhythms, flow and balance. When this is disrupted in any way it can give rise to symptoms. Sometimes this disruption can be very superficial, where a problem is generated, as for example in the Chinese understanding of Bell's Palsy, by exposure to a climate condition. BP is much more common in China where people work outdoors, and a strong wind blowing on one side of the face is sometimes seen as the cause. 'Wind' is seen to disrupt and block the flow. We see occasional cases, less so now that aircon is so common, where people have driven for long distances with a car window open to their right side.Of course, the superficial flow of energy also connects to deeper flows which connect in turn to Organs, functional units which are similar to their western counterparts but have wider meaning. Some of the functions governed by the Organs can have effects on areas of the body, especially one-sided effects. The skill and art of the practitioner lies in gathering all of the information and making sense of what is stopping the flow and how it can be corrected as economically and elegantly as possible.

Clearly not all problems of this type are going to be treatable, but for those cases where there is some reasonable chance of change and improvement, there will often be clear diagnostic information which will guide a practitioner. There is no substitute for popping along to visit a BAcC member local to you who can give you a brief and informal assessment, hopefully without charge, of what he or she believes may be possible with acupuncture treatment.

 

Q:  I have been seeing things on the internet that a daith ear piercing helps with migraines. Is there any truth in this?

A:  It is a fair bet that everything will work for someone. The real issue is finding something that will work for everyone.

Ear acupuncture is a relatively modern phenomenon, developed largely by a French neurologist called Paul Nogier in the late 1950s. There are some classical and traditional antecedents, but it is a mainly modern practice. From our understanding of the sections of the ear where the Daith piercings are inserted have no direct connection with points as understood after Nogier which might have an impact on migraines. That said, we would be the first to say that there are no specific points for migraines, and if an imbalance in the system which was the root cause of a migraine-causing imbalance happened by chance to be treated by the Daith piercing it is possible that it may have an effect.

We have borrowed this short section of text from the website of an American practitioner who has researched this practice thoroughly because we believe that this is about the best that you can say:

  • The daith does not come anywhere close to stimulating points that acupuncture experts use to treat migraine headaches.
  • Clinical experience suggests that body piercings offer temporary (1-2 weeks) therapeutic benefit at best. They definitely do not represent a long term cure for any condition, including migraines.
  • The daith is an advanced piercing that is often done incorrectly and with inappropriate jewelry. A bad piercing and/or the wrong jewelry is likely to result in excessive pain and serious problems with healing, including the formation of unsightly (and sometimes permanent) bumps around the piercing, as well as potentially serious infections.
  • All cartilage piercings require diligent aftercare (including daily washing and soaking with saline) for the entire six month period of time that it takes to heal. During the healing period ear buds and swimming must be avoided.

Most of this is not exactly unfamiliar territory to those having normal ear piercing. Ear infections are not only painful but far too close to the brain and other delicate structures to be allowed to develop. However, we understand that this type of piercing in this area is slightly more dangerous, although for a professional assessment you might have to talk to someone who specialises in this kind of work.

We would be remiss if we did not mention that traditional acupuncture has a good record in treating migraines, as our factsheet shows

  http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/migraines.html

and as the recommendation by NICE for acupuncture in the treatment of chronic headaches shows. If you are a migraine sufferer you might want to seek the advice of a BAcC member local to you about what treatment may be able to offer. 

Q:  I am 61 years old female and I have had a non scaly erythemous rash for about a year. It started on one inner thigh and has spread to the other, the abdomen and under my arms. It can be sore and itchy at times. I have seen a dermatologist but there is no diagnosis. Can you recommend acupuncture and/or a local acupunctuist.

A:  We are always intrigued by problems such as this. As you may already know from more general reading on the website, traditional acupuncture is based on a theory of energy called 'qi', and its rhythms, flow and balance across the body. The energy flows in distinct patterns on the surface of the body, and each channel or meridian, as they are called, is connected to one or more Organs, the functional units within the system which overlap slightly with the western concept of an organ but are understood to have far wider functions on all levels.

What this means is that when someone develops a rash which spreads over time, there are several ways of looking at what is happening. It could be a problem in a specific channel, and the pattern of the rash's development may well outline the path of a channel and its successors, or it may point to an underlying pathology in the Organ which is generating Heat in this case which is being directed away from the Organ to the outside. The skilled practitioner will then be doing their own detective work to see whether the pattern involves just the Organ which is possibly generating the symptoms, or whether it is reacting to patterns of disharmony elsewhere. Chinese medicine is a great deal more than simply a correspondence between a symptom and the use of a number of points, and the sophistication of the understanding of aetiology and pathology which leads to the unique and individualised treatment is not as well understood yet as it might be. That is out continuing challenge!

