A: We have been asked this question several times, and an answer we gave over a year ago still holds good. 
 
 
Tinnitus

Q. My husband has had severe tinnitus for 3 years. He has had an MRI, CAT scan appointments with the ENT hospital with no relief.He has tried cranial osteopathy, and a Chinese acupuncturist but this didn't help either. The last course of treatment with the osteopath was about 6 months ago and the acupuncturist over a year ago. He would like to try acupuncture again please can you recommend someone with experience in tinnitus. He doesn't mind travelling to see the right person.

A. Tinnitus is one of the more intractable conditions which people seek acupuncture treatment for. Our Tinnitus fact sheet, found at lists a small amount of research which suggests that acupuncture may help, but there have been no significant trials which provide solid evidence. It is also fair to say that many practitioners are very cautious about taking on patients for whom tinnitus is the primary problem. As we can see from your husband's history of treatment, it is quite easy to spend considerable time and money and be no better off than when you started, and the individual case reports in the tinnitus sufferers' magazines often have the same shape.

 We are not aware of any member who specialises in the treatment of tinnitus. However, what many practitioners do find when treating people with tinnitus is that while the noise remains largely unchanged their ability to cope with it seems to improve. Evidence for this is largely anecdotal, though, and it would be wise to discuss carefully with any future practitioner whether they think that they might be able to help. In all events we would recommend that frequent and regular reviews of outcomes and progress are essential.

We don't think you can say more than this. There are two or three clearly identifable patterns in Chinese medicine, described as syndromes, where tinnitus is a specific named symptom which frequently appears, and it is possible, if your tinnitus has arisen as a part of the syndrome, that there may be some help which acupuncture treatment may offer. An experienced practitioner should be able to make a very straightforward determination on whether this is the case. Overall, however, there is not a great deal of cause for optomism about getting rid of the unwanted noise.  
 

A:  From a Chinese medicine perspective the anxiety and the dyspepsia may form part of a much larger picture, so although a BAcC member would be very interested in your dyspepsia and exactly how it manifested, they would be equally interested in the anxiety and how that had developed and now manifested.
 
From a Chinese medicine perspective everything is viewed from an understanding of body mind and spirit as a form of energy, called 'qi', which flows in defined patterns in the body and whose rhythms and balance directly affect our health and wellbeing. There is also a very profound sense that everything is inter-connected, so where conventional medicine sees symptoms separately and even sometimes treats them separately (a counsellor for anxiety, a gastro-enterologist for stomach disorders) a Chinese medicine practitioner may see causal patterns between symptoms or more likely both symptoms coming from an entirely separate cause. Treating a symptom in isolation would be rather like turning off an alarm rather than dealing with the fire.
 
This interconnectedness means that acupuncture research, while it is helpful, rarely reflects the sophistication of the system of medicine, dealing as it does with named conditions in isolation from everything else. That said, there is some evidence that acupuncture can help with anxiety, as our factsheet shows

Please click here
 
 
and equally some evidence for the treatment of gastro-intestinal disorders

please click here
 
 
In neither case is the research data solid enough for us to lay claim to efficacy, but we have found both anxiety and digestive problems like reflux, to be among the top twenty conditions with which patients present to our members, and since most referrals come from word of mouth, this suggests that others before them have had treatment and said 'you ought to try this.'
 
There are many other questions we would need to ask before we could offer anything more definite, however, not least of which is whether you are taking medications for the anxiety and the possibility that these, from our perspective, are directly or indirectly causal in the digestive disorder. Even from a conventional perspective there are often side effects associated with anxiolytics, and it may be worth checking any leaflets to see whether this is the case. If so, you need to discuss with your doctor a possible change of tablet.
 
The best course of action is to visit a BAcC local to you and seek a brief face to face assessment in which they can tell you whether, based on what they can see, they believe acupuncture treatment may be of benefit to you.  

 

Q:  I am a 32 year old female trying to conceive. I have a history of endometriosis and ovarian cysts. I have had two laparoscopic surgeries to drain the cysts and remove some adhesions as well.  The last laparoscopy was in Oct 2012.  Fertility investigations show that I am ovulating spontaneously but one of my fallopian tubes is blocked. I have been actively trying to conceive for 14 months now.  Would acupuncture help in conceiving?  Secondly, would acupuncture help in improving the symptoms of endometriosis such as painful periods?

A: As far as research into the  acupuncture treatment of fertility is concerned there is very little of sufficient quality to be able to make any encouraging noises about what acupuncture might achieve.

Our factsheet please click here
 

 
is very clear on this point. However, there are so many different reasons why someone may not be fertile or may have their fertility compromised that research in conventional terms, which reduces variables to the absolute minimum may be difficult to set up, given that it would have to find a significant number of women with exactly the same fertility issue.
 
The difference, and to an extent, advantage of Chinese medicine, however, is that it has an entirely different picture of the way that the body mind and spirit function based on an understanding that everything consists of an energy which the Chinese call 'qi'. As long as this energy flows freely and is in balance, all of the natural functions of the body perform as they are intended to. Once there are weaknesses or blockages in the system, then ill health or failure of function occurs. Sometimes there are specific causal relationships between blockages and functional failures/symptoms, and sometimes the symptoms are just an indicator that the whole system is not working well. The skill of the practitioner is to identify and correct patterns of imbalance, and because there is a Chinese medicine understanding of the mechanism of pregnancy a practitioner may be able to establish a direct causal link which explains why a woman is not getting pregnant. More usually the practitioner simply has to put the system in as good a working order as possible to enable conception to take place normally.
 
