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A: This is not easy for us to answer. Although some of our members use auricular acupuncture, it is not a part of the mainstream traditional acupuncture tradition, having really developed in thelast half century in Europe, although based on Chinese understanding of inter-relationships between parts of the body. This American site:
provides an answer to your specific question, as well as offering a great deal more information about the tradition and the way that it is practised in the US.
There are a number of UK organisations which offer auricular acupuncture, many of which have grouped together to form an umbrella body called the Microsystems Acupuncture Regulatory Working Group. Further details of its work, and the contact numbers for its members can be found on
This may be able to provide you with more information, should you need it.
Q: I' ve got pain in my back L4 & L5. Will I get rid of some of the pain after a first session of acupuncture? How quickly does acupunture work?
A: Without knowing exactly what kind of pain you have, how it has developed, what may have caused it and what else has happened to bring on the pain, it is very difficult to say!
This kind of question highlights the problems that we have using a different system of medicine from the one which is all around us and embedded in our common culture. People have 'bad backs', 'migraines', 'asthma', and so on, and a great deal of conventional medicine deals with this named condition in a very specific way. By contrast, the individual symptoms which piece together to define a named condition in conventional medicine are interpreted in Chinese medicine in an entirely different conceptual framework, so that there is no equivalent of a NICE guideline for a lower back problem because there are as many variations in the exact nature of the problem as there are people with it. A truism of our work is that twenty people with migraines may have twenty unique and different diganoses in Chinese medicine which would be treated in twenty different ways. We treat the person, not the disease.
However, clinical experience usually follows familiar patterns, and with back pains in this area there is often some change relatively quickly, and the question is how much and how sustainable it is. We usually warn our patients that for the first 48 hours after treatment it is possible that the pain and stiffness may increase a little, but after that there should be progress. The NICE guidelines for treating lower back pain recommend ten sessions, but most BAcC members would be reviewing a patient's progress at four or five sessions, at which point it is often possible to determine how well someone may respond. What you want to avoid is a pattern where there is some improvement for a short while which then reverts to the status quo. If this happens more than four or five times then the short term relief may not warrant the expense of treatment.
Each case is unique and different, though, and there may be other factors in play which would determine how much change and improvement you might experience. Have we had people for whom one treatment did the trick? Yes. Have we had patients who have not responded at all? Yes. The best advice is to visit a BAcC member local to you to get a brief face to face assessment of whether acupuncture treatment may be of benefit to your specific problem.
Q: Is Rother District Council (East Sussex) linked in anyway to the Acupuncture Association? I ask as I have been told that most London Councils are affiliated and accept the rule of the society.
A: We think what you are alluding to here is the difference between the registration of acupuncturists in the UK outside London and the licensing of acupuncturists in Greater London.
Outside London, local authorities grant a one-off registration to a practitioner under the Local Government Miscellaneous Provisions Act 1982. This registers the premises and the practitioner, and often if the premises have already been registered by someone working there, any new practitioners joining their set-up pay a lower fee. There are no affiliations or exemptions granted to any organisations or members of organisations, unless the practitioner is a doctor or dentist in which cae they do not have to register.
In London, however, most local authorities have adopted the London Local Authorities Act 1991 which requires the annual licensing of 'special treatments' of which acupuncture is regarded to be one. There are, however, provisions within the Act to exempt practitioners registered with statutory bodies, such as physiotherapists or osteopaths, and also members of professional organisations which can demonstrate that they have all of the necessary codes of conduct, registers and disciplinary processes to protect the public interest. A list is maintained of these associations, and a recent version can be found on Westminster's website at:
In all cases a practitioner belonging to one of these bodies is required to make themselves known to the local authority if they set up business in a borough, and the local environmental health officers have the power to inspect premises and require standards to be met on penalty of refusing to accept the exemption and requiring a licence subject to conditions.
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.