Q:  I am pregnant again after having had a previous caesarean section. I am hoping for a vaginal birth this time. Is acupunture for induction of labour safe when a woman has had a caesarean in the past?

A: The core of this question is whether it is safe to have acupuncture for induction of labour, to which the answer is yes, as long as it is with the consent of the midwife or consultant in charge of your case. Generally speaking most obstetricians will only consider inducing a labour after 41 weeks or one week after predicted due date, and no acupuncturist will attempt to induce labour before this. Once you have reached this stage the team looking after you will be considering either a medical induction or another caesarean, and this is the point where acupuncture practitioners are often called into the case.
 
There was considerable debate inside the BAcC some years ago about whether this could or should be done independently of the medical team looking after the mother, but our view was that it is far better for all efforts to be co-ordinated at this point than to have someone operating outside the system. In our experience most conventional teams are happy for the mother to have acupuncture as a means of avoiding medical induction or C-sections, and the crucial things is that if the labour does kick in then all of the next steps are already in place for the birth to take place.
 
Acupuncture for the induction of labour is a very gentle process and if it works is probably a little less of a jolt to the system than drugs which tend to kick in very quickly, so we would always recommend using it first if the medical team are OK with this. Many of our members now focus their work very much on treating pregnancy and late-stage pregnancy, and checking the websites of a few BAcC members local to you will quickly reveal who has this focus and often what postgraduate training they have had in this field.
 
 

Q: Can acupuncture help with circulation disorders? I've had a varicose vain surgery about 10 years ago, but it didn't resolve the problem of re-appearing spider vains and pain in my lower left leg. Pain is currently managed by antistax, but I'm searching for a solution to the problem itself

A: This question highlights a major difference between Chinese medicine and Western medicine. Varicose veins are a very common problem for which western medicine usually only recommends surgery, in the form of stripping along with a few newer techniques involving laser work, or continuing management with medication and various forms of support hose. From a Chinese medicine perspective, though, the cause is seen to lie in a failure of body's energetic functions which maintain good circulation and which promote the body's internal 'gravity' in the form of the upward movement of energy, or 'qi' as it is named in Chinese thought. Being able to identify functional disturbances is not in itself enough to go straight ahead with treatment, however; the practitioner needs to elicit whether these functional disturbances are the primary problem or a reflection and response to other disharmonies in the system. This differentiation often determines whether the treatment will provide short or longer term relief, and is one reason by symptomatic treatment is not something we encourage. In short, though, Chinese's medicines understanding of the same symptoms in functional terms can inform and underpin treatment aimed at reducing the causes of varicose vein formation and development. 
 
There is, of course, very little research evidence of the kind accepted in the West (although many thousands of untranslated studies are done in China each year), and it would be fair to say that by the time most patients with varicose veins or spider veins consult an acupuncturist the problems are often well advanced. However, the small amount of research which does exist suggests that acupuncture treatment may be effective in reducing some of the pain which people experience, although the characteristic knobbly lumps and bumps which people have are relatively intractable.

We advise you to contact a BAcC member local to you to seek their advice on what can be done and what your reasonable expectations might be. It is a sad reflection on modern times that there are many people offering cures for problems which are not amenable to cure, and complementary medicine is no stranger to the 'magic solutions'. Our members, however, are trained to ensure that they do not offer false or unrealistic expectations.

As well as acupuncture treatment you may well find that your practitioner makes a number of recommendations about diet and exercise to help maintain any improvements in your circulation. An American acupuncture website which is generally well respected has articles such as this

 http://www.acupuncture.com/newsletters/m_aug10/varicoseveins.htm

which point to a number of simple exercises which might augment any treatment (although we canot comment on the herbs and lotions mentioned since these fall beyond our scope of practice)

Q: I recently had some accupuncture through my GP. Unfortunately this made me feel extremely sick. Following this I was admitted to hospital for several weeks for treatment for these and other problems. 
However, I am considering trying it again for my cervical dystonia and spondylosis (mainly affecting my left upper back and left side of my neck) which is causing me major problems with pain, stiffness and mobility.
I am hoping you can give me an idea of where the correct points are for any treatment, and how many sessions might be needed?

