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Q:  I've enquired about starting a course in September for 9months at masters level at a cost of £2300. The gentleman that I spoke to about it said I would be qualified to practice after this time,  but on looking further into acupuncture I found that I need to train for 3 years. I have a nursing diploma if this makes any difference and the course is with John Moores. Does this sound like an accredited course and worth my time.

A:  We have to declare a bias here - the course is offered through John Moores University by the British Academy of Western Medical Acupuncture. BAWMA is the organisation which lodged a counter-petition to our Petition for a Royal Charter at the eleventh hour of the last day of the six week consulation period. It would be fair to say that we do not enjoy cordial relations with this body.
 
The course in question is intended for nurses and medically trained practitioners who aim to use acupuncture as an adjunct to their existing professional responsibilities. We have no problem with that, since the rules of their registering bodies about working within scope of practice and the requirement only to use acupuncture when there is an accepted evidence base strictly limits the range which a practitioner has for using the modality.
 
In our view, the course is fit for purpose if used within these limits, although on a technical level we have some reservations about the formula treatment aspects of the course which have none of the slightly greater sophistication of courses run for doctors and physios. However, we have serious reservations about the course as a foundation for independent practice outside a regulatory framework where acupuncture is being offered on a generalist basis, i.e. treating whatever people bring to the clinic. For such a role it is our view that the three year course is essential, not  only because of the  breadth of knowledge which one needs to have but also because there should be a large element of supervised practice and clinical training to equip someone properly for the responsibility of being an independent practitioner. Even those with considerable training in conventional medicine can find the sole responsibility without the support network they have become used to quite daunting.
 
There is no doubt that many of the graduates of this course are extremely competent practitioners; we met many over the years of negotiation with the Department of Health about statutory regulation. However, the course itself is really only intended to be one which adds to an existing skill base within a medical practice. As a basis for independent practice it would, in our view, not meet the requirements of any future statutory regulator.
 

Q: I shattered my elbow 5 years ago, i am unable to fully straighten my arm now. I am experiencing pins and needles in my fingers and aching in my elbow, also a cold sensation through my arm and wondered if acupuncture would help

A: An enormous amount depends on the extent to which these symptoms have arisen because of physical damage. To borrow the language of the retail market in sales, 'once it's gone, it's gone,' and if the damage to bone, muscle or nerve is directly causing your symptoms, then it is not likely that acupuncture treatment is going to make a great deal of difference. You may experience some pain relief, and then the question will be how much relief and how sustainable it can be.
 
However, the overlap between east and west is not a precise fit, and there are occasions when damage from a western medical perspective can cause damage from a Chinese medical perspective which can outlast the apparent recovery of the part affected. Chinese medicine has a very elaborate and sophisticated understanding of the flow of energy in the body (known  as 'qi' in Chinese medicine), and also of the functions of the Organs as the creators and movers of the body's qi. The kinds of symptoms you have could well point to blockages and to changes in the body's functioning, and acupuncture treatment may be able to help.
 
The best advice we can give you is to visit a BAcC member local to you and seek their advice based on a face to face assessment.    

Q:  I have been told that I have wear in my 5th and 6th vertebra can acupuncture help this. I have also been told I have positional vertigo could it also help this?

A: Starting with positional vertigo, as our factsheet shows there is some evidence that acupuncture treatment may be helpful, as our factsheet shows:
 
 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/vertigo.html

 

There are a number of conventional treatments for positional vertigo, however, and some of these are well worth a go. Many involve peculiar sequences of movements to remove or re-position little bits of debris within the canals of the ear which appear to be linked to the problem. Acupuncture can help where there is evidence, from a Chinese medicine perspective, of some blockage in the flow of energy around the ears which, whether a local problem or systemic one, could be moved by using needles and reduce the impairment which causes the spinning feeling on movement.

 

The presentations of vertigo tend to be unique to the individual, though, and the best advice is to visit a BAcC member local to you for a brief face to face assessment of whether they think treatment may benefit you.

 

As far as the wear and tear in the 5th and 6th vertebrae is concerned, we're not sure which ones you're referring to, the cervical spine (neck) or the thoracic spine (back). If your cervical vertebrae are worn there is a possibility that you may suffer from some minor impingement which could cause secondary problems in the upper arms and neck. If this is affecting the movement of your neck and head it may be associated with your vertigo, although this would be a long shot.  In either case, what's gone has gone, and the best that acupuncture treatment might achieve would be some reduction in the inflammation and discomfort caused by the narrowing of vertebral gaps and attendant pressure on surrounding tissues. The only question would be how much relief from the discomfort, and how sustainable it turned out to be. If the effects can last weeks rather than days, there may be some value to having regular treatment.

