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A:  This question illustrates the problems we have with published research and its use and interpretation. There is a systematic review published a little while ago

which appears to be quite encouraging, citing as it does the cumulative results of 13 studies. While we would normally be quite positive about this, making our usual comments  about this bearing out our clinical experience, the reality is far more complex.  In fact, the Cochrane database assessment of the value of acupuncture treatment is far less encouraging

 Many of the cases we see and have seen are very complex, and some of the manifestations of what can often be a very broad brush clinical definition are a great deal easier to treat than others. In all cases, though, it is making sense of the symptoms within the overall presentation which matters, and the labelling of all sorts of presentations under the one diagnostic banner headline can be misleading.

 That said, paediatric acupuncture is an area of specialism within traditional acupuncture where some of the postgraduate training has reached a stage where it may be formally recognised as the basis for claiming expert practice. In the source texts used by the courses there are several clearly identified syndromes which fall under the general heading of ADHD and some well tried treatment protocols, along with lifestyle advice, which may be beneficial.

 Rather than say blithely 'it will work' we would advise you to try to find someone in your area who has undertaken this postgraduate training and ask their advice. If it is you own child who has the problem then we would recommend that you try to arrange a brief face to face consultation to see what may be possible. Our internal procedures don't allow us to make individual recommendations, but if you use the google search terms 'acupuncture children' and the town where you live we strongly suspect that you will find someone who has undertaken training with some of the well established postgraduate courses. That is not to say that any of our members may not be able to help, but children are not simply small adults, and there are specific problems which they face which may require slightly more fine tuning than is found in ordinary generalist practice.



A:  There is a surprising amount of research information for the acupuncture treatment of dry eye syndrome. The last time we reviewed this condition there seemed to be one or two studies, but two have been published recently, along with a review article.

 The two studies

 show very encouraging results, and the review

concludes that acupuncture treatment is better than the use of artificial tears for the condition. Of course, this falls a long way short of the amount and quality of evidence which would enable us to give an unqualified recommendation, but it is nonetheless very encouraging.

 We have to remember, though, that from a Chinese medicine perspective a symptom seen in isolation from the system as a whole is not that informative. There are all sorts of functional disturbances from this perspective which might lead to this symptom, and the key concern is to try to remove its causes as much as to simply try to stop the symptom alone. Sometimes this will be enough, but more often if the underlying patterns of imbalance are not addressed it will ultimately return, and that does not do justice to what acupuncture may be able to offer. A skilled practitioner will be able to make sense of why this symptom has appeared in you as a unique individual, and will use all sorts of other information to get a sense of how the whole system is functioning.

 The best advice which we can give is to visit a local BAcC member for a brief face to face consultation. This will be far more informative than we can be at this range, and most of our colleagues are usually willing to give up some time without charge to assess whether acupuncture is the best treatment option. This also has the advantage of meeting the practitioner and seeing where they work before committing to treatment.


Can you advise if it is necessary to have a specialist for depression to treat with accupuncture. 

There is no need to seek out a specialist to treat depression with acupuncture. We are all generalists who treat people rather than conditions, and the huge strength of Chinese medicine is that it looks at the unique and individual presentation of every patient. It would not be unusual for twenty people with the same named condition to be treated in twenty entirely different ways. The practitioner will work to find out exactly what 'depression' means for someone - it's a name that covers a huge range of possible disturbances of the system - and then look at why these problems have arisen in these individuals.


There has been a fair bit of research into the use of acupuncture to treat depression, as our factsheet shows


but by far the most interesting result was a study recently conducted by one of our leading researcher/practitioners


which showed some very positive outcomes. Hugh has also written several follow-up articles looking at the data he and his colleagues collected, but these are a little on the scholarly side.


Most of us have treated people with depression as a primary referral because friends, family and colleagues who have come for a problem like backache or headache have found that acupuncture has helped depression too, and have referred on friends for whom depression is the main issue. The only time any of us might be cautious in taking on a case would be if someone's depression was linked to a serious psychiatric illness. Here we do recognise that there are special skills which might be needed, but there are very few patients in this category who present for treatment.


Sadly we can't recommend individual practitioners - we have no criteria to go for one over another - but also it follows from what we have said is that we think all of our members are suitably qualified to address the problem you have. If you use the postcode search facility on our home page you will find a number of people who are geographically closest, and most are willing to give up a little time, often without charge, to discuss whether acupuncture treatment is the best option for you. This also has the advantage that you can meet them and see where they work before committing to treatment. 

I am a licensed acupuncturist in the U.S. I'm wondering what I would need to do to work in the UK?  I would appreciate any insight and guidance

In the absence of statutory regulation (SR) for acupuncture in the UK there are very few restrictions on acupuncture practice. There have been several working groups in the last fifteen years which have recommended SR, and with it protection of title and recognised training standards, but SR on the UK is now mainly risk-based, and the truth is that we are a very safe profession compared to conventional medicine. As such there is no enthusiasm to commit public funds to an unnecessary process.

The only regulation which affects most practitioners is the registration or licensing process enacted by local authorities to regulate skin piercing activities, which means that we are regulated alongside tattooists and body piercers! There are different pieces of legislation in place across the UK. In Greater London there is an annual licensing procedure from which SR professionals (physios, osteos, etc) are exempt, as well as voluntary organisations such as the BAcC which have met certain criteria. Elsewhere in the UK another form of one-off registration exists for every practice in which someone works. In Scotland there is annual licensing with exemptions only for SR professionals.

Although the legislation does not set standards of training, many authorities have added their own requirements to be able to knock back people who have done very short training or are not able to demonstrate some level of competence. The level of training in the US is probably of a slightly higher standard than required in the UK , so there should be no problem in convincing a local authority of your bona fides.

You will obviously need indemnity insurance, and although this is freely available for not a great deal (£100 a year, whatever that means in the current post-Brexit exchange rate), the BAcC provides insurance as a part of its membership package, and we always recommend that anyone setting up in the UK investigates what the offers are from various professional bodies because membership of such is a pretty important investment. Obviously we like to think of ourselves as the lead body, accredited as we are by the Professional Standards Authority and with nearly 3000 members, but there are others whom we meet on a regular basis who can be trusted.

Other than that it's really a matter of visas and work permits but we tend not to make pronouncements about these - they vary so much according to someone's unique personal circumstances that it would be unwise for us to say too much for fear of getting it wrong.

And that's about that. Our experience is that in these post-recessionary times it can take as much as two to three years to build up a self-sustaining practice, but we have seen dynamic individuals get full to capacity in six months, so again it depends on the individual.

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


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.

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