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A:  There is no published research for the treatment of hidradenitis suppuritiva that we can find, at least, not in English; we have no doubt that it has been studied and researched in China but the vast majority of Chinese studies are never translated. Generally speaking when we cannot find research we often do internet searches, as you no doubt have done, to see that the popular perception is of the use of acupuncture, and we found surprisingly little. It is estimated that about 1% of the population suffer from HS, but a great deal goes undiagnosed as people simply live with it or, given where it often appears, are too embarrassed to go to the GP. Even so, there are usually more of the 'acupuncture fixed my problem' postings, so we suspect that the success rate has not been high.

Of course, traditional acupuncture treats the person, not the condition, and each patient is regarded as unique and different. This means that a properly trained practitioner will look at the whole system to find out what generates the imbalances which then lead to symptoms. Named conditions are what bring patients to a practitioner, but the work is not focused on the named condition alone. Treating a symptom in isolation from the overall pattern is seen by the Chinese as turning of an alarm because you don't like the noise without investigating what made it go off. The general pathology of HS suggests what the Chinese would call local accumulations of Heat and Damp, but why they manifest in ten sufferers might lead to ten entirely different diagnoses.

We often advise prospective patients to seek a brief face to face assessment with a local BAcC member to see if they can get a better idea of whether acupuncture treatment might help. In your case, though, we think there may well be merit in seeing someone who is also trained in Chinese Herbal Medicine. The RCHM is a national organisation for Chinese herbal medicine, and about 90% of its members are also BAcC members. It is something of a piece of received wisdom in the profession that skin problems often respond really well to herbal medicine, and if you are thinking of using Chinese medicine, this may give you the best shot of getting rid of this truly distressing problem.

Q:  Is acupuncture  suitable to help with arthritis in the feet. Both of my feet suffer, one more than the other, to the point that they are so stiff I am unable to walk without a frame.

A:

It will come as no surprise to hear that we have answered questions on this before. One typical answer was:

Would acupuncture be of any benefit to painful feet due to arthritis?

We have produced a fact sheet on osteoarthritis

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

and as you can see, research into the treatment of arthritis in the feet is not that common. There are many hundreds, if not thousands, of studies published in Chinese every year, but only a small percentage are translated, and we are sure that there has probably been research but we are unlikely to see it.

Although acupuncture has a reasonably good record for offering relief in cases of osteoarthritis, it would be fair to say that arthritis in the feet can be much more difficult to treat. The very tight 'fit' of the foot bones means that where osteoarthritis starts to develop it can be very difficult to overcome the constant rubbing and inflammation which this causes in order to break the cycle of pain - inflammation leads to pain leads to more inflammation and more pain, and so on.

However, one of the great strengths of Chinese medicine is that it looks at symptoms as a part of a much wider pattern of energy flow in the body, and can sometimes make sense of systemic conditions which manifest in specific areas. Treatment may involve not just the affected area, but also points elsewhere on the body which can begin to put right the underlying imbalances which are the true cause of the problems. 

Arthritis has been around as long as men have walked upright, and the ancient Chinese had their own ways of differentiating the various types based on the nature of the symptoms - better with heat or cold, movement or rest, etc etc. This has led to some well-established protocols which may offer some benefit.

However, each person is as unique and different as their symptoms, and in some cases the deterioration will have gone beyond the point where treatment will be of benefit other than as short term pain relief. The best advice we can give is that you visit a BAcC member local to you for an informal chat and brief face to face assessment of what they think might be possible. We are confident that they will give you an honest and realistic assessment of what they think acupuncture treatment might offer.

We do not think we can improve on this as an answer as far as acupuncture is concerned. What we should add, though, is that some of the more gentle manipulative therapies can often be very beneficial. Many BAcC members, for example, use tui na, a form of Chinese massage, and this can often generate a great deal more movement. However, we have also know patients to use traditional massage and often reflexology to great effect.

We still believe that it is worthwhile having a chat with a traditional acupuncturist first, though. If the stiffness in the feet is a consequence of a much more widespread systemic condition, as understood in Chinese medicine terms, where the tendons and ligaments are not being properly nourished, no amount of massage or manipulation is going to resolve the problem quickly until the deeper underlying pattern has been remedied.

Q:  I am a veteran of acupuncture treatment having used it for high blood pressure, stress, injury, boosting immune system during flu and cold season. My acupuncturist is an 85 year old Chinese lady so extremely experienced and talented. During my last treatment, I experienced what I will call an
"episode". Increased heart rate, heavy breathing, dizzy, light nausea, feeling of rush of blood from abdomen up thru chest and midway down to
elbows. I did not mention it at the time, nearly like a panic attach. However, post treatment, I had five more "episodes" spaced exactly 2 hours
apart. They lasted about 2 minutes each. No headache or lingering effects. Next day, no more episodes. I am thinking it has to do with some "energy"
release associated with the treatment. Can you offer any insight?>

A:

In cases such as yours, which can be distressing even if you are a veteran patient, the best person to ask for advice and clarification is the practitioner herself. It may well be as you surmise, some form of energy release associated with the treatment, and the exact two hour spacing is suggestive of an energetic effect - as your practitioner may well have told you, in Chinese medicine there are regular two hour pulses where the different Organs are seen to be at their peak and it is not unknown for these transition points to be clearly marked to transient symptoms. Sometimes this can happen frequently enough to be recognised as a pattern in itself; Deficient Gall Bladder energy, for example, can make someone wake at 3.00 am bright awake and raring to go.