The one additional point we would make is that the received wisdom inside our profession is that Chinese herbal medicine is often the preferred modality for treating skin problems. CHM gained some considerable exposure in the 1980s and 1990s when one particular London clinic had queues going around the block for skin problem treatments, many of which we successful. The reality is that any trained Chinese herbalist belonging to the Register of Chinese Herbal Medicine or the Association of Traditional Chinese Medicine will offer the same standard of care. Most RCHM members are also BAcC members, and this may offer the best option.

On balance, based on what you have told us there may be straightforward acupuncture treatments which can help with what you have. We cannot make individual recommendations, mainly because we take the view that all of our members are equally well qualified in what they do to offer the same level of quality service. Our postcode database search on the home page will identify at least half a dozen practitioners in close proximity to you.

 

Q:  Can acupuncture help moderate sleep apnoea? Are there any outcome studies that compare acupuncture for moderate sleep apnoea with C-pap technologies?

A:  Rather oddly we have not been asked questions about the use of acupuncture treatment in sleep apnea before, and on investigation we found three studies

http://www.ncbi.nlm.nih.gov/pubmed/20615853

http://www.ncbi.nlm.nih.gov/pubmed/17023212

http://www.ncbi.nlm.nih.gov/pubmed/19186731which appear to give very encouraging results. As always the studies are rather small, and this does mean that they are not really considered robust enough to make substantive claims for what might be possible. However, they are significantly better than some we see which fail to draw any conclusions.

Unfortunately there are no studies which compare the use of acupuncture with C-Pap machines. The trials all test acupuncture against sham acupuncture, itself a rather difficult comparison because it is based on the premise that sham acupuncture has no effects, where from our perspective it may simply be testing sub-optimal treatment against optimal treatment. We suspect it might be possible to find research data from the use of C-pap machines and compare the outcomes, but this is beyond what we can meaningfully generate and fraught with methodological problems.

The issue for us, though, is not whether there is evidence of studies to underpin the treatment but whether there are discernible patterns of disturbance in the energy of the body which give some clue in Chinese medicine terms about what is happening. Some systems of TCM have very specific syndromes where the symptoms of apnea are accompanied by other pathological changes which point directly to potential treatments, but even this is not an essential requirement for successful treatment. The very early systems of diagnosis and treatment were often asymptomatic, literally treating the person rather than the condition with which they presented, in the simple belief that a system in balance took care of itself.

The best advice we can offer, and usually do, is to visit a BAcC member local to you for a brief face to face assessment of what may be possible. This will be able to take into account some of the unique aspects of your presentation which will better inform a skilled practitioner about what is going on.

 

Q:  I have had a persistent cough for 15 years. I have seen A specialist at Kings College London and been to several cough clinics, none have provided a solution. The cough is very violent and puts a great deal of stress on my body. The problem has been diagnosed as nerve damage to my throat, which causes an overreaction to the slightest irritation resulting in severe bouts of coughing. Is there any form of acupuncture that may relieve or stop the problem.

A:  We are assuming that having been under specialist care you have had all of the available tests, and we are a little surprised that nothing has shown up. However, we have seen cases like this where the body seems to have developed a sensitivity reaction for which no obvious solution can be found. We answered a question about a similar problem some time ago, and the response we gave included the following comment and advice:

If none of these has been identified as a cause, or even if they have, there may be some merit in looking at acupuncture treatment. There is not a great deal of evidence for the treatment of coughing, but this is mainly a reflection of the many different causes of coughing and the difficulties of designing a trial which generates meaningful results. Persistent coughing has certainly be a symptom recognised within traditional Chinese medicine, and if it appears alongside other symptoms and alongside the diagnostic evidence which a trained practitioner will find using Chinese medicine techniques, there are a number of clearly defined syndromes which offer treatment protocols to address the underlying patterns.

Even where there is no recognised syndrome, it is important to remember that in its earliest forms Chinese medicine was asymptomatic, i.e. it treated the patient as a whole based on the diagnostic evidence and not necessarily with regard to what they reported. In this way the treatment could truly be said to be unique. The underlying premise was symptoms only appear when the system as a whole is out of balance, and because of the internal patterns of energy flow, a symptom may not necessarily arise where the actual problem lies. The skill and art of the practitioner is to go to the root of the problem and once this is treated, there should be an improvement in the symptoms.

On that basis, and given that the problem has not always been there, it may well be worth having a brief chat with a BAcC member local to you to determine what may be possible. What the earlier answer does not cover in detail is the fact that traditional Chinese medicine sees the whole system, body, mind and spirit, as a united whole, and there are quite often connections to what is happening in a patient's life which can make some sense of an unusual symptom. Even where this is not the case, however, there is some evidence, especially from the treatment of phantom limb pain, that acupuncture treatment may be able to turn off or reduce the volume of a nerve signal to the point where it becomes more tolerable.

The only caution we have about slightly less frequent problems is that it can be quite easy to have a great many treatments where the results do not justify the continuing expense. You are probably more likely than many to notice circumstances where the reaction is less extreme, but even so we would always recommend finding some relatively objective outcome measure to assess the benefits of treatment.

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