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A: We would say that this is not impossible but not normal. A great deal depends on what you mean by swelling. Is the whole lower back swollen or just the area where the needle was inserted? is there any bruising? Does the area hurt without you touching it or is it something you can actually feel when you are walking around?

Without a lot more information we are a bit stumped as to what to advise. It is not unknown for people to experience a little more discomfort after a first treatment, and this usually resolves after 48 hours at the latest. If a problem persists after that it may be that there has been a slight bruising in deeper tissue which will eventually emerge. On very rare occasions it can also be an allergic reaction to the needles themselves, but we think this is highly unlikely.

The best advice we can give is that you contact the practitioner and pop back in for him or her to see. If the swelling persists for more than 48 hours you might also want to pop along to your GP just for reassurance.

We suspect that this is a transient reaction and should disappear quite quickly, and our best would be on deep bruising. However, it is important that your practitioner takes note of this

Q:  I've recently developed sensory nerve discomfort on my shoulder blades .I already have idiopathic peripheral neuropathy so I know what nerve pain is . This is touch related as there is no discomfort when there is no clothing touching my shoulder blades . I did a simple experiment with 3 shirts/t-shirts . The first had a rough/course texture , the second had a gripping texture , the latter was soft & smooth . The first two both caused discomfort , the latter virtually none , I had a friend present & we both agreed on the descriptions regarding the "shirts" .
I would also add that I use a thoracic brace for exercising & the pressure of the brace on the my shoulder blades seems to alleviate the discomfort .
I thus thought , albeit from a very limited understanding of acupuncture : its use of pressure points & the fact that a GP at  my practice has used acupuncture for many years for a variety of maladies for the benefit of practice patients is there any evidence of its efficacy in treating sensory nerve discomfort .

A:We do have a number of fact sheets on our website about neuropathic pain and also a number of answers to earlier queries about diabetic neuropathy, but none really quite addresses the problem which you describe.

We suspect that with your problem it really is a case where going back to first principles may offer the best chance of finding some relief from the problem you have. As you probably already know from background reading, the theories of traditional acupuncture are based on the flow of energy called 'qi' and its rhythms, flow and balance in the body. Understanding how problems occur means being able to identify and understand how the flow might have been disturbed where the problem is and also how this fits against the overall backdrop of someone's health. The practitioner invariably, as with any pain, asks questions about whether the problem area feels hot or cold, responds to hear or cold, responds to pressure, is better or worse at different times of day, and so on. The answers to these questions all point to specific disruptions in the flow of energy and hopefully towards solutions.

There are a number of formula points which can be used as short term palliatives, and on occasion these may provide a permanent solution. The majority of cases like this, though, where there is an area of skin and superficial muscular discomfort, require something more sophisticated by way of treatment. Of course, in saying this, we would ourselves be looking at the other possible environmental factors which might be causing the problem, but we assume that you have probably done an exhaustive check on things which might have affected the area.

The best advice we can offer, since it is an unusual and specific presentation, is to visit a BAcC member local to you for a brief assessment of whether acupuncture might be of benefit. A skilled practitioner could usually elicit in a very few minutes how treatable something is, and most of our colleagues are happy to give up a short amount of time to make this determination

Q:  I have symptoms of arrhythmia.I do have an ICD to keep my heart in check in case of a runaway tachycardia episode .I take mexiletine and sotalol to prevent that from happening. .The drugs themselves are enough to kill me.  Would acupuncture be a viable alternative to all these medications,and to better my overall health? I am more than ready for a change! (Sick and tired of being sick and tired) I am only 61 yrs old with a lot of living yet to do.  I'm in good health otherwise.Just can't do the things I used to do......frustrating!!!

A:  We have to say that acupuncture is not viable as an alternative to your current medications.

This is a problem which we confront quite often with medications, and especially those prescribed for asthma. The medications are prescribed as a preventative, and if someone's condition is stable then it is extremely unlikely that a GP will consider stopping or reducing the dose. This is not a surprise. There is evidence to suggest that if long term medications for asthma are removed there is a slightly increased risk of a serious or fatal attack, and faced with this possibility for any preventive medicine it is likely to mean a lifetime regime. Better than the alternative, as they say.

