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A:  As our factsheet shows

the evidence for the use of acupuncture, while limited, is fairly good. In particular there is a systematic review from 2009 which combines the data from several studies which appears to be very positive. As always, though, there is not enough research for us to be able to give an unequivocal recommendation.

That said, acne can present in many areas of the body and to varying degrees of severity, so it is quite difficult to give an all-purpose response like this. Someone who has had the condition for thirty years and tried every medication under the sun is going to be a different proposition from someone who has a small but recent outbreak. In all cases the advice we usually give is that someone visits a BAcC member local to them for a short face to face assessment which many members offer without charge. This will enable them to give you a slightly more balanced view of what might be possible for your specific case.

We often suggest that a prospective patient considers adding Chinese herbal medicine to the mix. There is a considerable amount of anecdotal evidence in the profession that herbal medicine can greatly add to the treatment of skin conditions, possibly because the daily regimen based on the same diagnostics principles adds weight to the treatment. Members of the Register of Chinese Herbal Medicine are very often also members of the BAcC, and members of the Association of Traditional Chinese Medicine often use both modalities as a matter of course, so it may well taking this into account as you look for a practitioner.

Q:  I've had treatment for my neck,shoulders,and back.  After the treatments I feel great but when I wake up the next day I feel achy and tired.

A:  This is not an unusual reaction after treatment. We often alert patients especially after the first and second session, that they may experience a resurgence of the pains they have had to an even greater extent. This is not a bad thing, and if nothing else shows that the treatment is having an effect. Since lasting adverse effects are very unusual after treatment it is usually a good sign. We only get concerned if an episode of tiredness and achiness lasts for a great deal longer or if the pattern continues without any discernible improvement in the problems for which someone came to treatment.

The mechanism for this is not clearly understood. Since Chinese medicine is premised on a flow of energy, called qi, there are explanations which borrow the analogy of chilblains which can be very painful when they are warmed up after a walk in the cold. Not a very positive analogy but gets across the idea of a circulation being restored not always being a comfortable process. More plausible is the fact that treatment is aimed at restoring proper function in the body, and ultimately this will impact on structure. If the body starts to realign then various muscle groups are going to rearrange themselves. Treatment is also aimed at expelling pathogens, and we often find that the outward travel of these can make someone feel like they are on the edge of a cold.

However, whatever the explanation in either system of medicine, we can reassure you that this is not uncommon, and while we would not want to state as a general principle that things sometimes get worse to get better, it is a frequent enough event to be predictable in cases of muscular problems in the neck and back.

The only other factor which we would explore is whether someone is cashing in their 'feeling good' after treatment by over-doing it a little. The mild euphoria and relaxation after treatment Is quite common, and we do find that people can sometimes take this sense of well-being down the gym or into the park for a run. We usually advise our patients to take it easy after treatment while the system is in flux, and leave it time to settle.


A:  The most obvious advice to offer for the tear in the plantar fascia is to rest the foot as much as possible and to stop any exercise which might put strain on it. The treatment for plantar tears will be much the same as the treatment for plantar fasciitis, on which we said a while ago

Can acupuncture help with plantar fasciitis?

Plantar fasciitis can be a very unpleasant and debilitating problem. There is some evidence for the use of acupuncture treatment, as this paper shows,

and if you google 'acupuncture' and 'plantar fasciitis' you will find a number of other papers which suggest that there may be benefits from treatment. However, the combined weight of the various studies is not enough to be able to give an unqualified recommendation.

That said, the strength of Chinese medicine is that it operates from an entirely different paradigm or theoretical basis, and has different ways of making sense of the symptoms which a patient is experiencing. This can sometimes offer treatment options which would not necessarily translate into a western understanding of physiology, although there is usually an overlap. The system of medicine rests on a theory of energy, called 'qi', whose flow and balance determine how well the various systems of the body function. Many problems like plantar fasciitis point to local blockages and disturbances, often due to over-use or poor gait, which once they have become established remain a problem even after someone's habits have changed. Symptoms such as this can also point to more systemic problems, and the skill of the practitioner lies in making a clear diagnosis of the whole system before starting to correct aspects of it.