However, your practitioner will be able to make sense of these against the backdrop of your energetic balance and the patterns she has treated for many years. We have absolutely no doubt that she will find your report fascinating and diagnostically significant. At this distance, however, and with no other information to hand there isn't a great deal that we can add. Each patient is unique and different, and even though this cluster of symptoms could appear in twenty different patients there would be twenty different reasons why this was so.

The one rider we would add is that although the episodes happened during and immediately after an acupuncture session, they may be unconnected. If you do experience similar episodes but not immediately after acupuncture treatment it may be worthwhile having a chat with your GP about other possibilities. This is not intended to alarm, but we do occasionally fall prey to what is termed the 'post hoc, propter hoc' problem where because something happens at the time of treatment or shortly after it is assumed to be directly related. What we try to avoid at all costs is patients and practitioners getting locked into discussions about whether an effect was or was not attributable to treatment while the effect goes untreated and univestigated.

 

Q:  I am suffering from a facial spasm that started as an intermittent twitching eye and has progressed tower 18months to a spasm from my eye to my jaw. The doctor said, " come back when you can't stand it any more and I can arrange Botox injections." Internet research has given me the name Hemifacial spasms.  I would like to investigate acupuncture as a solution. What advice can you give me?

A:  We were asked a similar question quite some time ago and the answer we gave

Intuitively acupuncture would seem to be an obvious treatment for a condition like this.  Chinese medicine has a way of describing disturbances in function (in this case the facial nerves) within the context of the flowing nature of qi (energy).  Utilizing the pathways of the flow of energy to promote the smooth passage of qi in the affected areas and so possibly seeing improvement in the way the nerves behave, can be seen a improving this condition.  In Chinese medicine theory, many tics and tremors are seen as a manifestation of Internal Wind, and there are well established treatment protocols for addressing this.

 
Our best advice for conditions like this, though, is always to visit a BAcC member local to you and ask for a brief face to face assessment of what they think might be able to influence. It’s always worth a go to find out how much improvement can be made.   

looks on reflection a little thin.

If you look at the research you will find papers like this one:

http://www.ncbi.nlm.nih.gov/pubmed/22875561

which is a systematic review of dozens of papers. This concludes that there evidence appears favourable but the methodological quality of the research is suspect. This should be read with caution. Much of the research comes from China where there is often less interest in finding out whether it works (acupuncture has lasted 2500 years so there must be something in it) but more interest in what works better. This means the gold standard of western drug research, the randomised double blind control trial is not always the model used, and in the West this is, in our view somewhat unreasonably, used as the benchmark for efficacy for all purposes. The  World Health Organisation  has a much more user-friendly gradation of trials.

That said, there are enough studies showing positive results to warrant giving acupuncture a try. In our somewhat briefer answer we referred to the fact that there were often protocols and understandings within Chinese medicine of the kinds of symptoms from which you are suffering. Indeed, in a largely agrarian society where people are exposed to climate more than we are there is often a much great number of cases of Bell's Palsy and other superficial muscular problems because of exposure to wind especially.

The advice we gave, to visit a local BAcC member and seek a brief face to face assessment still holds good. All that we would add is that you set very clear and measurable outcomes if you do decide to go ahead with treatment and also fixed review periods. Symptoms like this are especially unpleasant, and patients often want to continue treatment in hope rather than expectation, and a wise practitioner will draw a line if there is no sign of change, and look for other referrals which may help.

A:  Difficult to answer without knowing exactly how the ear and throat are annoying you. Chinese medicine has addressed for over two thousand years all of the health problems from which modern people still suffer, and a traditional acupuncturist will always take a very full case history which covers the main problems you have, any other niggling chronic problems which you may have, your medical history and family medical history and lifestyle questions about sleeping, eating and eliminatory patterns. From all of this material the practitioner can assess whether this is a short term problem or whether it is the tip of a much larger iceberg. This in turn will determine how the treatment is undertaken.

Generally speaking, even with short term problems in the ear and throat the  treatment may not be entirely local. There may be some needles near the head and ears, but it is equally possible that needles could be applied anywhere. The internal connections or pathways are such that points on the foot will affect the head, and vice versa, and there is a very strong likelihood that if constitutional points are used for a systemic problem, the needles will be applied in the first instance to points on the arm below the elbow or on the leg below the knee. These are often the 'starter for ten' needles to assess what strength and frequency of treatment may be necessary, and often are sufficient in themselves.

Does it hurt? Not really. The needles are very fine, much thinner than sewing needles, and they are usually inserted through a plastic guide tube which both guarantees sterility and also applies a light pressure to the skin which masks the sense of the needle going in. Sometimes people can feel the slight prick as the needle penetrates the skin, but a much more common sensation is a dull ache, either on or shortly after insertion of the needle. The Chinese call this sensation 'deqi', pronounced 'derchee', and regard it as essential for a good result. the Japanese, however, are exactly the opposite, and try very hard to make sure that the needles are not felt on entry. Whichever approach a practitioner uses it is highly unlikely to hurt very much at all. let's face it, men have acupuncture treatment, so it can't be that bad.

The best advice we can give, without more information to go on, is that you visit a BAcC member local to you for a brief chat and face to face assessment of how, or if, they think acupuncture treatment might help you. Most are happy to give up a little time without charge and equally happy to refer on to other forms of healthcare practice if they think that it may be more effective for you.

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