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Q:  I would like to find an acupuncturist who has been trained in both the five elements and Chinese acupuncture, local if possible. Can you recommend someone?

A:  We aren't able to make specific recommendations, partly because we don't have any means  of deciding fairly who we should recommend but mainly because we believe that all of our members are equally well qualified to deal with whatever problems they have to address.

Determining who practises what is not quite as easy as you might believe. We know exactly where people completed their initial training, and there are a number of institutions which specialise in using the five element system (which is Chinese acupuncture but not the same as the misleadingly named TCM which is the Beijing standard used across the world). However, after graduation many members choose to focus on only one aspect of the work they trained in and many start to undertake postgraduate study in other forms of acupuncture, like Japanese or Korean acupuncture. These are all in the same overall lineage of Chinese medicine but have slightly different diagnostic and treatment ideas. 2500 years of Chinese medicine has left room for a great many variations. This makes it very difficult to find exactly who does what.

We're afraid to say that the only way that you are going to be certain that a practitioner meets your criteria is to use our postcode search facility on the home page and then check websites or ring individual practitioners who can tell you what they do. Most of us know what we all do, and our guess is that the first person you contact will tell you precisely whom you need to see.

This is our problem as much as yours, we have to say. When we use a specific style and want to refer a patient who moves or a personal referral to someone who works exactly as we do it is no easier to find out. Over the years we've toyed with several ideas to help us as much as the public, but none deliver what we want. We hope, though, that you find exactly what you want.    

Q:  I am planning to do a facial acupuncture course with John Tindall in Colliers Wood. I would like to know if  this course has been accredited by BABTAC and  is it possible to become a member of the British Acupuncture Council.

A: We're afraid that the short answer is no.

This is not a reflection on the course or the accreditation machinery in place, but the British Acupuncture Council only accepts graduates of course which meet a degree-level requirement of 3600 hours of training which is designed to make graduates capable of independent practice. Courses are either accredited by the British Acupuncture Accreditation Board which entitle graduates to automatic eligibility to the BAcC, or individual applicants are taken through an assessment and interview route which uses this standard as a yardstick. The 3600 hours of training is in line with current World Health Organisation recommendations.

Q: I have hypothyroidism and am taking a 100 dose of thyroxine daily.
Since being diagnosed 10 years ago my weight went from 10stone to 12 stone over the first 3 years and has been steady at 12stone ever since. I do not eat sweets etc and have a pretty good diet. I know I am overweight and need help do you think acupuncture could be the answer. I have faith in it as I had a course to relieve severe hip pain some years ago and it worked wonders. I am a 65 year old female.

A:  We are always a mite cautious in answering questions about the management and effects of thyroid problems. Our clinical experience is that it can often take patients a considerable time to achieve a good balance of thyroxine, and one of the consequences of using acupuncture is that it can boost residual functions across the whole system. When people have limited function in the thyroid, and also in the pancreas and other endocrine glands, we are always concerned that we might just prompt the whole system to work better and cause fresh problems.

The first thing we would want to check is whether your thyroxine dose is precisely matched to your needs. Fluid retention and subsequent weight gain would be a sign of hypothyroidism, and it may just be that the dose you are taking is not quite meeting your current needs. On the assumption, though, that we can rule this out, the advice we give to people about acupuncture and weight loss is consistently the same - unless there is clear evidence that there are functional disturbances from a Chinese medicine point of view which might be causing some of the weight gain, we would never recommend acupuncture as a general treatment for weight loss. While our underlying belief is that a system in balance will perform better in all respects, and might in theory bring weight under control, the evidence from research and from our clinical practice is not that favourable.

One of the problems, of course, is that when we treat people for weight loss, it is rarely the only thing they are doing, and as people who go to Weightwatchers and similar organisations know from their initial briefing, after a short period of rapid loss every pound takes time, with targets set very low at a pound every two weeks or so. It is very difficult with this kind of time frame in mind to be able to determine whether acupuncture works or not, and whether it is having a direct effect or simply helping to maintain someone's determination to carry on.

That said, there are a number of syndromes recognised in Chinese medicine where we can and do give advice, and sometimes treatment, which can have an effect. Chinese dietary advice is always to eat more at the beginning of the day than later, and to avoid certain types of food. There was a saying used in this country 'breakfast like a king, lunch like a lord and dine like a pauper' which expresses well the best pattern of eating to fit in with the body's natural rhythms. Our digestive functions are far better in the earlier part of the day, and meals taken in the evening are never digested as well.