A: We are sorry to hear of your problems, although we have to say that we would be very surprised if the acupuncture was a significant cause of your admission to hospital. Acupuncture is an extremely safe practice with a very low incidence of adverse events. When these do occur they are very often transient, that is, they last for no more than a day or so and tend to be relatively minor - a headache, feeling very tired, and so on. Serious adverse events are very rare. However, we are heartened that you are considering further treatment.
 
In answer to your first question, it is impossible to predict where the needles will be applied. The strength of Chinese medicine is that it is primarily focused on treating the person, not simply the symptom. If the practitioner finds that the whole system is out of balance, and takes the view that this needs to be corrected before dealing with a local problem, or instead of treating locally, then the needles could be anywhere on the body. In practice, treatment is often a combination of treatment for the system as a whole and of the affected part, and it is highly likely that there may be one or two needles near the areas where you are experiencing pain and discomfort. Although one cannot predict what a practitioner might do, very often points on the neck and shoulder are supplemented with points lower down the arm on the affected side, but without taking a detailed case history and making a thorough examination it is impossible to say.
 
As for frequency of treatment it is again difficult to predict. We advise members to review progress regularly to avoid a kind of 'treatment habit' building up. Normally after three, four or five sessions there should be some appreciable change, and the practitioner's task is to discuss with you whether the rate of change is a sign of a long term improvement and to assess how sustainable it is. Treatment which makes you feel well for 24 hours and then reverts, and this happening several times without the change 'holding' is perhaps a sign that the treatment is only offering temporary pain relief. If this is so, then everyone needs to be really clear about possible outcomes if treatment carries on.
 
We advise you to speak to a BAcC member local to you and see whether you can have a short face to face consultation. The fact that you mention 'other problems' may have a bearing on how well they can treat a single problem against a more complex backdrop. 
 

It isn't totally clear from your question what you need to know. We suspect that you are asking which pressure points to use for specific problems, and if that is the case I'm sorry to say that we can't really help you. Although there are acupuncture points which can be used as acupressure points for temporary relief of problems, our members are trained to ensure that in dealing with specific symptoms they see these against a backdrop of the whole picture of someone's health. Treating a problem without doing this could mean turning off an important alarm bell without finding out what the underlying issue is.

It is always best to see a qualified professional first to ensure that there is nothing significant which needs to be addressed. If they then gave you advice on how to self-treat to maintain progress, that would be preferable.

Q:I have insomnia caused by an over active mind. I have no trouble at all going to sleep, but I often wake in the night, usually to go to the toilet, and my mind starts racing and I can't go back to sleep. Please could you let me know if acupuncture can help with this sort of insomnia?

A: As far as insomnia itself is concerned, there have been many trials which seem to show that acupuncture may be of benefit to you. A systematic review at
 
http://www.ncbi.nlm.nih.gov/pubmed/19922248
 
which is effectively a review of all trials in order to aggregate their findings, makes the same positive noises with which we are familiar - 'signs that there is an effect but need larger trials to confirm'.
 
However, the great strength of Chinese medicine is that each person is unique and different, and no single disease label will ever capture that. Your experience of insomnia, while similar to others, will not be exactly the same, and it is the small details even in the brief note which you send which would excite the practitioner's interest. Getting to sleep originally but waking later, needing to go to the toilet, the description of the mind racing, your sense of having an over active mind - all of these suggest possible changes in the body's functions as understood in Chinese medicine which, together with signs which a practitioner uses like the reading the tongue and taking the pulse at the wrist, would lead them to a diagnosis unique to you. Treatment would then be aimed at correcting the specific imbalances which manifest in order encourage proper function again.
 
The practitioner would routinely ask a great many questions about lifestyle and daily habits, and there may well be some additional clues and keys in what they find. We're sure that you have eliminated the obvious culprits, like strong caffeine drinks towards the evening, and also too much liquid before sleeping, but there may be nonetheless things that you are eating, drinking or doing which, given your own specific patterns of energy, may be causing the cycle to continue. Of course, the worst problem is dealing with the expectation that once you wake you're awake, and that's that. For people who have never suffered insomnia this is difficult to understand, but rather like the film Groundhog Day, the dreadful feeling that it's 3.00am and you're awake exactly the same again is a hard one to describe to someone who has never experienced it.
 
Our best advice is to contact a BACC member local to you for a bried face to face chat about whether they think they can help your specific case, and if so, what their expectation might be. We trust that they will give you an honest assessment.