However, we do treat many people with lifetime medication regimes and there is no doubt in our minds that acupuncture can sometimes make the side effects of the medication less unpleasant, and may also start to address the underlying problem for which someone is taking the meds. There are obviously no trials to validate this statement - they'd never get ethical approval - but from a Chinese medicine perspective the drugs themselves are a toxin which will have an impact on the body's energies beyond the positive effects they have on the specific problem, and it is always possible to reduce the discomfort that these cause. A classic example for us is the use of acupuncture for the nausea caused by chemotherapy. There is a great deal of research which shows that the anti-emetic effect is strong without compromising the effect the drug has on cancer cells.

The best advice that we can give is that you visit a BAcC member local to you for a brief consultation about what benefits acupuncture may be able to offer. Your condition will have some sort of history, and even a brief narrative account may well offer some useful insights into what the problem is from a Chinese medicine perspective, what the underlying causes may be, and also what effects the medications are having on the system. This may encourage a practitioner to feel that there is a good chance of reducing the impact that these medications are having. 

A:  We find it quite difficult to answer questions about very specific problems like this. There is little or no research into problems like this, and where this is it tends to be in the form of case studies. These are interesting but offer far too many confounding factors to be able to draw any conclusions or recommendations. In modern times the advertising rules are now far too prescriptive to make claim without proper evidence (although we often argue with the ASA about what counts as 'proper'!)

However, symptoms are the same the world over, and in its 2500 year history there is a rich vein of addressing the pains and discomfort which people feel from problems like this by looking at their structure and appearance from within the framework of traditional Chinese medicine. This is an entirely different paradigm of medicine with patterns and syndromes which sound utterly alien to the untutored ear,  but it has stood the test of time. If we drop disease labels out of the picture and focus on what someone experiences as a change in the balance and flow of energy, called 'qi', on which the system is based we often find local blockages and systemic weaknesses, the correction of which can make a significant difference.

Essentially Chinese medicine treats the person, not the condition, and the practitioner will want to understand why this particular symptom developed in this person. In this sense traditional acupuncture can help in the treatment of most named conditions, but we have to be careful because 'treat' implies 'cure', and this is often not the case. All that we can do is to maximise the balance of the individual and then let nature take its course. Sometimes the results are very good, on other occasions there are many hereditary and lifestyle issues which limit what is possible.

The best advice that we can give is that you visit a BAcC member local to you for an informal chat about the possible benefits of acupuncture. You will be able to let them know a great deal more about what exactly is happening, and this will offer the chance of a much better and more precise view than we can offer here. Most do not charge to have a quick look at a problem, and of course you get to meet them and see where they work before committing yourself to treatment.

Q:  Can acupuncture make tendonitis worse, I have had 2 sessions now the first session was fine, but after my second session I was sore, which was 5 days ago & I am having trouble moving my neck, lying down & stabbing pain in my shoulder with swelling, also a slight bruise has come up on the inside of my arm. 

A:  The short answer to your question is 'yes.'

With all forms of musculo-skeletal treatment we warn patients of the potential for symptoms to become a little more pronounced after the first session or sessions. This is very often the case for back and neck problems. There is no definitive reason for why this happens. Most of us take the view that although we treat function rather than structure, when we get the balance of the body's energies more as it should be the structure of the body will start to adjust. This means that tendons and muscles which have adapted to an imperfect structure will have to tighten or loosen, and this will always involve a certain amount of discomfort. Some colleagues also talk about the restoration of energy flow being somewhat akin to putting cold feet in front of a fire after a long walk - immediate relief followed by pain as the circulation improves.

However, the fact that you have such a large range of problems suggests that the treatment may just be a little too powerful for you. Generally speaking if someone is quite sensitive to treatment, as many are, the effects may be a little too dramatic and we tend to scale back our endeavours with no loss of outcome - less really can be more. The fact that you have a small bruise, which probably comes from needling, may be indicative of this.

The most important person to discuss this with, though, is your practitioner. He or she will know exactly what they have done, and also how much they have done, and can provide you with the necessary reassurance. They can also adjust the treatment if indeed it is the strength of what they have been doing which is causing you concerns.

What we do often find, though, is that this sort of effect only happens with the first couple of treatments. After that there just tends to be steady progress, and the main concern is then how much progress and how sustainable it is.


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