A:  In theory acupuncture treatment for your lower back should have no harmful side effects or secondary effects on your other health conditions. The underlying aim of all acupuncture treatment is to restore the natural flow, rhythms and balances of the energy of the body, called 'qi' in Chinese medicine, and as such it is more likely that treatment for your back may have a beneficial effect on any other conditions which you have, especially since from a Chinese medicine perspective the practitioner is treating the person, not simply the symptom.
 
In fact, this is the one caution we do tend to issue, given that we are not sure whether you are talking about Type 1 or Type 2 diabetes. In the case of the latter there is very often a residual pancreatic function generating some, but not adequate, insulin, and a combination of oral medication and diet ensure that someone is able to maintain their blood sugar at safe levels. There have been one or two cases where the use of acupuncture has stimulated this residual function, and as a consequence has reduced the blood sugar. This has never yet resulted in a serious hypoglycaemic episode, but it remains a theoretical possibility immediately after a treatment, so we tend to caution patients about carrying some glucose or a carton or orange juice in case they feel their levels dropping a little. In the main, however, acupuncture is always seen as encouraging homeostasis, a correction to normal function, rather than an 'overshoot', so this is more a theoretical than real risk.

There can be some substantial variations in the length of appointment times depending on the style of acupuncture practised by your acupuncturist and also the complexity of the case history which you bring to the treatment. One of the founding associations of the BAcC consisted of graduates of a college where the initial session was often two hours long and each treatment session up to an hour long. At the other end of the scale there are highly experienced practitioners who can often glean what they need to within half an hour and continue with half hour sessions.

Generally speaking we tell people to expect to spend somewhere between and hour and a hour and a half for the initial session and between half an hour to an hour for subsequent sessions. 
 
The obvious point to make, though, is that the quality of the treatment and the success of the outcomes are what matter, and these are not measured in minutes. 

Q:  I've had chronic lower back pain for three months now. I had my second session of acupuncture yesterday from my physiotherapist and the pain was unbearable. The first session had been painful when the needles were twisted but was bearable and it wore off. This time I had a different physio. Some needles went in fine and the twisting caused a little discomfort. However,  one needle when it was twisted caused me to scream out in pain and as he twisted I was actually shouting stop stop. Can you explain why this is? Also afterwards I felt I'll, very cold and had pins and needles in both legs. I am now reluctant to go to third session.

A: We always tread rather carefully in answering questions like this. Generally speaking, acupuncture needles should be relatively imperceptible; most people experience only a mild dull aching sensation, or a slight tingling feeling like a very weak electric shock. In some styles of practice, especially that used by many Chinese practitioners, there is a more vigorous manipulation of the needle to produce a much more significant dull ache, but many people barely feel anything, especially since the advent of guide tubes for insertion of needles which dull the sensations in the area.
 
So, in essence, the only pain which occurs beyond this can be a direct insertion into or very close to a nerve, or tangling the needle in muscle fibre. In either case, we always tell our members to remove the needle immediately, and indeed, if a patient tells you to stop, then you stop - to continue would certainly invite censure by the BAcC and possibly be construed as an assault.
 
We suspect that what has happened here is that someone has used a fairly large gauge of needle, which many musculo-skeletal acupuncture treatments use, and that it has been inserted quite vigorously into a muscle or nerve. The effects which you have experienced afterwards we would categorise as 'needle shock', a form of shock which creates the kinds of sensations which you have and which is like the delayed shock someone experiences after an accident.
 
There is a more subtle point here, as well, which rests on our belief that using acupuncture as an adjunct to orthodox medical or physiotherapy treatment is fine, as long as the practitioner is aware of the possible reactions which we would anticipate from using the same specific points in our tradition. It may be a different theory of treatment, but the needles still go in the same places. There is a point, for example, near the elbow which is used for treating tennis elbow but which can also, in our system, cause a sharp and immediate fall in blood pressure. If someone with a tendency to postural hypotension had this treatment they might faint. We have long argued that just as we have studied western medicine well enough to know when to refer someone to conventional care, conventional heathcare professionals have a duty of care to be aware of the cautions which inform our work in traditional Chinese medicine.
 
This is all very well, but what do you do? We think that you would still probably benefit from acupuncture treatment, because chronic back pain has been shown by reliable research to be benefit from acupuncture, but you should raise with the practitioner both the fact that you have had such unpleasant reactions to treatment, and the fact that you would reserve to right in future to tell him or her to stop as soon as you say so. It is important that you feel that you control the situation. If the practitioner does not agree, find someone else! If they do agree, and still carry on as before, report them to their regulator.
 
