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Q:  I am wanting to get my navel pierced, and I have read many articles online claiming that it could block an important energy channel. I do no take everything
I read online as fact, and I am asking here to get correct information. I have had fertility issues in the past, and I do not want to do anything that could
jeopardize that, with it now being healed.

A:  We are aware that it is a commonly received wisdom that piercings interfere with the flow of energy in the major channels of the body, and a rapid google search did in fact turn up a large number of websites which in some cases had very alarmist warnings about the long term effects of piercing on the body, especially navel piercing. These warnings ranged from where it is to what the metals are, and more.

We have to say that there is no evidence of which we are aware that proves or disproves the effects being described. Our own feeling is that if the effects were directly causally related, then there would be a great deal more energetic disturbance on a regular basis. This particular practitioner has seen hundreds of people with navel piercings over the years and detected no demonstrable blockages or long term health consequences in any of them which could be attributed to a piercing.

We would have to say that it is a theoretical possibility, but that it would most likely have to add to an existing weakness or defect to have any significant impact. The same issue is often raised about ear piercings and their effect on points which are related to energy systems in auricular acupuncture, but we have never seen warnings about causing unintended treatment or causing secondary disruption.

In the end it's a matter of personal choice, and as long as the piercing is undertaken by someone who is properly trained, insured and registered to do it, we cannot see how there is a strong probability that anything will be adversely affected. However, we do have to accept that in some people there may be an energetic effect. If this is going to be significant enough to impact on major issues like fertility, for example, we would assume that there may be other signs and symptoms of imbalance, and you should just
keep an eye on anything which changes in the weeks and months after the piercing.

Not everyone in our organisation will agree with this view, but without categorical evidence that it is harmful we do not feel that we can say anything different.


Q: I am suffering from acute chronic pain in the lower part of my legs. I live in Delhi, do  you know of an acupucnturist who can treat at home?

A:  There is a long history of acupuncture being used for pain relief, as our factsheet on chronic pain

shows. The measurement of pain and its neurotransmitter trails lends itself to western research methodology.

However, the kind of pain which you describe would almost certainly be of interest to a practitioner because of how it is presenting. The theories of Chinese medicine are premised on a flow of energy, called 'qi', whose flow and balance determine the health and well-being of the person. When this flow is disrupted, pain and poor function result. For a problem such as yours, the practitioner would want to establish whether the problem was local rather than systemic, although the fact that it is on both sides seems to indicate systemic, and then to look at what aspect of the body's function was causing this to happen. The fact that you have had heart operations will almost certainly be a factor to take into account; there are a number of heart problems which dispose people to circulatory problems in the lower limbs, and a number of other conditions which predispose people to heart and circulatory disorders. An acupuncturist will always see local problems in the context of the whole person rather than simply stick needles in where it hurts.

With any treatment for pain relief, the bottom line is how much relief the treatment gives and how sustainable it is. This can often, unfortunately, come down to money and the balance between the amount of relief and the cost of achieving it. It is possible that treatment may improve the circulation and remove the pain, which we hope to be the case, but in the event that the pain arises from a condition which is unlikely to be reversed, like atherosclerosis in the arteries of the lower leg, it is important to maintain a regular review of whether the treatment is worthwhile.

We have very few overseas members working in Delhi and we have no idea of their working patterns. Many practitioners are not happy with undertaking home visits because to charge realistically for the time it takes to travel to and from the patient can sometimes make treatment unaffordable. However, you can always ask any practitioners local to you whether they are prepared to do this. Since we cannot direct you to any of our members, we can only advise that you check that the people you call are properly trained. For us, a sound training involves three years of study to a degree level. Bona fide practitioners will have done this; any others with less training may be a gamble.

A:  The BAcC gives very comprehensive advice to members about the absolute and relative contraindications for acupuncture treatment, but because there are very few absolute contraindications we do not publish a list. The majority of areas where we tell members that acupuncture treatment would be inadvisable are where patients or prospective patients have bleeding disorders, weakened immune systems, malignancies (but only as far as not treating near the tumours) or lymphoedema in certain circumstances. There are also a number of localised restrictions such as avoiding treatment near pacemakers or other implanted devices, restrictions on some techniques where patients have had heart valve replacements or rheumatic heart disease in earlier times, and restrictions on treatment where a patient's condition is unstable, as in poorly controlled epilepsy.

That said, the flexibility of traditional Chinese acupuncture means often needles can be applied in area of the body which connect with areas of disease without compromising them, so it is really only major immune suppression in blood disorders, immune system problems or post-transplant, or bleeding disorders where the INR is outside the safe range where we would say to a patient that treatment was not possible. In many cases, however, where people really want treatment and there is a question mark, BAcC members will always contact the senior conventional medical practitioner in charge of a case and seek their authority before proceeding. What the consultant says goes, and this does mean on occasion that, for example, treating lymphoedema is ruled out by a consultant, even though there is research evidence which shows that needling away from an affected limb works, because he or she places a blanket ban on all acupuncture for the patient. In these circumstances our role can only be to educate and inform, not to disobey.

