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Q:  We are not quite sure what the best advice we can give is. 'Twisted bowel' used in a medical context is a serious problem, and unless there have been extensive investigations which show that the extent of the twisting is not serious, then in most cases surgery would be very likely. The risks of loss of blood supply in or around the bowel are very considerable, and can lead to life threatening infection.

 

We suspect that you are using the term in a more informal way which people often employ when they have irritable bowel syndrome and have visited a number of complementary therapists who use the term in a slightly more loose way. As far as treatment of IBS is concerned, the evidence for the successful use of acupuncture was dismissed as inconclusive many years ago, but the last decade has seen a number of very encouraging studies as our factsheet

 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html

 

demonstrates. These all point to an enhancement of the bowel function and positive changes in gut motility which may have an impact on what is being described as twisted bowel.

 

There is always a danger of getting too involved with the technicalities of western named conditions and forgetting that in traditional Chinese medicine the main thrust of diagnosis and treatment was and remains setting the whole system in order in the simple but effective belief that a system in balance corrects itself. Although primarily concerned with function rather than structure there is no doubt that in many cases restoring what we consider to be good function can lead to a major improvement in structure, most obviously seen in treating lower back pain. If a system is in balance, then in theory it should regain its natural shape.

 

However, we would need a great deal more detail before being able to offer a guess at a prognosis, and your best option is to visit a BAcC member local to you for a brief face to face assessment of what is going on and what benefit acupuncture treatment may bring. Most BAcC members are happy to give up a little time without charge to discuss whether acupuncture is a sensible treatment option, and this also has the benefit of you being able to meet them and see where they work before committing to treatment.

A:  As the Department of Health's guidelines make very clear

 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/330925/MRSA_information_for_patients.pdf 

MRSA is relatively prevalent and widespread without necessarily causing infection. As such, it is very likely that a significant proportion of patients are carrying the bug without any trace of symptoms. This applies to almost all of the other infections which sporadically cause alarm in the public; blood borne viruses are very common in what is called a 'carrier' state where the person with the virus is unaware that they have it.

  Our Codes of Safe Practice have been designed to protect patient and practitioner alike from infection and cross infection. Our health and safety consultant, a man pre-eminent in his field, was emphatic that if a practitioner followed the Code to the letter there was no chance of infection. This is reflected in the advice we issued to members in the form of Guide to Safe Practice which provides background detail to interpret the Code. We wrote there:

MRSA and other ‘superbugs’

There has been much coverage of MRSA in the media in recent years and it is understandable that the idea of admitting a potentially highly infectious patient into your practice environment might cause some anxiety. The fact is that there are various degrees of this infection as MRSA can infect a range of tissues and body systems. Therefore, symptoms can vary and some patients may not even be aware that they are infected. Our response has always been to stick to the recommendations laid out in the Code. If these are properly followed, there is virtually no risk of cross-infection.

 We have also advised practitioners, however, to use their professional judgement in these cases and to make adjustments to the Code over and above the basic requirements if they felt more comfortable this way. Some practitioners, for instance, preferred to treat the patient at home to avoid any exposure to other patients; some felt taking on an infected patient was beyond their limits and decided to refer them.

In other words we allowed our members to exercise professional judgement based on the individual circumstances of each case and also the individual circumstances of their practice. If, for example, a practitioner has several immuno-compromised patients on their list it may be sensible to maintain a safe booking distance between them and patients with potentially dangerous conditions.

That said there are few reports of problems worldwide, although one case in the UK illustrates the need to keep on one's toes:

A 15 year-old boy in the U.K. was treated with acupuncture for eczema. Two days after his fifth treatment he suffered bilateral knee swelling, fever, and subsequent endocarditis from Staphylococcus aureus (Buckley 2011). He was admitted to a hospital for weeks and was left with permanent cardiac damage. Four months prior to the initiation of acupuncture, nasal and skin swabs isolated Staphylococcus aureus. The acupuncturist was likely not aware of this finding and inserted needles at the sites of his eczema lesions on his knees and then firmly massaged the knees following acupuncture, carrying Staph deep into the tissues. This patient’s abnormal skin barrier function, leading to colonization with S. aureus, was a predisposing risk factor. Here, acupuncture caused a complication that is rare and unexpected, and yet might have been avoided.

