Find a local acupuncturist
To search by other criteria - name, town - click here
Latest posts are at the bottom of this page.
Use the filter buttons above to help find answers - click on the boxes
Q: I am currently at university and putting together a research protocol using acupuncture for TMJ pain relief. I have searched hi and low but can't seem to find a recommended amount of acupuncture for pain relief. Has one been published or can you tell me whether one or two treatments a week is more effective and why for my rational.
A: We are not aware of any strict rules for the number of treatments someone may need each week for pain relief in these kinds of conditions. A great deal depends on the culture in which the treatment is offered. In China, for example, where treatment is often delivered in an out-patient setting in a hospital it is not at all unusual to be given a course of ten treatments with treatment administered once a day. Some of the high street shops in the UK tried to replicate this practice but ran into a certain amount of consumer resistance because they did not discount the treatment.
Most practitioners make a judgement, based on clinical experience, on the amount of treatment necessary to develop a momentum which preserves the treatment effects. Very crudely put, acute conditons might be treated twice or three times a week initially to bring them under control, whereas more chronic pain might be treated once a week. If you are designing a protocol, the distinction between acute and chronic pain may form a part of your design and protocol, and this will have implications for how often you treat, as will the ease of getting your trial subjects to the treatment setting - more difficulty means higher dropout rates.
There are no textbook 'optimal' solutions, however. The decision about how often to treat would form a part of the design which the researcher would have to make a case for in establishing a sufficiently robust protocol to assess efficacy or effectiveness.
Q: What are the legal implications and requirements for an acupuncturist when treating a patient who refuses to register with a GP?
A: There are no legal requirements of which we are aware about treating patients who are not registered with a GP. Registration with a GP through the NHS is entirely a matter of choice for a patient, and if someone exercises their choice not to register it does not mean that we cannot treat them or are not legally allowed to treat them.
However, there are circumstances where it may be essential to refer a patient on to orthodox or conventional medical services. Indeed, this is taken seriously by many regulatory bodies, and the Advertising Standards Authority has a long and very exhaustive list of named conditions which it believes put a patient at risk if someone who is not suitably medically qualified promotes their treatment instead of referring to orthodox care or fails to ensure that someone is receiving orthodox care.
This might present something of an ethical dilemma for a BAcC member. If the practitioner believes that the patient should consult an orthodox medical practitioner and the patient refuses, the question would be whether offering some treatment 'blind', so to speak, is better than refusing to treat and running the risk that the patient will have no treatment of any kind. In circumstances like this our members would almost certainly seek advice from our experts in the field of insurance, conventional medicine and law.
The BAcC has all of these expert facilities in place, and if there is any perceived risk to either patent or practitioner, we advise and encourage our members to contact us.
This will always remain a troublesome area, however. Even if someone is registered with a GP they may refuse consent for a practitioner to contact the GP or may listen to the practitioner's advice and ignore it. Breaching confidentiality by disclosing details to a third party, even in the patient's best interests, is also a minefield, and the legal advice we have been given is that only in exceptional circumstances can disclosures without consent be made, and only where there is a real risk to the general public.
Essentially we would deal with each case on its own merits, given that some medical needs are more pressing than other. It would be true to say, though, that such instances are quite rare, and we hear of very few people who opt out of registration with a GP.
Q: I have had twp sessions of acupucture to help me with lower back pain and sciatica. Before the first session my symptoms were not too bad. The following day my sciatica appeared to be more agitated. After the second session my back started to ache. It's been 3 days since my last session and both symptoms are causing me trouble. Is this normal?
A: We would not go so far as to say that this is 'normal', but it can happen. Acupuncture can cause minor transient adverse events, and it is not unknown for people to have a day, or two at most, after a session where the system is in a state of flux and symptoms can become a little worse. In some cases this can be quite marked, but in all cases this should stop after about 48 hours.
If a problem continues after this, there are a number of possibilities. First, and this has to be expressed with great care in order not to offend a patient, the deterioration or increase in discomfort may have nothing to do with the acupuncture treatment. Many lower back problems have a 'tipping point' after which the symptoms become quite severe, and often what is happening at the time this takes place is unconnected to the change. A more positive therapeutic outcome, and very commonly experienced after osteopathic treatment of lower back problems, is that as the body reasserts its proper form some of the muscles which have been operating in a distorted structure are now forced to accommodate the better structure within which they should function. This is rather like the pain people sometimes experience after sitting in a restricted legroom seat at the theatre and then standing up.
