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Q:  Following an MRI scan I have been diagnosed with a sacral stress fracture.   I am 63 - Could accupuncture help accelerate the repair of the fracture?
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A:There is very little research evidence on the acceleration in the healing of fractures with acupuncture, at least not on human subjects. In the field of animal acupuncture research, several studies point to faster recovery, but whether these results can be extrapolated to cover human fractures is a major debating point. Anecdotally, of course, we hear many stories of patients who have used acupuncture alongside conventional treatment with great success, and there are specific points within the tradition of Chinese medicine which are believed to have a direct effect on the healing of bone. None of these is sufficient to allow us to make an unqualified recommendation.

What we can say is that there is likely to be some benefit from acupuncture treatment for the pain which you are undoubtedly experiencing. In fact pain relief has been one of the most heavily researched areas of treatment, not least because there are some very sophisticated systems for patients to be able to express the extent to which they are in pain and because the chemical markers, the levels of neurotransmitters involved in pain relief in the body, are easily measured and assessed for change. The only question, as with all treatment, is the extent of the pain relief and how sustainable it is.

However, on the assumption that this is something which you are managing, the best we can say is that acupuncture treatment may be able to assist with the healing process, but it may be difficult to find sufficiently robust outcome measures to know whether there has been an effect.

The best advice that we can give, however, is that you visit a BAcC member local to you and ask their advice in a brief face to face consultation. There may be factors in your overall balance which are slowing down you recovery as well as the specific issues of the fracture itself, and a well-trained and experienced practitioner should be able to give you a clear sense of what can be done.

Q:  I had a crushed disc (L5)diagnosed in 2005 which was treated at the time with traction. For the last 4 years or so I have suffered sciatica in my right leg (down the back of the thigh from the hip and down the side of my right calf into my ankle. I recently had acupuncture to try to improve this and it seems to have worked, the pain has gone. Unfortunately,  the same weekend that the pain went my foot dropped  I am now struggling to walk. I'm awaiting an MRI scan and my consultant doesn't believe the acupuncture cured the sciatica but my question is could what worked on the sciatic pain have caused the drop foot?

A:In our view it is extremely unlikely that there is a direct causal relationship between the acupuncture treatment and the dropped foot. 'Dropped foot' is normally caused by some form of nerve impingement, and if someone has needled directly into or adjacent to a nerve you would have been in no doubt that this had happened.
 
The only thing that we can surmise is that after the disc had become crushed there had been a significant tightening of muscles in the area to guard the disturbance, and that this may have exacerbated the nerve impingement causing the sciatica or even been its direct cause. Acupuncture is well-known for its properties of relaxing tension in muscles, both in eastern and western versions, and it is just possible that the relaxation of the muscles which have caused the sciatica has in turn allowed a second impingement to happen, causing the dropped foot.
 
This is all speculation, however, and the MRI you will have will probably show what is going on. We're not sure what kind of consultant you are seeing, but if he or she is a neurologist they should be able to pinpoint exactly where the impingement lies which is causing the dropped foot.
 
Further treatment with acupuncture may, in fact, be able to help with the problem you now have; it is not unknown for the treatment of one problem to uncover a secondary problem, and so on. However, a great deal will depend on the source of the problem and whether it is actual physical damage to the discs and/or vertebrae which is causing the problem. If not, then from a Chinese medicine perspective any weakness of movement in a limb is usually regarded as a blockage in the flow of energy, or 'qi' as it is called, and treatment would be aimed at restoring this flow and removing the symptom.
 
This is something which your practitioner will be only too happy to discuss with you, to see if you can be relieved of both problems.  

A great deal depends on what accompanies the balance problem, or indeed whether it is a stand-alone problem.
 
There are a number of conditions like Meniere's disease, vertigo, labyrinthitis and so on, where changes in the structure or infections in the inner ear area can cause significant balance problems as well as generating other symptoms like nausea and headaches. Because there is no precise overlap between the classifications of conventional medicine and Chinese medicine, there may be many different ways of treating the same named condition depending on what else a practitioner finds to be out of kilter in a system. This means that it can be quite easy on occasion to identify a group of signs and symptoms which are likely to be amenable to treatment and which enable one to treat with confidence. On other occasions it can be very unclear, and when this happens we have to rely on the very basic premise of Chinese medicine, that if the energy ('qi') of the body is balanced and free-flowing, then symptoms will resolve through the body's capacity to heal itself.
 
There is a fair measure of evidence for a number of balance related problems, as our factsheet shows:
 
 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/vertigo.html
 
but we would have to admit that many of the trials which do report success are not conducted by using Chinese medicine as it is practised, and while we would contend that the personalisation of treatment to the unique individual is a far stronger treatment than a treatment repeated formulaically several times, that is the basis on which most research is conducted to meet the current 'gold standard.' One trial of this kind
 
http://www.ncbi.nlm.nih.gov/pubmed/19606509
 
generated some very interesting results, but the formula applied would not be appropriate for everyone.
 