In this case, since the presentations of plantar fasciitis can be very different, we would advise you to visit a BAcC member local to you for a brief face to face assessment of the problem before committing to treatment. We are fairly sure that you will have seen a chiropodist as well as your GP, but if you have not, we would highly recommend that you do. There are a number of treatment options which can work alongside acupuncture treatment to great effect, and with these sorts of problems it is often a combined approach which pays the greatest dividends.

There is less evidence for the treatment of a calcified achilles tendon, but we would probably tend to see both symptoms together as evidence of a disturbance in the flow of energy caused by over-use which has led to a deficiency of flow and in turn a number of blockages in the area. Our practical experience is that there is often a response to treatment, and the main issue is not whether treatment will work but the extent to which it works and how sustainable any change might be.

All in all, though, there is usually an underlying cause of over-use or poor use, and the most important thing alongside rest and treatment is to see if someone can provide the kind of analysis of the mechanical structure of the movements of the foot while running or exercising which show if there are any displacements putting pressure on specific parts of the structure of the foot. Some sports shops offer tread analysis, and this can often highlight a need for orthotics in running shoes which can prevent uneven strain.

Of course, if you are not over-doing the exercise, we would be interested as practitioners to see what other constitutional factors were in play to generate a problem which is normally associated with running. Local injuries are often predicated on overall weaknesses in the system, which is why people living an identical lifestyle can be symptom free.  The skill and art of the Chinese medicine practitioner lies in making sense of the overall picture to ensure that local treatment can not only be effective but stay effective.

As the earlier answer says, the best advice is to visit a BAcC member local to you for a brief assessment where they can take a look at the problem and offer a slightly better informed view than we can offer at a distance.

Q:  My husband was diagnosed with parkinsons disease about 2 years ago, but at his last appointment with the neurologist he said it was possible he had PSP.

Over the last 6 months my husbands walking has deteriorated drastically and he has freezing episodes every few steps. His balance is very very poor and he has frequent falls despite walking with various walking aids in the house. He cannot go out on his own any more and it is very difficult for me to take him anywhere on my own.

He does not have much in the way of tremors but sometimes his speech is slurred and he is very very slow in eating and all movements. The right side of his body does not have much strength.

He has been on Madapor for two years but this does not seem to make much of an improvement. He is 83 years of age and his brain is still very sharp. Could you tell me whether acupuncture would help him with his walking as I am now at the end of my tether to know what to do for him.

I am a great believer in complementary medicine and treatments and have tried many things for him. 

A: This is a very difficult question to answer. If the diagnosis is indeed PSP, then there really is not a great deal which treatment might offer. There are a number of studies of the use of acupuncture for the treatment of Parkinsons Disease (PD), most of which showed no statistical bias in the treatment group and those which were slightly more positive tended to be so in only one of the aspects of Parkinsons, like sleep quality or rest. However, the overall picture is not very positive.

From a Chinese medicine perspective the various symptoms associated with Parkinsons are understood in a number of ways as disturbances in the flow of energy, and since the portmanteau of possible symptoms is quite broad, there are occasions when treatment does appear to make a difference, mainly of the 'getting worse slower' kind rather than the 'rapid reversal' kind. One of the problems, however, is that once someone has the disease label of PD or PSP everything which happens to them is filtered through this and seen as a manifestation of the underlying problem. This may well be the case, but there are going to be times when a problem is not directly causally related to the PD itself but arises as a consequence of disturbances caused by functional changes arising from the PD. If so, there is a small but real hope that a specific symptom could be helped.

The important factor is that the practitioner who makes this judgement is experienced enough to determine whether it is worth trying, and having tried whether the results after two or three sessions show any indication that the treatment is having an effect. It is crucial to avoid the triumph of hope over experience when someone ploughs on, often running up a large bill, with no discernible change in the patient. We always believe that in cases like this, if the symptom is likely to respond as a separate issue from the underlying condition then four of five sessions will be more than enough to be sure.

We have to be honest, though, and say that we are not that optimistic that there will be much change, given your husband's age and general state of health. However, nothing ventured, nothing gained, and the use of acupuncture would certainly not make things worse.

