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The $64,000 question is what we mean by 'help' in these circumstances. The first thing a practitioner would need to know was the exact nature of the accident. If there has been permanent damage to a physical structure like a bone, tendon or ligament, or if a nerve has been damaged beyond the body's ability to repair, then this severely limits what might be possible. There is a very small amount of evidence that acupuncture may be able to help nerve regeneration but this comes from the experimental end of the acupuncture world and often involves trials on animals, or 'ratpuncture' as some of our colleagues cheerfully dismiss it.

Within the limitations posed by physical damage, however, the Chinese medicine systems have an entirely different way of looking at the workings of the body as a flow of energy, called 'qi', whose balance, flow and rhythm determine the state of a person's health. Where there has been accidental damage to the body, this is seen as impairing the flow of qi in the affected area, and there may be some physical damage the effects of which might be lessened by treatment. It is not unusual, for example, for patients who have had major scarring from injury or surgery to face difficulties in the flow of energy because of the physical obstruction caused by keloid (or cheloid) tissue. Very simple procedures to reinstate the local flow can sometimes have profound effects.

There is also a different way of looking at the flaccidity of muscles. In conventional medicine this is usually viewed as a direct consequence of nerve damage and a great deal of physiotherapy treatment is applied to retain whatever function is left. From the chinese medicine point of view, the weakness and loss of bulk in muscles is seen as a weakness in the flow of qi, and needles are used to promote good flow. This is most clearly instanced in post-stroke treatment, where in China acupuncture is applied vigorously and as soon as possible to the muscles which have been affected by the stroke to try to restore the flow of qi. Reasonably good evidence suggests that this can really speed up recovery, although as always the quality and methodological soundness of Chinese studies is often in question.

However, the advice we tend to give rather frequently is to arrange a brief visit to a BAcC member local to you for them to be able to give you a face to face assessment of what acupuncture treatment may be able to achieve. Each person is regarded as unique and different in Chinese medicine, so even two people with the same presenting symptom would often be given entirely different treatment. What we can't see at this remove, and can't tell from your question, is the actual damage from the accident, and also the investigations and tests you have had to establish the limitations within which recovery is possible. With that information a practitioner should be able to give you a reasonable estimate of what acupuncture treatment may be able to achieve.

A: There are a number of studies of the use of acupuncture for treating Raynauds, such as:
  
and
  
which are also included in our factsheet

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

but as we conclude there, the evidence is not really conclusive enough to give any guarantee that acupuncture would be of benefit.
 
However, Chinese medicine looks at the functioning of the body in entirely different ways from orthodox medicine, and the theories, which are based on the flolw of energy called 'qi' in the body, can often provide treatment strategies where western medicine has nothing to offer. This is not to claim acupuncture will succeed where orthodox medicine failed; many conditions are just as difficult to treat in the eastern paradigm as they are are in the western one. The different understanding of human physiology and the different techniques often provide alternative approaches where western medicine has run out of options, and Raynauds Syndrome is a condition whose intractability means that sufferers are often left with few options.

In particular, an acupuncturist might focus on the parts of the system which are understood in Chinese medicine to be responsible for ensuring that energy is properly distributed to the extremities. Some of these Organs (capitalised to differentiate the concept from that of a western organ) have a number of wide ranging functions, and if one aspect is failing there should be evidence of poor performance in other functions which confirm what is going on. The taking the pulse at the wrist and looking at the tongue can also provide evidence of how different parts of the system function and inter-relate. After taking a look at how the whole system is functioning a practitioner will have a clear idea of whether there is a functional dusturbance in the whole system or local blockage, and treat accordingly. Whatever he or she finds will be unique to you; the very great strength of Chinese medicine is that it treats patients, not simply conditions, and finding out why you in particular have this problem is an essential part of trying to solve it. 

 Our best advice is to contact a BAcC member local to you and seek their advice face to face in whether they can help with the Raynauds as it manifests in your system. We are confident that they will give you an honest assessmenmt of whether acupuncture would be of benefit to you. 


 

A:  We note the question mark after the mention of carpal tunnel - has this been mentioned in passing or is this one of several possible diagnoses offered?
 
Generally speaking, the evidence for the treatment of carpal tunnel syndrome with acupuncture is a little patchy. Our factsheet
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/carpal-tunnel-syndrome.html
 
spells out the fact that the trials which have been held have been equivocal, although it does make the point that the use of 'sham' acupuncture as a control is always a problem. The idea that a needle inserted 'just anywhere' has no effect is wrong, and should be better understood as the contrast between needling at a classically known site against needling elsewhere at a site which may sometimes contingently have more effect than the classical point.
 
The symptoms of carpal tunnel are relatively distinct. The condition is believed to result from the impingement of the median nerve by the tendons of the inner arm as they narrow at the wrist, and symptoms will follow closely the distribution of the nerve itself. While this may cause pain and discomfort in the wrist itself, there are a number of other conditions which can also affect the wrist and which can be very painful. A neurological assessment should rapidly identify what is happening.
 
