A:  The evidence for the use of acupuncture treatment for hearing loss is patchy. There have been a number of small but relatively inconclusive studies, but the focus of each has been very specific, not simply a generalised loss of hearing but a specific physical or neurological cause. On the basis of this we would have to be very guarded in our recommendations.
 
However, hearing loss has been around since ancient times, and the Chinese medicine practitioners of the last 2000 years have addressed it in a number of ways based on their understanding of how the energy of the body, called 'qi', promotes and maintains the faculty of hearing. If any of the aspects of the system which work together to provide this faculty are injured or weakened, then someone's hearing may be affected.
 
In practical terms, this might mean that there are clearly discernible patterns which a practitioner might see quickly and be able to offer you some encouragement. Even in the absence of clearly identifiable patterns there may still be some hope of change; chinese medicine is based on the balance of the system as a whole, and although symptoms are important they are not the same as the problem, simply a manifestation of the deeper underlying imbalances. Someone working at this kind of level might also be able to help.
 
However, we have to say that acupuncture treatment does not have a highly convincing track record in treatment hearing loss because the majority of causes are to do with the nerves or physical changes in the ear, and neither is likely to be amenable to treatment. That does not mean it is not worth visiting a BAcC member local to you for advice; it is always worthwhile getting a face to face assessment of what someone believes they may be able to achieve, and it is possible they may see more cause for optimism than you are getting here.
 
As far as ear wax is concerned, syringing is always the best option, or Hopi ear candles if you want to try something slightly alternative. We are not aware of any acupuncture treatment that can guarantee to help this, and the conventional options are simple and effective.
 

Q: What protocols do all the acupuncturists follow also what legislation is most important to acupuncture?

A:  A slightly difficult question to answer!
 
Taking the easier half first, since there is no statutory regulation of acupuncture practice, the only laws which directly apply to the practice of acupuncture are those to do with the safety and hygiene of premises. For most of the UK the relevant legislation is Local Government Miscellaneous Provisions Act 1982 as amended by the Local Government Act 2003. This requires every practitioner to register with the local authority's environmental health department, and requires a one-off fee for every practitioner in every premise where they work. Some authorities conduct annual inspections, but the majority don't.
 
The only exceptions are Greater London and Scotland. In Greater London, nearly all boroughs have adopted the London Local Authorities Act 1991 which requires acupuncturists to be licensed annually unless they belong to an exempt body, of which the BAcC is one. Statutorily regulated practitioners are also exempt from licensing. Although BAcC members are exempt from licensing there is a set of model requirements which they have to meet, largely the same as the BAcC's, and they have to notify the EHOs that they are working in a borough - exempt does not mean off the radar.
 
In Scotland the adoption of the new licensing system for skin piercing of all kinds in 2006 means that all acupuncture practitioners except those who are regulated by statute already are required to have an annual licence.
 
As far as ptotocols are concerned, the general requirements for acupuncture practice by BAcC members can be found at the website of the British Acupuncture Accreditation Board (http://baab.co.uk/downloads.html) where the Standards for the Practice of Acupuncture and the Standards for Education and Training in Acupuncture can be found. We must stress that these are BAcC standards; other acupuncture professionals can do pretty much what they want, although the majority aspire to similar levels of competence.
 
The word 'protocol' is also used in a much more specific context in Chinese medicine to describe treatment options and patterns which a practitioner might adopt for conditions as understood in Chinese medicine. Any of the textbooks by Giovannie Maciocia would be representative of this kind of approach. This is largely what is called 'TCM', a specific style of treatment. There are many others, and in a broad church like the BAcC there could not be a definitive list of protocols of this kind which was not exhaustive to the point of being useless. There are a number of majority styles in use, however, like TCM, Five Element and Stems and Branches, on which a google search will provide a wealth of detail. You will also find that there are conventional medical practitioners using acupuncture within three main styles - segmental, trigger point and neurophysiological. Again a google search will provide the background you need.
 

Q:  My 87 year old mother still suffers from pain in her leg following an attack of shingles 3 years ago. It is not always there but at its worst makes her walk with a pronounced limp. She is generally active, drives and plays a little golf. Could acupuncture be useful.


A: We have extracted the following text from an answer we gave some months ago on the treatment of shingles elsewhere in the body:
 
Shingles can be extremely debilitating and distressing. From a Chinese medicine perspective it is one of a number of conditions where the symptoms are described as 'invasions', in this case of Wind and Heat, which disrupt the body's energies and which treatment aims to expel. There have been a number of articles in Chinese medicine journals and magazines over the years which describe ways of using traditional chinese medicine techniques to reduce the severity of the symptoms, usually with some success, and it is usually thought, as with any 'invasion', that the sooner treatment starts, the better.
 
However, Chinese case studies and reports, and to an extent Chinese medicine case studies in the west, are premised on the belief that acupuncture works, and are mainly concerned to establish what works better. In the West medicial science is still sceptical about whether acupuncture works at all, and many of the studies are of greater complexity because they are trying to test whether there is sufficient proof of efficacy to make it a treatment one could say with certainty would be beneficial. One such study is about to take place, the protocol having already been published

 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739152/
 
Elsewhere, as our fact sheet shows please click here
 
there have been a number of studies of post-herpetic neuralgia and trigeminal neuralgia which are cautiously optimistic about the benefits of acupuncture treatment.
 
We would advise you to contact a BAcC member local to you to seek their advice.