There are a number of practitioners in your area, and you can generate a list by simply using the postcode search function on our home page.

I have received several acupuncture treatments (about 6) for my chronic migraines and also for my neck, shoulder, and lower back tension. I have had a mostly very positive experience with acupuncture, and I have not had a serious migraine (one lasting several days) since I began my acupuncture treatment. However, after my most recent acupuncture treatment on wednesday evening, the following day I experienced itching on my upper back near my shoulders. The itch I could not help but scratch, but at this point there was no visible rash on my skin. The following day, I developed a strange rash mostly on one side of my upper back and shoulder and up the back of my neck. The rash exhibits tiny bumps (almost like goose bumps, but constantly there) and they become red and inflamed after a warm shower or if rubbed against clothing. The bumps do not have any liquid or drainage present at all. They are just very itchy and uncomfortable. During the acupuncture session that preceded the rash development, I received needles in the area where the rash developed, among other areas, and also some electric pulsing on my right shoulder and right lower back. The rash developed on my left shoulder and up the back of my neck. It has now been 4 days since my acupuncture treatment, and 3 days with the rash. And while it appears to be getting better (I think), it is still very itchy and quite uncomfortable. I haven't experienced any changes in my diet or activities, so acupuncture seems to be the appropriate place to look for a cause of this rash. I also have no known allergies and have never had a rash like this before. I should also note that in my acupuncture session before the most recent one (a week before), I do remember experiencing some itching on my upper back the following day but it was less severe, lasted only one day, and did not develop into a rash. Do you think the rash could be a result of the acupuncture treatment? Do you think it should be cause for concern or is this a somewhat common side effect? What do you think I should do to remedy it, and do you think I should continue my acupuncture treatments moving forward? Any insight would be greatly appreciated.#

A: Rashes are not unknown after acupuncture treatment, although they are rather unusual. The most frequent cause is the constituents of the needles themselves. Some needles contain minute traces of nickel, and there are many patients with quite severe nickel reactions for whom this would be too much. There are also needles which have a very thin silicone coating which again is not good news to those people who are reactive to it.

However, if either of these had been the case, then it would be really unusual to find that some but not all of the points had been affected, and the rash would usually be more consistent across the whole body.  It also seems to be unconnected to specific interventions. If, for example, you had said that the electric pulsing was applied there and nowhere else, then we would have wondered whether this had been the trigger.  It wasn't, though; it was used on the other side.

This leaves only three possibilities:

1) this is a positive reaction to treatment, where heat is being released from the inside in non-blistering spots. This may sound a little odd, but we have seen on many occasions cases where the initial reaction to treatment is good all the way until after five or six sessions a patient will develop a rash, often tracing the exact route of a channel. If this is the case, it can be an example of what we would describe as clearing the interior, where a pathogen is said to have gone inwards from the outside, and once the system rights itself, the reverse happens. If this is the case, it will clear after this session and possibly one more session and not return

2) there is some aspect of treatment which you may not have noticed but which may have had an impact. This might be the use of various massage oils on an area, or the cleansing of points with a particular kind of alcohol wipe, which your body does not appreciate, but which only causes a reaction in this area. This can happen; people sometimes do have sensitive areas which react strongly where the rest of the body does not.

3) the problem could be entirely unrelated to the treatment as such, but the treatment in some ways might act as a trigger. This is the least likely, again because of the limited area which has been affected. However, a mild case of shingles is a possibility, especially since the problem is one-sided, and if you google images of this problem you can see whether what you have something similar. The itching, redness and discomfort may point in this direction.

It would be worth seeing your GP if this continues, whether or not it was caused by the treatment. If there is something uncomfortable going on you need to get on top of it straight away. We think you should also discuss this as soon as possible with your practitioner. They are in the best place to determine whether it could be a result of the treatment based on what they have found and on what they have been treating. The fact that the treatment has been working so far is great, and it would be a shame to stop now when this problem may not be related to the treatment itself. Most practitioners are more than happy to look into outcomes like this to see whether they can hep to clear them, and in any event are the best placed to see first hand what is happening and give you the appropriate advice.

We hope that you continue to do well with the migraine treatment and hope this episode is soon a thing of the past.

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