Buckley D. Staphylococcus aureus endocarditis as a complication of acupuncture for eczema. Br J Dermatol. 2011;164(6):1405-6.

Sensible communication between practitioner and patient, however, should be sufficient to ensure that this sort of situation does not occur.

  

Q:I have just had my fist session of acupuncture for an ongoing lower back condition ( slipped disk ) - she inserted 7 needles into my back, thigh, knee and ankle. Immediately after I felt ok, but 2 days on I have been suffering with dizziness, worse pain in my back than before the session and I have diarrhea - is this normal?

A: 'Normal' is a word which we hesitate to use in these situations because it implies that this happens all the time, but it's fair to say that with all patients with lower back problems we do tend to advise them that pain and stiffness may be a little greater for the next couple of days. We are not alone in doing this; osteopaths and chiropractors routinely offer the same advice.

 What we usually tell people is that if someone has been out of shape for a long while there is often a great deal of re-adjustment to be done. We work on function rather than structure, but once muscles start to work properly some are going to relax and others to be forced to stretch, and inevitably this is going to become a bit of an issue. This should subside in a couple of days, but if it doesn't it's probably worth contacting your practitioner to ask their advice.

 The lightheadedness may be a part of the same pattern. Energy flows will be changing, and this may lead to a few ripples in the system. However, the diarrhoea is less likely to be an outcome of treatment. We have colleagues who might claim that this was the body purging itself of toxins, and if your overall history is complex and there are a number of background problems now or in the past then it is just possible that there may be a connection. We suspect, though, that taken in conjunction with the lightheaded feeling you may have a bug which has simply happened to coincide with the treatment rather than being caused by it. Here again, if it last longer than a couple of days more you might want to seek advice.

 In general, though, the best person to ask is always the practitioner looking after you. Some may get a little defensive, as is only natural, but the majority will be only too happy to reassure you and to interpret what is happening in the context of your unique case history which they will have gone through in detail on your first session.

Q:  I can't sleep I am not falling asleep till about four in the morning.   I don't feel tired.  I have tried everything it's getting me down.  I can't go on like this.  I wonder if you can help me please.

A:  There is no doubt that acupuncture has a good track record for helping with insomnia. While the studies are not really sufficient in quantity to make substantive claims such as there have been, as you can see from our factsheet

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1283-insomnia.html

 are very encouraging.

 The real strength of traditional acupuncture, however, is not in treating conditions as much as it is in treating the people with the conditions. Although a dozen people with insomnia may present for treatment with exactly the same kind of insomnia, it would be not unusual if each was treated differently. The failure to get to sleep is a sign that the system is out of balance, but the causes can be quite different. The art and skill of the practitioner lies in finding out exactly why this distressing symptom occurs in you.

 Of course, as you well know, the problem becomes a spiral of descent into despair. Less sleep means that people become more anxious, less able to concentrate, and this can all make the problem far worse. The treatment can also help with these sorts of aspects. Invariable we find that there are often life conditions or emotional states which precede the onset of the problem, and these too form a part of the diagnostic process.

 The best advice, especially for someone suffering as you are, is to visit a BAcC member local to you for a brief face to face assessment of what is going on. The advice will be much more precise than we can give here, and most members are happy to see someone without a small amount of time without charge to establish whether acupuncture is the best option. This also gives you a chance to meet them and see where they work before committing to treatment.
 

A:  There are no set limits for the amount of time for which needles can be left inserted nor specific requirements for particular conditions.

 There are many different styles of acupuncture in use in the UK. Some use a simple 'in and straight out' technique for stimulating energy, while others leave the needles in for twenty minutes or more. There are also techniques and specific treatments which could involve needles being left in for an hour. 

 Basically, then, the person you need to ask if you have any concerns about the needles being left in is the practitioner treating you. If this is a factor which concerns you about committing to treatment then we are sure that our members would be more than happy to discuss what they do and adjust treatment to your individual preferences where possible.

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