Our understanding, though, is that 14 months is still well within the limit at which conventional medicine starts to show concern, and it could simply be a matter of luck. In this case there would be no problem with having acupuncture anyway to prepare the system as well as possible, even though the practitiioner might find you in good balance (although the blocked tube and endometriosis suggest otherwise). 
 
The caution in modern times is that the fertility industry has become a big business, and there are now many people offering acupuncture treatment as a part of their package for helping women with problems who are not necessarily using the sophisticated system of Chinese medicine as it was intended. Formula treatments are rarely going to be enough to deal with complex issues, and the strength of Chinese medicine lies in the skill and artistry of the practitioner in discerning the unique patterns of the individual's disease.

The endometriosis you mention could be having an impact on your fertility, as our factsheet shows:
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/endometriosis.html
 
The evidence for the use of acupuncture in the treatment of endometriosis is a bit thin. One Cochrane review concluded that there were insufficient trials which met the standard criteria to be able to draw a conclusion
 
http://www.ncbi.nlm.nih.gov/pubmed/21901713
 
although two studies seemed to us to be relatively positive.
 
http://www.ncbi.nlm.nih.gov/pubmed/20728977
 
http://www.ncbi.nlm.nih.gov/pubmed/18794019
 
Our clinical experience, however, is that while acupuncture treatment can reduce the severity of the pains and to an extent regularise the menstrual cycle, it is not a condition which responds rapidly to treatment, so it would be unwise to have too many expectations about what can be achieved with treatment.

Our advice is always to visit a BAcC member local to you for a face to face assessment of whether they think acupuncture can help. We are in the process of developing systems for accrediting postgraduate training in the field of obstetrics so that members can make it known that they experts in the field, but since this work is still being finalised we cannot give referrals to individual practitioners with special expertise in this field. Most BAcC members who spend a great deal of their time working with fertility issues are very clear about this on their websites, and it should be relatively simple to identify a BAcC member near you with this particular focus in their practice.  
 
 

A: The evidence for the benefits of acupuncture treatment for arthritic pain, as witnessed by our fact sheet
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/osteoarthritis.html
 

is relatively encouraging. Not surprisingly the research has focused on the major joints like the hip and knee, but the problem, from a Chinese medicine perspective, is the same whichever joint the pain manifests is, and the fact that treatment of knee can bring relief means that in principle the same may apply to the toes.
 
There are obviously confounding factors. A great deal depends on your age and general health. In the elderly or in the diabetic some of the pains may be attributable to a number of other factors where the value of acupuncture treatment may be less, but the question is not really 'does it work?' as much as 'how much does it work and how sustainable is the improvement one can achieve?' It is a difficult truth to acknowledge that the depth of someone's pocket can make a difference. We have come across patients with almost limitless funds who can afford to have treatment every three days in perpetuity because the treatment lasts that long before wearing off. Most people, however, are not so blessed, and the question which has to be answered, if the treatment does bring short term relief but is not incremental, is how long one should reasonably carry on and at what cost. We know of practitioners who do deals with patients to provide frequent short treatments within their purse, but we do not tell our members how they should work, and many find this kind of treatment, which is often quite formulaic, not to their taste.

 There is also the possibility that there are other interventions which may offer good results. A significant minority of BAcC members also belong to the RCHM and practise Chinese herbal medicine. This can be a very powerful force for recovery, especially since the treatment can be delivered daily and supplemented by regular acupuncture treatment. We have also found that reflexology is often cited by older patients as a very effective way of obtaining relief from some of the more nagging chronic pains.

 It may be repetitive to say the same thing with every question we receive, but our practitioners are the best resource a potential patient has to determine what benefits acupuncture treatment may provide them with. They will not sign someone up for treatment if they think it will not work, and will always cross refer to other forms of healthcare if they believe that these will get to the point quicker. We advise you to seek out a BAcC member local to you and ask for their opinion based on a brief face to face assessment.
 
 

Q  My son is 14 and dislocated his elbow last summer since then he has been unable to straighten his arm completely.  He recently had an operation to remove excess tissue from his elbow joint and came out of the op with a straight arm.   However,  since then his arm has shortened again.  He is doing the exercises that his physio has given him but i wondered if there was anything else we could do to help this.

A:  This is a rather difficult question to answer without slightly more information about the exact nature of the dislocation, and the physio's assessment of what may need to be done to restore greater mobility in the joint. Our understanding is that most people suffer a 5-15 degree loss of extension even when the dislocation heals well, so one has to be cautious about chasing rainbows.
 
If the loss of extension is a result if irreversible physical damage to the ligaments and tendons there may be little hope of using acupuncture treatment to good effect. The majority of problems seem to arise, however, when the joint is immobilised, and the consolidation and stiffening of tissue is something for which acupuncture treatment may be beneficial. Chinese medicine is based on an entirely different understanding of the body, mind and emotions based on the concept of 'qi', a form of energy whose flow and balance determine how healthy someone is and to which treatment is directed in order to restore balance when this has been lost. Although the majority of Chinese medicine and acupuncture treatments are systemic, the same logic applies to physical injuries and the process of recovery. The flow of Qi is blocked or derailed by an injury, and restoring the proper flow in an area should, in theory, help to restore the full range of movement. If this local treatment is supported by systemic treatment aimed at helping the whole body to repair better, then this may make the results more sustainable.
 
The best advice that we can give you is to visit a BAcC member local to you and ask them to offer a slightly more focused view based on a brief face to face assessment of the problem. We are confident that they will give you an honest appraisal of what may be possible and if they feel it is not within their scope of practice they may well have other useful suggestions about what may be of benefit. Many BAcC members use techniques such as moxibustion, a warming herb used to encourage recovery, and tui na, a form of massage, both of which can be helpful in promoting a flow of qi where this has been compromised.