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Q:  I was involved in a car accident last November I had several physio sessions and I thought I was all ok and ended sessions in February, in  less than a month my shoulder and neck were playing up again.  I continue to do exercises and I've had acupuncture in Ireland a few times when I visited there in April, this seemed to help.  I was advised I would need possibly  more intensive sessions Will accupunture help me?

A:  You have the advantage over many of our 'ask the expert' correspondents insofar as you have already had acupuncture and it seemed to help. You've also had what we can't give but wish we could to, a face to face assessment of whether treatment would be beneficial in your own case. If, as seems to be the case, your practitioner thinks it would be worthwhile continuing, then this is the advice to follow.
 
Whether you return to your pre-accident state of health is another matter. It is true to say that shoulder and neck injuries are amongst the more difficult to treat because of the delicate balance of forces in the shoulder joint and the difficulty of repairing small tears in ligaments and tendons in a joint which is in relatively constant use. If you have been given a range of exercises by a physio, however, these will have been carefully designed to maximise your recovery, and together with the acupuncture treatment, there is a good chance you will recover most, if not all, of your previous function.
 
Accidents tend to have a much wider effect than the simple physical damage alone, and the paradigm of Chinese medicine in which body mind and emotions are seen as interconnected and interdependent can be particularly helpful in addressing some of the other consequences of an accident, like the shock itself. In Chinese medicine a major disruption in any part or level of the system can have repercussions across whole system, and we sometimes find this can impair someone's physical recovery. If your practitioner treats you rather than simply treating your symptoms, he or she will address all of these kinds of issue on looking at the overall picture.
 
We have just entered 'HA5' in the practitioner search function on our homepage and generated about twenty hits for people working in your area, so you should have no problem in locating a BAcC member to take over your treatment.   
 

 

Q:  Could you tell me if acupuncture can be used to help with chronic facial pain? The actual condition is known as 'post traumatic trigeminal neuropathy'.

We have produced a fact sheet on this question
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/facial-pain.html
 
although this is more restricted to problems with the tempero-mandibular joint that trigeminal neuropathy.
 
If you click on this link
 
http://www.acupuncture.org.uk/Search.html?searchphrase=all&searchword=facial%20pain
 
you will also find a number of responses we have given to questions similar to yours.
 
There is also a factsheet on neuropathic pain
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html
 
which offers a useful summary of the various studies of the use of acupuncture to treat trigeminal neuralgia.
 
If you look through these various responses, however, you will see much the same advice in each one. The evidence is encouraging but far from conclusive, although it would be fair to say that the gold standard of research in western medicine, the randomised double blind control trial is not the most appropriate tool for assessing traditional acupuncture. However, there are a number of treatment possibilities within the paradigm of Chinese medicine, to do with blockages or deficiencies in the flow of energy, or 'qi' as it is called, which a practitioner might be able to identify and correct. Your best bet here is to contact a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture may be of benefit.
 
We have to say, however, that trigeminal neuralgia or neuropathy does appear to be a rather intractable condition, and we are usually relatively cautious about the prognosis when we take on patients in whom this is their main complaint. You will note that in one or two replies we have suggested that cranial osteopathy may offer another treatment option. The pathway of the trigeminal nerve is easily compromised by some of the physical structures around the tempero-mandibular joint, and subtle manipulation may offer possibilities.
 
As to your last question, there is a very considerable difference between the theories of western and eastern acupuncture, although in practice the choice of points used for treatment may be very similar, although chosen for entirely different reasons. Western acupuncture is largely symptom driven, and the needles will almost always be inserted where the problem lies or close by. in some varieties points on the same dermatome, or area of influence of a nerve, may mean a slightly greater distance between needle and target, but the approach will usually be a neurophysiological one and involve blocking signals or boosting the body's pain control response. The traditional acupuncturist, by contrast, is looking at the symptom in its context in the whole body, and while this may well mean local treatment, it will also probably involve treatment elsewhere in recognition of the fact that symptoms generally arise against a backdrop of wider disharmony. For your problem, it may well be true that either will do, but there are conditions where we believe local treatment will probably fail where traditional treatment may not.        

