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Ask the Expert
Q: I have my leg in plaster would I still be able to have acupuncture for my sciatica?
A: The answer is 'yes.'
The strength of Chinese medicine is its flexibility in situations like yours. If the practitioner needs to move energy in the area where the sciatica manifests it is possible to do so either by using local points or what are called 'distal' points, points which often lie at the end of a channel or meridian which flows through/under the plastered area and which can have an effect on the area even when far away. This can often be confusing for patients when they have treatment for headaches and have needles stuck in their feet, or finding that a first aid point for haemorrhoids lies on the very top of the head, but when we show them our charts and diagrams they can see that it makes perfect sense.
In cases where a limb is in plaster it is very common to needle the opposite limb in the points where the plastered limb would have been needled. The channels of the body are bilateral, and the received wisdom is that there is a resonance between the two channels such that needling one will affect the other. For people in plaster this is the most common approach to treating a 'concealed' problem.
The only question we would want to resolve before treating someone for sciatica where they were in plaster was how much the injury was contributing to the condition. It may well be that the plaster is a major factor, in which case one might have to be slightly more cautious about making estimations about prognosis.
The evidence for the use of acupuncture in the treatment of sciatica is good, although not yet conclusive, as our factsheet shows
Q: I have recently been diagnosed with coronary artery disease and unstable angina, for which I have been prescribed a raft of drugs. Please can you advise me as to whether acupuncture would be appropriate treatment, and if it would whether it could offer an alternative route to all the drugs.
A: We have to say straight away that all of our members are under strict instruction not to interfere with prescriptions issued by a patient's GP, either by asking them to change or stop or, as importantly, supporting a patient's decision to stop taking a drug which may be life sustaining. There are, of course, a huge number of medications prescribed on a 'use as needed' basis, and if someone finds that acupuncture treatment means that they can do without the meds, so much the better.
In your case, however, both conditions carry a high risk factor if untreated, and it would be potentially very dangerous to stop taking your prescribed medications. That does not mean that acupuncture cannot help, and if you did decide to go ahead with treatment, you may well find that some of the symptoms are relieved. The problem you would then have is to convince a doctor who has made the prescription that the acupuncture, and not the medication, has had the desired effect. Most will conclude that the drugs are working, and be all the more reluctant to let you stop.
The best course of action is to discuss with your doctor what might be possible by way of a planned reduction over time, and what markers they would be looking for, whether these be achieved by medication or acupuncture. In this way it remains an open question as to what is working, but the end result is the same.
We have to say, though, that with both of these conditions, the chances are that the doctor will not entertain a reduction unless there were very significant and measurable changes in your heart function which made him or her confident that you were a very low risk.
As far as the symptoms themselves are concerned, there is a small amount of research for the use of acupuncture, but as this systematic review
clearly says, there would need to be many more trials of greater power and number to assess properly whether acupuncture is a viable treatment option.
It may well be worth talking to a BAcC member local to you, though, because a face to face assessment will be much more helpful than what we can offer at a distance, and we are understandably cautious when we have to work from brief descriptions of a problem.
A: We have a factsheet on our website
which outlines some of the research evidence for the treatment of herpes zoster (shingles) and makes encouraging noises.
However, from a Chinese medicine perspective, shingles is described in terms of being an 'external invasion of wind and heat', and there are protocols which are used for its treatment when it first appears. As in the equivalent western treatment, the taking of acyclovir, there is a strong correlation between early treatment and reduction in the severity of the symptoms. In Chinese medicine, there are many case studies which describe how rapid intervention to expel the pathogens seems to make a considerable difference.
Once the condition is entrenched, though, it becomes more difficult to shift, whichever system of medicine is used, and the best that one can hope for from acupuncture treatment is usually only the reduction in severity of the symptoms.
A great deal depends on where the rashes have appeared. Those of the face and head can be particularly uncomfortable, and many patients are happy to accept whatever relief they can get. We always counsel caution in cases like this, because relief can be transient, and prolonged treatment can become very expensive. If someone values the relief they get, whatever the expense, we like to ensure that they do so as a conscious choice and not simply rack up a large bill over time through habit. Our experience is that patients like to be in charge of this kind of process and can become upset if they aren't involved in regular reviews of progress and outcome.
A: We have to be very careful when answering questions of this nature. Our belief is that acupuncture treatment can help to optimise the functioning of the Organs as understood in Chinese medicine, and there is clearly an overlap between what the ancient Chinese saw as the functions and the functions as understood in conventional western medicine.
However, if by 'deteriorating kidney function' you are describing the degeneration which occurs when there is a serious kidney disease it is unlikely that acupuncture treatment will make a great deal of difference. The best that one could hope for, as a wise patient once said, is 'getting worse slower', and there is considerable anecdotal evidence which has accumulated over the years that disease conditions can appear to slow down and as importantly, the quality of life seems to improve. If the prognosis from a conventional point of view is poor, then it would be wrong to claim that acupuncture treatment can make a difference.
If, however, you are using the term 'kidney function' in a more colloquial sense to describe urinary problems, there is more evidence than acupuncture may be of benefit. If so, there are a number of fact sheets on our website
which provide useful background.
We think, though, that you probably mean advancing kidney disease, and some symptom relief is probably the best you could achieve. It is always worthwhile talking to a BAcC member local to you to get the benefit of a face to face assessment of what treatment may offer. With such little detail to go on we may be understating the potential benefits.
We are not quite sure whether there is a specific ranking system which you have heard of; we ourselves are unaware of any such system and can't quite imagine how it would work. Although Chinese medicine is a comprehensive system of medicine, there are areas of treatment with which it cannot deal, such as emergency medicine or surgery, and comparisons with other forms of treatment.
When asked about the WHO attitude to acupuncture we usually refer people to the following document
which outlines the WHO's assessment of the efficacy of acupuncture treatment over a wide range of conditions. The strength of this document is that it covers a broader range of 'proofs' than are usually accepted in the West. The standard used in conventional medicine, the so-called randomised control trial, is not an effective instrument for testing acupuncture, and this means we have ended up with a rather stark works/doesn't work contrast which sets the bar very high and discounts trials which, while not RCTs, show that there is a great deal of evidence that acupuncture works for conditions. The WHO has four grades of evidence, and assigns a wide range of problems to what it considers are appropriate points on this scale.
The document explains very clearly what these four standards of proof are, and many of our patients have been both helped and reassured by the comprehensive nature of the list and its assessment of problems for which they are considering acupuncture treatment.