This advice holds good for post-herpetic pain in the leg. From a Chinese medicine perspective something which has 'invaded' the body has the capacity to keep on causing pain and discomfort until it is turfed out, and that is no different when the problem has been in situ for sox months or six years. The invasion is said to obstruct the flow of 'qi', or energy, in the leg, and a practitioner will want to ensure that flow is restored locally as well as the overall balance and flow tuned to ensure that the recovery is well-founded and maintained.
 
It is worth your mother visiting a BAcC member local to her to see whether, based on a  brief face to face assessment, they think they can help her with treatment.    
 
 

Q:  I'm 67 years old now and it doesn't affect me so much now but 'shyness' has always been a problem for me. Can accupuncture help me in any way? Also, is there anything that can be done for 'erectile disfunction'?

A: We were asked a similar question about erectile disfunction a while ago, and our answer was:
 

I would like to find out if acupuncture will help me having a stonger erection

Q:  I am 69 years in good health, I would like to find out if acupuncture will help me havE a stonger erection

 A:  We are assuming that your question is about making good a slight loss of normal function (erectile dysfunction/ED) rather than whether acupuncture can be used as a sexual enhancement technique. There are a number of small studies, two of which you can find here 
 
http://www.ncbi.nlm.nih.gov/pubmed/14562135
 
http://www.ncbi.nlm.nih.gov/pubmed/10098953
 
which give some encouragement to the possibility that acupuncture in conjunction with conventional strategies can help men suffering from ED. However, the studies are small and far from conclusive, so we couldn't give a definite and positive recommendation.
 
As a general comment we would say that there are many reasons why men can begin to suffer from ED. These can range from the simple fact of ageing and the effects of conditions which become more apparent in older age, like mature onset diabetes, or to the problems associated with excessive drinking or smoking, through to the kinds of complex psychological issues which have arisen as a consequence of someone's life experience. Whether acupuncture can offer any help depends a great deal on the background against which the problem has arisen.
 
Traditional Chinese acupuncture is primarily concerned with the restoration of balance and flow in the energy of the body, and there are several distinct patterns of disease, or 'syndromes', in which poor flow or blockage of energy ('qi' as it is called in Chinese medicine) can cause erectile problems. If this were to be the case, and there were other confirming factors pointing to a specific syndrome in the overall diagnosis, there may be some possibility that acupuncture could provide some help. However, if the cause of the ED lies in a pathological condition which means that there has been some permanent loss or weakening of blood supply to the sexual organs, then acupuncture would be less likely to have any effect.
 
Our only advice to you can be to seek the view of a BAcC member local to you and discuss the matter face to face, perhaps offering them a little more background information on which they can give you a clearer assessment of whether they think acupuncture treatment may be of benefit.    
 

This advice still holds good.
 
As far as shyness is concerned, the theories of Chinese medicine address the whole person, body mind and spirit, and as such the classic texts do refer to conditions which would probably not be regarded as treatable in conventional medicine, or if so, belong to the field fo counselling or psychotherapy. We are not knocking these as options; many members refer patients on in a very responsible fashion if they believe that one of the talking therapies can be of real benefit to a patient.
 
However, a key word underlying all Chinese medicine is 'appropriate', and all of the responses of the mind and emotions which can make life difficult are often a normal response gone a little too far. Fear is a very useful emotion, but too much fear paralyses someone. Anger can be necessary and appropriate, but not if it becomes a smouldering resentment which takes over a life. If there are energetic reasons, i.e. patterns of imbalance which relate directly to what you describe as shyness, there may be something which Chinese medicine in the form of acupuncture treatment may be able to offer. We have certainly dealt with similar cases, although we have to honest and say that most often these derive from events many many years earlier, and the more deeply ingrained patterns often need one of the talking therapies as the main key to change.
 
There is certainly no harm in asking a BAcC member local to you what, based on a short face to face assessment, they believe they may be able to do for you.
 

Q:  I am wondering about acupuncture on the perineum during the last weeks of pregnancy. What would this do and is this commom practice/becoming more common practice in order to try to prevent perineal tears during childbirth? Do you reccommend this?

A:  We tread rather carefully in answering questions like these. Although there is an increasing number of BAcC members who use acupuncture both to help women to become pregnant and to assist them through the pregnancy and childbirth, we have not yet fully agreed the standards which someone would need to meet to declare themselves to be an 'expert practitioner', nor the standard treatment patterns over and above the chinese medicine patterns in which all members are already fully trained. It is quite possible, therefore, that some members may have been using perineal acupuncture as well as forms of massage to help prepare the area for childbirth and avoid tearing, but we could not make this a recommendation because we do not have the evidence which can show us that it is effective and safe.
 
Our understanding, and we would not profess to be experts, is that factors which predispose to tearing are less to do with the physical condition of the area and more to do with the size of the babies and sometimes the speed with which they are delivered. Acupuncture treatment which encourages the natural sequence of events at childbirth may have an impact on the speed of delivery and make it more consistent with the mother's ability to go easily through the process.
 
Our own inclination is to keep the interventions to a minimum during the late stages of pregnancy, and to avoid the use of local needles which may have effects other than those intended. There is, for example an extremely powerful acupuncture point on the base of the perineum, and we would have reservations about using this for a local effect at this critical time.
 
There is, of course, a considerable literature for the use of acupuncture in helping the mother to recover from tears after delivery, and also anecdotally many accounts of the benefits of acupuncture for dealing with the discomforts and blockages caused by scarring after a tear.
 
Our best advice to you has to be to check, if someone is offering this as a treatment option, what the provenance of their information and training is. There are several well-recognised postgraduate courses in obstetric acupuncture available in the UK, and graduates of these courses will be only too willing to tell you what they do and why. If someone is doing it because it 'seems like a good thing to do' , tread very carefully.