A:  We are not quite sure from your question whether you are referring to a nasal drip or post-nasal drip, and also whether you have this an an allergic reaction or as a non-allergic condition. As a systematic review of treatment options for both allergic and non-allergic rhinitis demonstrates
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121056/
 
a great deal more research has been undertaken into the allergic variety, and acupuncture tested more for this than for the non-allergic kind, where only one significant trial has been done. Our own BAcC factsheet offers a comprehensive summary of the allergic rhinitis tests.
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/allergic-rhinitis.html
 
However, while the evidence from trials on both conditions remains inconclusive but encouraging, the real strength of Chinese medicine lies in its entirely different paradigm or way of understanding the body, mind and emotions as an integreated whole. When someone has a symptom like a nasal drip, the symptom itself will only make sense in the wider context of the energy of the body, and could in this case be a functional disturbance in the mechanisms, from a Chinese medicine perspective, which control the flow and accumulation of fluids in the body, or a wider disturbance in the system as a whole which equated to what we might describe in modern terms as a weakness in the immune system. The skill of the practitioner lies in being able to make sense of the symptom in the context of the other diagnostic signs, and offering each patient a treatment programme unique to their own needs.
 
With not much to go on by way of context all that we can say is that we have treated people who have presented with this as a main symptom, so it does not fall into the category of 'not worth trying'. However, to get a sense of whether acupuncture will work for you, it would be best to contact a BAcC member local to you and seek a brief face to face consultation, hopefully without charge, in which they can offer you a better and more informed view of whether acupuncture treatment might be worthwhile for you.   

A:  We had a very strong temptation to say 'no', but a quick piece of internet research revealed a number of case studies such as this one
 
http://www.ncbi.nlm.nih.gov/pubmed/20569038
 
which may give some hope.
 
Our reasons for thinking that 'no' would be the best answer are rooted in our clinical experience that many people come to us having had polyps removed several times, and after each removal there is a short period of grace after which the polyps reform. To us this seems rather like harvesting an unwanted crop which will simply keep on growing.
 
From a Chinese medicine perspective polyps are seen either as a result of local blockages in the flow of energy, or 'qi' as it is called, or as one of a number of symptoms pointing to a systemic problem with specific Organs (capitalised to distinguish the concept of Organ in Chinese medicine from the slightly more limited understanding of organs in western medicine). In either case there is a possibility that treating the local blockage or tonifying the whole system may clear the accumulated fluids and make then less likely to recur. However, our clinical experience has not been that great, and we have often wondered how much the peristent attempts to deal with things by surgery has piled complication upon complication in trying to deal with the problem.
 
You could certainly not do any harm by visiting a BAcC member local to you and getting a more accurate face to face assessment of what might be possible than we can give here, but if you did decide to have treatment as a consequence, we would recommend clearly defined outcomes and frequent review periods to ensure that you do not get locked into a long sequence of treatment with little or no change being visible.  

Q:  I had accupuncture therapy for the first time due to stress and anxiety.  i experienced strong vertigo type symptoms when the needle was inserted in my palm, please explain if this is normal and why it happened. Also, the feeling quickly subsided once the needle was removed.

A:  While we would not go so far as to say that what you experienced was 'normal' it does lie within the range of possible reactions to treatment, and for a variety of reasons. People can react very differently to treatment. Some are very sensitive and can experience quite profound reactions, like dizziness or even feeling faint, and one quickly adjusts the strength of treatment given (less needles, less stimulation of the needles) to ensure that they do not get overwhelmed by the experience. Others show almost no reaction to having needles inserted, and are a puzzle to us because they should feel the tiny pinprick if nothing else.
 
Most people experience one of two common reactions, a short tingling sensation or a slightly longer lasting dull ache, which the Chinese call 'deqi'. The key thing is that both of these sensations tend to be short-lived, and if they do produce a manifest reaction like a headache or dizziness, this lasts at worst for only few hours. What you experienced, especially with the sensation going when the needles was removed, suggests that you are quite sensitive to treatment. It would be worth your while telling your practitioner in detail about what you experienced to make any adjustments necessary.
 
It is also important to bear in mind that acupuncture can be a very powerful therapy, and if the practitioner has been trying to clear blockages or reinstate a flow in putting your system back in order, this can often produce a 'surge' of energy which people experience as you did. This is a very positive sign.
 
We should mention in passing, however, a much more prosaic cause of odd reactioins to treatment is people not having eaten enough prior to the needles. This is one of the commonest causes of feeling faint during or after treatment.