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Q:  I have just graduated with a bachelors degree from Changchun Chinese Medicine University.  I would like to know if you can advise me, what is needed in terms of licensing and registration to open my own acupuncture clinic in the UK.

A: It basically depends where you intend to work in the UK. If you are based in Greater London, most boroughs have adopted the London Local Authorities Act 1991 which means that unless you belong to an exempt body, such as the BAcC or the ATCM< you will have to pay for an annual licence. In Scotland, a similar situtation obtains, insofar as unless you are a statutorily regulated healthcare professional, there is a requirement for annual licences. As you are probably aware there is currently no statutory regulation of acupuncture, nor likely to be in the short term.
 
In the rest of the UK the Local Government Miscellaneous Provisions 1982 Act applies which requires a one-off registration for the practitioner in each practice in which they work, i.e. if someone joins an existing registered practice they have to register personally, and they are already registered in a borough but set up a new practice in the same borough they have to register that.
 
The registration and licensing processes involve an inspection of premises, and usually also a check on the training of the person who is applying to work there.
 
You will also need professional indemnity insurance, and the local authority will almost certainly want to see proof of this.
 
There are no other statutory requirements for setting up in business asa practitioner, but clearly quite a lot of planning legislation of which one must be aware, as well as some keenly policed restrictions on marketing and advertising which can be found on the Advertising Standards Authority website.
 
We believe that the wisest course of action is to join a professional association in order to benefit from updates about the current legislation and also to belong to a network of fellow professionals. It is tough setting up business at the moment, and the support and advice of professional colleagues is invaluable.  
 

Q:  I have cut my leg down to the bone.  I dont want to take antibiotics but I might have to.  Can you help with the healing process and get blood supply etc to the area? I am on a zimmer frame.

A:  We have to say that in this situation for your own safety you will probably need to be on antibiotics. We hope we are not presuming too much by thinking that a zimmer frame means that you are retirement age or over, but if this is the case then antibiotics are all the more important. Infections in open wounds in people in their sixties and beyond have a capacity to get out of control very quickly.

As to whether acupuncture encourages wound healing, we would certainly say that from personal experience in practice we often receive feedback from patients that their conventional medical practitioners are surprised by how quickly they have recovered, but proving this through research would be quite difficult, and as a result we aren't able to give a more definite recommendation than that. However, the basic premise of Chinese medicine is treating the person rather than the condition and encouraging all body systems to work as well as they can. On that basis we would have to say that it creates the best possible environment for healing from that perspective.

We have nearly 3000 members all over the country, and the quickest way to find out if there is someone near you is to use the practitioner search facility on the home page at www.acupuncture.org.uk. If possible you can arrange to see one for a brief assessment of whether acupuncture treatment is the best option for you.

Q: My friend has fractured his elbow and is in a lot of pain. He had a plaster cast but got it removed after a few weeks because the pain had increased. The pain he says is becoming almost unbearable. Would acupuncture help?

A: This is a tricky one. There is no doubt that acupuncture can be used for pain relief, and this was indeed one of the first uses in the West and one for which a considerable amount of research exists - researchers love precise definition, and there are a number of neurotransmitters involved in pain control by the body which can be measured very precisely to assess whether treatment with acupuncture has an effect. Our fact sheet is very clear on this:

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

The main issue is how much pain relief treatment can achieve and how sustainable any relief is. If the equation works in someone's favour regular treatment can make a fracture bearable while it heals.

Fractures are as old as time, and there are a number of points used within Chinese medicine for specific bone mending purposes. Because they have always formed a part of the teachings which we have each been given when we trained most of us routinely use specific points when patients have broken bines, and nearly always receive feedback from patients that their bones are healing quickly and well, often faster than their doctors expect. However, this has not been well-researched and although there are cases studies like this

http://www.ncbi.nlm.nih.gov/pubmed/23131374

and a number of studies using animals which suggest accelerated bone healing, there are no results which are substantial enough evidence for us to be able to give an unqualified recommendation for the use of treatment.