The main Organs of digestion, the Stomach and Spleen (we capitalise them to denote the Chinese medicine understanding), also work better when the food is fit for purpose. The Spleen is said to like warm dry food, and if it is over-loaded with cold and damp food, it under-performs and can lead to a condition the Chinese call Dampness which can mean an accumulation of fluids, especially in the middle third of the body and lower limbs) and a general feeling of sluggishness. When you think that the usual reaction to weight problems is to eat lots of salad, raw fruit and raw vegetables, it is not hard to see how things can easily get worse rather than better. This doesn't mean not eating all of these foods; they are still a healthy diet. It means rather to balance the coldness with something either physically hot or spicy hot. You rarely see cold food in a Chinese restaurant; even fresh vegetables are stir-fried to retain the crispness but lose the coldness.

What we sometimes advise prospective patients to do is to begin with a number of small dietary changes, and perhaps have a number of acupuncture treatments to see what happens. If the system is waterlogged this can sometimes mean that there is an immediate response to treatment and better dietary patterns. We have to be realistic insofar as people can't always change their eating patterns in one go, and we also need to be able to distinguish between what we do and what the dietary change is doing. However, if there seems to be some progress, then we usually discuss regular but spaced out treatment to keep the system working towards a better overall balance.

As always, it is best to visit a BAcC member local to you for a brief chat about what may be possible. Whatever we say here it will never be as accurate as what someone can tell you even from a brief look at diagnostic signs.

A:  It came as a surprise to us that there have been a number of studies of teeth grinding/bruxism. One example of this is

http://www.ncbi.nlm.nih.gov/pubmed/15108607

and another

http://www.researchgate.net/publication/235768598_Acupuncture_as_therapeutic_resourcein_patient_with_bruxism

although it has to be said that this is an unusual approach, not drawing on traditional acupuncture but on auricular acupuncture which is a much more modern development.

The problem of bruxism is usually described as multifactorial, arising from a combination of causes and very often having a mental and emotional causes as well as arising as a consequence of conditions like sleep apnoea and from some forms of medication. Some of these causes are very commonly treated by acupuncture, as our factsheet on anxiety, for example, shows

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

The only way to get a clear answer, though, would be to visit a BAcC member local to you for a brief informal assessment of what treatment may be able to offer. The main purpose of seeing you face to face would be to check whether this was a stand-alone symptom, or whether there were other factors involved. In Chinese medicine diagnosis it is rare to find a single free-standing symptom. Most symptoms are evidence of a functional disorder within the system as a whole, and the Organs of the body (capitalised to distinguish what this means from the western concept of an organ) have a range of functions which means that a single one out of kilter might generate several symptoms manifesting on different levels. The skill of the practitioner lies in getting information from patients about their overall functioning and making sense of the various ways in which these depart from their normal range.

If the practitioner can see immediate connections which point to straightforward treatments, they will be able to give you a good idea of how successful treatment may be. Even if there are no obvious connections it does not mean that treatment may not work; the most ancient systems were asymptomatic, driven by the simple belief that a symptom in balance did not generate symptoms and that these would lessen and go. Versions of this style of treatment are still very popular and successful today.

You can find a list of practitioners close to where you live by using the postcode search function on our home page.  

Q: I am having physiotherapy for what I understand so far is a right sacro iliac joint problem vs right L3. L4 nerve compression. My physio has suggested a course of acupuncture may help the stinging and sharp nerve pain that I am experiencing in my right leg from knee to calf. Particularly bad at night. Is this good information and how do I find an appropriate accupuncturist near me? 

A: We think that the physiotherapist's assessment of the value of a course of acupuncture treatment is probably well-founded. 

From what you describe your symptoms are very similar to what many people would call sciatica. We have produced a factsheet on this

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

which makes some very encouraging remarks about the growing body of research supporting the use of acupuncture treatment. When we conduct patient surveys online, we find that sciatica is high on the list of conditions for which people have sought a practitioner.

A great deal depends on the exact presentation of the symptoms and how significant the weakness of the sacro-iliac joint is. If there is still considerable work to do to stabilise this by building up the muscles, then it may be a case of two steps forwards, one step backwards in terms of controlling the pain. Once the joint has become more stable then treatment tends to be more effective at settling the discomfort for longer periods of time.

The best assessment of problems like these, however, is done face to face. Normally we advise people to seek out a member and see if they will offer a few minutes without charge to see whether acupuncture would or could help. A referral from a physio, though, is pretty much always based on a good assessment of what will help, and physios tend now to be very knowledgeable about acupuncture treatment even if they do not administer it themselves.Ca

The best way to find a practitioner near you is to use the 'find a practitioner'search facility on our home page www.acupuncture.org.uk. This is postcode based and much more sensitive than an area search in finding the nearest BAcC members to you. 

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