Hopefully, though, the treatment will have the desired effect and help to relieve your back pain. 
 

Q:  My mum is experiencing severe sciatic pain at the moment and has tried a range of pain medications, most latterly morphine, and this is not relieving the pain at all. It has been going on for a period of 3 weeks now and it is limiting her ability to mobilise. She is incredibly low as a result. Although she is reluctant to consider acupuncture I'd really appreciate it if you could direct me to some resources which she may find encouraging/provide advice?

A:  We have a fact sheet on our website which provides some, but not very helpful, background - it is probably too technical and not accessible enough for someone who is simply trying to weigh up the benefits of treatment. The sheet
 
 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/sciatica.html
 
also refers to other factsheets on back pain and arthritis, both of which can be found on the home page of the website under the button for research and sub-section factsheets.
 
There are a number of 'lighter' articles on the internet, largely from the US and from Australia, an example of which is
 
https://www.acufinder.com/Acupuncture+Information/Detail/Sciatica+Treatment+with+Acupuncture
 
but what is of concern to us is that the pain has become so intense that your mother requires morphine. The majority of cases we see tend to be caused by disc problems or accidents, but the great majority, while extremely uncomfortable, do tend to be bearable in some positions. The need for morphine suggests something altogether more acute, and this would tend to make us think that acupuncture treatment may not be as effective if there is a direct physical cause involving, say, the complete collapse of a disc.
 
Acupuncture can certainly be used for general pain relief, and in fact this is one of the more heavily researched areas of treatment, especially because the neurotransmitter chemicals involved in pain are well understood and easily measured. Again we have a factsheet
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/chronic-pain.html
 
which talks about this. The only question with pain relief treatment is how much relief someone can get and how sustainable the relief is. This can often become a question of finances, unfortunately; if treatment buys two days of relief, it can become an expensive process to maintain the reduction in pain.
 
However, the first thing is to establish whether acupuncture could be of benefit, and that is best done by seeking the advice of a BAcC member local to you who can assess your mother's case far better face to face than we can here. The second point to make clear is that acupuncture will do no harm; it is a very safe treatment with a very low incidence of adverse effects. The treatment itself is unexceptional, and for someone who is dealing with pain at the level of your mother's current experience the needles will be almost imperceptible.
 
In cases like this we often suggest to a prospective patient that a course of four or five treatments would be enough to assess how well a person is responding and whether further treatment is worthwhile. However, as before, we would be concerned about someone in such pain as to require morphine, and we would see how much more investigation was possible within conventinal medicine and work with the patient to ensure that they receive all the help which is possible.     

Q:  I currently have no periods and am keen for my cycle to return so I can start a family. Is this something accupunture could help with?

A:  There is no short answer to this problem. There are a number of reasons why a woman's periods might not be happening, and before we could give a reasonable assessment we would have to know whether your hormone levels had been checked carefully, whether you had been on the pill for any length of time before your periods stopped, whether you were underweight or anaemic - all the sorts of questions which your GP would ask and the results of the tests to which he or she would refer you.
 
Of course, Chinese medicine works on an entirely different theoretical basis to western medicine, and amenorrhea has been a health issue for the whole duration of its two thousand year history, so there are obviously explananations for why someone's periods have stopped which can co-exist with a western diagnosis. It is, after all, the same body, just two separate ways of looking at it. However, the importance of having undertaken all of the conventional medical tests is that there are some reasons for the lack of periods which no amount of acupuncture treatment will affect, and western methods may be more assured and more effective.
 
That said, there are often functional disturbances and blockages in the flow of energy, understood in Chinese medicine as a pattern of flow and balance which maintains health bodily function, and the correction of these may, if there are no underlying problems which make it impossible, get the system moving again.
 
There is very little research into amenorrhea, because as the books will always say, this is a symptom, not a problem itself, and such research as does exist will be into the specific causes as identified in western medicine. The best advice we can give you is to visit a BAcC member local to you for a brief face to face assessment of your signs and symptoms, and also more importantly for a brief discussion of how the problem developed - were the periods sporadic and then stop, did they stop suddenly, and so on. Once they have had this brief chat with you they will be able to offer you an informed view of whether acupuncture treatment can help you.