 

The question which always manifests for us is that most people over the age of 50 have significant wear and tear in the spine, and it is not always the case that pains which appear in that area are directly caused by what the X-rays or scans show. If that was the case then it would be inconceivable that someone would improve, but we have encountered many clinical situations where the deterioration has remained but the symptoms have all vanished. The strength of Chinese medicine is that it is based on an entirely different view of how the body functions, and this can sometimes provide explanations for symptoms where conventional medicine is unable to explain adequately what is going on (this cuts the other way, by the way - the modern understanding of brain function, for example, explains problems which to the Chinese must have defied their attempts to understand and resolve). 

 

Again, however, we have to say that you are best served by seeing a BAcC member local to you for a face to face assessment of what might be possible. 
 

 

 

Q:  I have been an  epilepsy patient for a year.  I have had 3 seizures but  when the doctor reduces my medicine I have numbness in my epileptic leg.  This makes me  feel like a seizure is  coming but it doesn't.

A:  It is always very difficult to give advice in circumstances where we would never interfere with the prescribed medicine which a patient is taking unless it was with the explicit consent and approval of the doctor who prescribed it. In your particular case, the fact that the medicine controlled the seizures but has ceased doing so once the medication has been reduced suggests that you ought to go back to the doctor and report what has happened. If there is no reason for you not to go back on the original dose, then the likelihood is that he will put you on the original dose again. If there were clinical reasons why the doctor had to reduce the dose there may be other medications which can be used instead.
 
We also feel that it is important that you report the sensation you have in your left leg of feeling a heartbeat. This is usually of no consequence, but there are one or two conditions which might produce this as a symptom, one of which might require urgent attention. You would not be wasting the doctor's time to go back and tell them what is happening.
 
There is a history of the use of acupuncture to treat epilepsy, although the Chinese medicine view of what causes it is very different from the western view. In some cases, the methods of Chinese medicine cam make a difference, but the much more comprehensive understanding of what causes epilepsy which conventional medicine has achieved through scans and a sophisticated understanding of brain function means that there is a majority of cases which would not be helped by treatment. A systematic review of studies
 
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0013215/
 
is far from encouraging.
 
A visit to a BAcC member local to you might determine whether the specifics of your case meant that acupuncture might be of use but we have to repeat the main caution, that the medication which people have for controlling their seizures is not one with which a BAcC will interfere, nor support a patient who has stopped using their tablets without their doctor's permission. The risks form doing so are too great.   
 

Q:  Could acupunture help with pain in my heel and tight calf? I  have had a steriod injection  in my heel but it has not really helped.

A: There are a small number of encouraging studies, summarised in this systematic review:
 
http://www.ncbi.nlm.nih.gov/pubmed/23099290
 
We use the word 'encouraging' because the researchers used a protocol for gathering data which was partly devised by acupuncturists themselves within the framework often used to gather material, and the results reflect far more accurately than usual the probable benefits of acupuncture.
 
However, all reviews of this kind will conclude that more and better studies are needed. This is just a reflection of the fact that while acupuncture is regarded as a fringe actibity it will never attract the levels of funding which are required for studies of sufficient size, and we shall be continually reporting that there are encouraging but inconclusive signs!
 
We would really like to know a little more about how the condition which you have developed. This is quite often associated with exercising or jogging, and this impacts on the possible solutions. What we can say is thatwe would want to know what had been ruled out by conventional tests before we gave a professional view of whether we could help. There are some forms of damage in this area which would not be amenable to acupuncture treatment, and might only be corrected by surgery.
 
However, the majority of cases involve inflammation and tightening of the tendon, and from a Chinese medicine perspective this points either to local blockage and stagnation through over-use or accident, which might be amenable to local treatment, or a much more wide-ranging systemic condition of which this is the earliest manifestation. The skill and art of the practitioner is what enables them to determine the extent to which the problem is a reflection of a wider pattern of imbalance, and this in turn ensures that the treatment is not applied just locally as a quick fix which may not last that long.
 
The advice in all of these cases, where we lack the specifics of the problem and cannot make a face to face assessment is to visit a BAcC member local to you and see if they are happy to give up a short amount of time without charge to give you a more balanced view of what acupuncture treatment may be able to achieve. If they think there are other and more effective options, they are likely to say so.