There is a larger number of relative contraindications which make perfect sense - not needling into an open wound, not needling specific areas of the body - but these are more often than not a matter of professional judgement. The safety record of acupuncture treatment suggests that this works; serious adverse events from acupuncture treatment are rare and do not very often arise from using acupuncture where it would have been inadvisable.

There is also a large number of points which cannot be used from a Chinese medicine perspective for specific reasons. In pregnancy, for example, a number of points which have a heavily downward and expulsive effect are ruled out in the first trimester, as are a number of other points throughout the various stages of pregnancy. All students are taught these very carefully during their training, and all point books and charts make very clear annotations of when to avoid using specific points.

There is also an interesting set of points which we would avoid in certain patients but which are often used in western medical acupuncture for musculoskeletal problems. One of the major points for treating tennis elbow, for example, can if vigorously needled lower blood pressure quite dramatically. We are not sure that many conventional medics are aware of this, and one of our tasks is to compile a list of points which from a Chinese medicine perspective are ones where caution is needed.

We should add that our reason for avoiding a printed list is that where there are both relative and absolute contraindications for treatment, it would be unnecessarily alarmist to do so. As long as someone on anticoagulants has a stable INR, for example, there is no reason not to treat carefully with acupuncture, as long as shallow needling and minimal manipulation is used. The subtleties of this kind of judgement do not translate well to lists.

Q:  I have had recurring back pain problems for about 10 years.  I have had various physiotherpists give me exercise but I am still have back pain.  Would acupuncture help?

A: For back problems we can make a positive recommendation of acupuncture treatment. The evidence which has accumulated over the years has been sufficient to convince NICE, the body which defines suitable treatments within the NHS, that a course of up to ten treatments should be available within the NHS for chronic back pain. Unfortunately acupuncture is just one of a number of options for treatment, and we have seen very little evidence of anyone contracting with our members to provide treatment which is free at point of delivery, but in time we hope this begin to happen.

Our fact sheet on back pain

provides references to some of the research, but such is the prevalence of the problem there have been many more studies of varying degrees of rigour which all seem to point to positive outcomes.

The two factors which will be of interest to a practitioner will be the way that the problem developed and how it relates to the overall functioning of the body, and how entrenched some of the coping patterns have become. As far as the former is concerned, unless the pain has arisen as a consequence of an injury it is usually a part of the much larger picture of what is happening in the body, and this is the great strength of Chinese medicine, understanding this back pain in this person rather than simply applying formula treatments for everyone. The latter issue can sometimes be important. People learn a number of coping mechanisms to deal with the pain, such as holding their bodies in different ways, and it can sometimes take a while to encourage the muscles to revert to natural positions when they have been trained over time to hold the body in a position which avoids pain. Many of our members often work closely with osteopaths in a  two-pronged strategy to encourage the body back into its correct shape.

The best advice always, though, is to visit a BAcC member local to you for advice on whether acupuncture can help your specific problem. Although the evidence is good, most of us can tell quickly what the best options for a patient are, and are always happy to refer on to other healthcare professionals if we think that they are the best line of attack.


Q:  When I had acupuncture re-usable needles were used instead of disposable ones. I was assured by the acupuncturist that they were sterilised.  Shouldn't all acupuncture needles be disposable?

A: Don't panic! The risk of infection from a re-used needle is very very small indeed if the autoclave is used properly, the needles are prepared and stored properly and the autoclave is properly maintained. For forty years before the change to disposables autoclaving was standard practice, and there were no reports of cross infection from this method. The risk of prion transfer was taken very seriously when the BSE/vCJD crisis was happening, but was subsequently downgraded.

In short, there is no reason to get tested, and no reason to suspect that anything has gone wrong. The practitioner sounds as though she is on top of her game, and has made a choice which we would not permit for our members. For every thousand practitioner who re-use, though, there may be one who doesn't do it with proper care, and that is the one who might cause a problem.

Our view is that patients are more comfortable with disposable needles, there is no economic advantage to re-using them, and we cannot understand why someone would choose to do this. If the practitioner is one of our members, we need to know because we need to stop her from doing this. If you pass the name to us, we can take action without bringing your name into the discussion at all. If she belongs to another professional body we shall take the matter up with them; all, as far as we know, insist on disposables too. If she is working as a 'freelance' we may decide to go to the local authority licensing people, again keeping your details out of the loop. 

This is as much to protect her as it is to protect everyone else. If anyone did develop an unexpected infection, then the autoclaving would automatically tip the balance of probabilities against her because of the minute theoretical risk.

We are sorry that you have been made uncomfortable by her practice and our response to your query, but we are grateful that you have got in touch and equally certain that you have not been put at risk.

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