We are a little concerned to hear that the pain continues, and we are assuming that this is something which his health team are aware of. It may well be worth trying to have the joint X-rayed again to ensure that there is good healing of the tissue, and possibly MRI'd to make sure that there is no local nerve impingement. If this is all under control, then another factor to consider and which may bring your friend into the realm of acupuncture treatment, is that from a Chinese medicine perspective the bone itself is just a part of the energetic construction of the elbow area, and the fact that this is healing does not necessarily mean that the blockages created by the injury have all resolved. This can sometimes lead to situations where on the surface everything appears to have healed, but the energy of an area can still be severely disrupted. From the Chinese medicine point of view, the equation is simple - blockage equals pain.

Another rather more contentious way of looking at this which is to be found in some forms of osteopathy is that the shock of the accident can in some ways be still 'contained' within the healed bone even though to all intents and purposes it is as good as new. Some forms of treatment are aimed at releasing this shock, although it has to be said that this is far from universally agreed within the osteopathic world.

The best advice we can give to you to pass on to your friend is that they should visit a BAcC member local to them for an informal assessment of what acupuncture treatment may be able to do. We are sure that a face to face assessment of the problem will be enough for a practitioner to offer a very clear opinion of what may be possible.

A:'Balance problems' is probably not quite enough for us to go on to be able to offer you specific advice. There are a number of reasons why someone's balance may be starting to fail, and these can range from problems like vertigo and inner ear infections to muscular weaknesses to neurological disorders, and so on. There is no formula for 'balance' as such, and a BAcC member faced with someone who had balance problems would want to know the same things that your GP would ask, such as:

When did you first notice the problem?
Did it come on slowly or start quickly
When does it happen?
Are there any triggers you have noticed which make the problem come on or get worse?
Have you found anything which seems to help?

and so on.

Once a practitioner has this sort of information, they can begin to make sense of it within their diagnostic framework, be it Western or Eastern.

Within Chinese medicine, which has just as clearly defined an understanding of balance problems as western medicine, there may be other aspects of your general health and well-being which enable the practitioner to place your problem within the context of what is happening within your own system, and make treatment that much more strategically precise.

However, we have to be honest and say that at your age there is going to a slight deterioration in your ability to balance anyway, and the real issue is the extent to which what you are experiencing is over and above what a normal 70-year old should feel. We would advise that you talk to your GP as a matter of course because there are a number of neurological issues for which a loss of balance can be a symptom which acupuncture treatment may not be able to help, and you need to make sure that these have been discounted or, if present, treated promptly.

After that we suggest that you visit a BAcC member local to you and ask their advice, based on a brief assessment of what they can find, on whether acupuncture treatment may be of benefit to you.

Q:  Can my 15 year old son receive acupuncture? He has severe eczema.  This is a last resort we have tried everything.

A:  The use of acupuncture for skin conditions is not particularly well researched, as our fact sheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/eczema-and-psoriasis.html

There may be a number of reasons for this, one of which is that skin conditions form a 'fuzzy' set where the definition and location are not always precise enough to be testing like with like, a pre-condition of the randomised double blind control trial much loved by western science.

That said, there is a considerable amount of anecdotal evidence within the profession about good reactions to treatment, especialy a reduction in the amount of itching and discomfort. One has to be cautious, however; a very common effect of initial treatment is a radical improvement followed by a settling back to nearly the same state as before. We have seen a number of people become even more disheartened when this has happened, even though we have said that short-term results are unlikely and if they appear usually unsustainable.

It has to be said, though, that the collective view inside the BAcC is that skin problems are usually best treated with a combination of Chinese herbal medicine and acupuncture. There is something about the precision with which the formulae are designed and the daily routine of treatment which clearly seems to evince powerful changes in the system. Most members of the Register of Chinese Herbal Medicine are also BAcC acupuncturists, and finding someone in your area who practises both may be a very good way forward. The fact that your son is 15 may also be in his favour; although he takes up as much space as an adult, he is still a child and children can often respond much more quickly to treatment.

Our best advice to you is to see if there are BAcC members local to you who also use Chinese Herbal medicine, and to see if they can offer you a brief face to face assessment of whether they believe tahat acupuncture and herbal treatment can help your son.