In any event, the important thing is to discuss the problem with your practitioner and get their advice. They will know what treatments they have given and will be able to interpret what is happening to you better than we can at this remove. If they are concerned they may well invite you in for a flying visit just to take a look at the overall picture, and see if any short term adjustment is necessary.
Our expectation, however, is that by the time you read this the paim will have subsided considerably and you will be starting to feel the benefits of the treatment for your lower back.
Q. Has or can acupuncture be practiced on children with juvenile arthritis? My daughter suffered terribly with her knees & had had fluid drained on many occasions & steroid injections but it never lasts for long. She's also been on very strong pain killers too.
A. Many children are successfully treated with acupuncture, and juvenile arthritis is one of a number of conditions for which acupuncture is mentioned in nearly all of the review papers of alternative and complementary treatments for the condition. We would like to say that this is because there is robust evidence that it works, but we're afraid that it is simply a reflection of the fact that in desperate circumstances people will try almost anything, and there are going to be times when the treatment works.
That said, traditional acupuncture is based on an entirely different way of looking at the body as a flow of energy with distinct patterns and rhythms of flow. If these are disturbed either locally where the problem occurs or systemically of which the local problem is a specific manifestation, then until the flow is properly restored the symptom will continue. This is why, from a Chinese medicine perspective, the conventional treatments will appear strange - getting rid of the fluid or reducing the swelling isn't really dealing with the problem. A skilled practitioner will need to see what else is happening in the whole system and look at how things have progressed to be able to start to address the specific manifestations.
Children are also not the same a little adults. There are a number of ways in which a child's energy and its treatment is different from that of an adult. Although we have not yet fully agreed standards for paediatric acupuncture, there are a number of specialist postgraduate courses for treating children whose graduates are specially trained to work with children. Although most of us treat the occasional child, we would also concede that people who focus their time on this group develop a very effective way of working with children which is to everyone's advantage. We cannot give specific referrals, but using google to search for 'acupuncture' 'children' and your area may well generate a number of hits for BAcC members who have undertaken specialist training . The same search methods will also quickly identify the courses, some of which list graduates by area to help search for a practitioner with the requisite skills.
Our best advice is always to try to visit a BAcC member local to you to discuss whether acupuncture treatment is suitable. Most will offer a little time without charge to establish whether acupuncture is the best treatment, and most will also know of other techniques which it may be worth investigating if they feel that the problem lies outside the limits of their scope of practice.
The $64,000 question is what we mean by 'help' in these circumstances. The first thing a practitioner would need to know was the exact nature of the accident. If there has been permanent damage to a physical structure like a bone, tendon or ligament, or if a nerve has been damaged beyond the body's ability to repair, then this severely limits what might be possible. There is a very small amount of evidence that acupuncture may be able to help nerve regeneration but this comes from the experimental end of the acupuncture world and often involves trials on animals, or 'ratpuncture' as some of our colleagues cheerfully dismiss it.
Within the limitations posed by physical damage, however, the Chinese medicine systems have an entirely different way of looking at the workings of the body as a flow of energy, called 'qi', whose balance, flow and rhythm determine the state of a person's health. Where there has been accidental damage to the body, this is seen as impairing the flow of qi in the affected area, and there may be some physical damage the effects of which might be lessened by treatment. It is not unusual, for example, for patients who have had major scarring from injury or surgery to face difficulties in the flow of energy because of the physical obstruction caused by keloid (or cheloid) tissue. Very simple procedures to reinstate the local flow can sometimes have profound effects.
There is also a different way of looking at the flaccidity of muscles. In conventional medicine this is usually viewed as a direct consequence of nerve damage and a great deal of physiotherapy treatment is applied to retain whatever function is left. From the chinese medicine point of view, the weakness and loss of bulk in muscles is seen as a weakness in the flow of qi, and needles are used to promote good flow. This is most clearly instanced in post-stroke treatment, where in China acupuncture is applied vigorously and as soon as possible to the muscles which have been affected by the stroke to try to restore the flow of qi. Reasonably good evidence suggests that this can really speed up recovery, although as always the quality and methodological soundness of Chinese studies is often in question.
However, the advice we tend to give rather frequently is to arrange a brief visit to a BAcC member local to you for them to be able to give you a face to face assessment of what acupuncture treatment may be able to achieve. Each person is regarded as unique and different in Chinese medicine, so even two people with the same presenting symptom would often be given entirely different treatment. What we can't see at this remove, and can't tell from your question, is the actual damage from the accident, and also the investigations and tests you have had to establish the limitations within which recovery is possible. With that information a practitioner should be able to give you a reasonable estimate of what acupuncture treatment may be able to achieve.