For a generic problem such as this which might present against a vast range of contexts there is no substitute for visiting a BAcC member local to you to ask for a brief face to face assessment of the potential benefits of treatment. This will enable them to give you a far better informed view than we can do at a distance

Q:  Is  there  any truth in the micro acupuncture treatment for stargardt eye disease? We found many mentions of it and  the success after treatment.  Is this true?  is there anyone in the uk who  provides this treatment and  would you know roughly  the cost?

A:  The treatment of Stargardt's Syndrome with acupuncture, along with a number of similar conditions like retinitis pigmentosa, is a cause of some concern to us. There is very little research into the use of acupuncture for treating these problems, and it would be difficult to give a recommendation for treatment on the basis of what there is. At the same time there are a number of clinics using acupuncture, both in North America and in India, which claim some fairly remarkable results. We are as a consequence cautious, because although conventional medicine can often be dismissive of anecdotal evidence, it is often anecdotal evidence which points the way for more formal studies.

In the case of microsystems work you are fortunate insofar as there is a separate regulatory association for many of the microsystems, and their secretary is a BAcC member with a very sound understanding of the subtleties involved in these questions. He can be contacted through the website www.macrwg.org, and perhaps direct you to any of his constituent associations who treat this condition.

In general, we tend to take the view that with genetic conditions in which progressive deterioration is the usual outcome, one has to be realistic about what cna be achieved. 'Getting worse slower' may not sound like a very positive outcome, but as we have found when treating people with Parkinson's disease or MS, any slowing down of the disease is welcomed. There will be no research to validate claims of this kind because no-one has a clue about how fast an untreated disease may have progressed, but many patient's express a certainty that their conditions have stabilised with treatment.

Our best advice is that you proceed with caution and be rightly suspicious of any claims that sound too good to be true, because in our experience they usually are. Genetic conditions do not suddenly reverse of their own accord. If you do find someone who claims to treat this as a condition, set a very finite number of sessions with some very clear outcomes if you do go ahead. The average first session/subsequent session fee range for our members is £75/£50 in London, and £60/£40 outside London, if this helps to get a sense of proportion.

We have to say that targeting a condition as a unique problem is not the way that traditional acupuncture is practised. The underlying wisdom of the Chinese medicine system is that symptoms, of whatever kind, are simply an expression of a lack of balance in the whole system, and that in order to effect lasting and permanent change one has to work on the system as a whole. However, there are a number of conditions for which slightly more western orientated strategies have developed, especially in the microsystems acupuncture world, and their continued use suggests that there may be something which this approach can offer for a number of problems where someone's health is otherwise fine except for the unique presenting problem.

A:As you can imagine we have been asked this before, and the increasingly long answer, sweeping up all previous ones, which we most recently posted says:

A:We publish a fact sheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/thyroid-disease.html

which summarises the current research into the use of acupuncture in this area, but it has to be said that the amount of research is not adequate for us to give an unqualified endorsement of the use of acupuncture for Hashimoto's.

We were asked a similar question last year and we answered as follows:

Q: Can acupuncture be used to treat hypothyroidism ?

A: There isn't a great deal of research to underpin a straight recommendation for the use of acupuncture in the treatment of hypothyroidism.

What there is suggests that acupuncture may be of benefit, but this is a condition for which some form of maintenance medication is often essential and this makes testing it in trial conditions somewhat more difficult.

For the same reason our members are always told to be cautious in treating conditions where someone is on essential medication. Recommending that someone stops their medication is out of the question - only a doctor should be making this decision in the case of essential meds - and there is always an issue about adjustment. If the treatment has the effect of improving someone's thyroid function it may then mean that the dose of medication which they take may no longer be suitable. Since it often takes a long time to achieve a stable balance with the medication in the first place, it is important to avoid as much as possible the kind of yo-yo adjustments which people often experience when they are first prescribed their medication.

That said, the important point to make is that the Chinese would have recognised the symptoms of hypothyroidism two thousand years ago but have no idea about the relationship they had to a thyroid malfunction. The symptoms would have been analysed within the diagnostic systems of Chinese medicine, and a treatment plan devised to help correct them. The Chinese understanding of human physiology was entirely different, and rested on a concept of energy, called 'qi', and its various functions and inter-relationships. The kinds of symptoms which someone experiences with hypothyroidism would be linked to a failure of organic function as understood by the Chinese, and even where there was no explicit correspondence, the underlying premise, that where there is balance symptoms disappear, would nonetheless apply.

If you are thinking of having treatment it would be good to see if you can discuss your specific presentation first with one of our members, and see if they feel that this is something which they feel would be of benefit to you.

We would not really want to say anything more than this. There is certainly anecdotal evidence of which we are aware that patients have benefited from acupuncture treatment, but equally there is evidence of treatment having little or no effect. Since the essence of Chinese medicine treatment is that it is individualised, in the absence of more research we tend to be more circumspect and recommend that someone gets a face to face assessment of what may be possible.

We think that this remains sound advice, and believe that it is better to obtain advice on a case by case basis. The fact that you are in the very early stages of the condition does lend itself to greater hope that forms of treatment like acupuncture, which aim to restore homeostasis in the system as a whole, may be a very useful intervention, but a great deal will depend on the exact analysis of the condition which you have and of the possible predisposing factors which might have a bearing on what might be achieved.