However, there is something of a risk in discussing named western conditions and their treatment with acupuncture. Although the ancient Chinese probably has some understanding of nerves, their system of medicine was built on an understanding of the flow of energy, called 'qi', in the body and the functional nature of the internal Organs in distributing and maintaining this flow. The manifestations of pain and the precise location often showed the nature and cause of the disturbance in energy flow, and the needles were used to correct the problem, along with any more general or lifestyle advice which the patient needed. The danger of 'mixing systems' is that it becomes more difficult to understand from the conventional medical perspective how the traditional acupuncture perspective can work. 
 
Our clinical experience is that the symptoms associated with carpal tunnel syndrome and other wrist pains can often be relieved with acupuncture treatment, but the critical questions are how much relief one can get and how sustainable it is. Clearly the evidence for the reduction of pain and inflammation by acupuncture treatment is good, but this is of no use to a patient if the relief only lasts for a day and costs a small fortune to maintain.
 
Our best advice is always in cases like yours to see a BAcC member local to you for a face to face assessment of whether acupuncture treatment may help, and also to ensure that you get a thorough neurological asessment too. There are some conditions where surgery or splinting is a serious option, and you need to be able to get yourself on this pathway in case other forms of treatment do not help.   
 
 

Q: I recently watched a programme on television in which it was stated that acupuncture can be obtained free or at a greatly reduced cost if you volunteer to be a guinea pig for students to practice on. I have had acupuncture in the past for allergic rhinitis and found it to be very helpful but just could not afford to keep the treatments up. I enquired at my GP if I could have the treatment on the NHS but they only provide it for tennis elbow.

A:  The short answer is, we're afraid to say, 'no'. The list of training institutions which are in a formal relationship with the Accreditation Board can be found here:http://baab.co.uk/study-acupuncture/accredited-courses.html
 
and you will see that none is particularly close. In most cases the cost of travel would exceed the cost of treatment.
 
However, it would be fair to say that the great majority of our members are not driven by money, although clearly they have to pay bills and eat just like everybody else. Many members are willing to discount fees for patients who are genuinely hard up, and it may well be worthwhile asking the practitioners close to where you live whether they would be prepared to reduce fees.
 
However, this can get into some interesting discussions about what counts as hardship, and all of us have been 'burned' at least once in the early stages of our career by people pleading hardship when the patient's definition has extended to 'down to the last million and the Rolls has a puncture.' This particular expert let someone have treatment for £5 per session over several weeks on pleas of poverty, and was surprised, when asking whether the patient was booking in next week, to be told, 'oh no, dear, can't do that, we're off to Barbados for six weeks.' 
 
The vast majority of people who seek reductions are bona fide, however, and if you happen to live near BAcC members whose primary concern is helping people to get better, all shall be well. 
 

Q:  I was diagnosed with premature ovarian failure over a year ago and have been considering acupuncture as a treatment to perhaps improve my chances of conception. I am aware there are a few private clinics in my area, but do not have the funds to attend regularly. Firstly, I am wondering whether it would help me in any way, and secondly I am wondering whether there are any funded or trainees in my local area who may be able to treat me at a reduced rate?

A:  It would be fair to say that we have had a large number of enquiries about reduced rate treatment since the Channel 4 programme 'Something for Nothing' last week.  All we can say on this front is that there are a number of teaching institutions in a formal relationship with our sister body, the British Acupuncture Accreditation Board, which have teaching clinics which may be able to offer treatment at less than the market rate, and as we have said many times before, under the direct supervision of some of the most experienced practitioners in the country, so in no way a reflection on the standard of treatment.
 
However, it is also true to say that a great many BAcC members are willing to negotiate if treatment really is beyond someone's means. This is not often an advertising point in leaflets and on websites - we'd spend all of our time bartering, and we're professionals who warrant the fees which we charge - but many members are not in it just for the money and have a genuine desire to help people come what may.
 
The issue of POF, however, is a more tricky one. As our factsheet on fertility shows:
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html
 
there are a number of studies which seem to offer some encouragement that acupuncture treatment may enhance fertility. However, the treatment of infertility has become something of a growth area over the last decade, and we are troubled by the fact that there are a number of acupuncturists who are claiming expertise where there are no agreed standards. As far as Chinese medicine is concerned there is very little specialist treatment for gynaecological problems which is not a part of someone's core training as a practitioner. It is true that there are practitioners, many of whom are BAcC members, who have chosen to work almost exclusively with this group of patients, and where they do have a distinct advantage is often in their very thorough knowledge of conventional medicine in this area, more than the average practitioner.
 
From a Chinese medicine perspective, though, the failure to conceive and the disruption to the menstrual cycle would be seen against the backdrop of broader symptoms which a patient may have together with diagnostic signs unique to Chinese medicine, taking the pulse at the wrist and looking at the tongue. If these show functional disturbances there is a possibility that correcting them may have an impact on someone's fertility.
 
However, to give this kind of informed view is more than we can do online. We recommend that you pop along to a BAcC member near you, perhaps one who advertises on their website that they focus on working with fertility issues and seek face to face advice on whether acupuncture treatment may be worthwhile in your specific case.