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Q:  I had acupuncture  on my neck, shoulder and back.  I am suffering bad pain on the right side of back going into my buttocks. 

A:  A great deal depends on whether the pain is at a needle site or not, and to some extent what you were being treated for.

If the pain is at a needle site, then there is a small chance that you have a minor bruise which may not yet have shown itself at the surface but may be quietly impinging nerves in the area. If this is the case the pain will have come on soon after the treatment and been pretty consistent. It also means that as the bruise heals the pain will diminish, and eventually go.

However, if you were being treated for a back or neck problem it is not unusual for there to be a reaction after treatment which can make someone's symptoms worse before they start to get better. Very often the body becomes used to operating slightly out of kilter so when a practitioner tries to restore normal function and the body re-arranges itself it can feel very uncomfortable. Osteopaths and chiropractors tend to give the same warning to patients, but generally the adverse effects have worn off after two or three days.

There is always a chance that the pain has nothing to do with the treatment itself. We are not being defensive in saying this but we do come across cases where a pain kicks off after treatment that is not related to what has been done. In these circumstances our job is to ensure that someone gets the appropriate treatment rather than argue about whose fault it was. The diagnosis and treatment usually establishes quite quickly what the cause was.

The best advice we can give is that you speak first to the practitioner to get an idea of whether the pain is related to either the needle site or the problem you are addressing. If it is, then we expect that they will do their best to sort it out when they next see you. If they are mystified about the cause, or if you feel uneasy going back to confront them, and the pain carries on at the same pitch it would be worth booking an appointment with your GP to make sure everything is OK. This is just a precaution, but always worth taking rather than wait too long (given that same day appointments are something of a rarity).

We have a cycle for replies which means that by the time you get this we are hoping that the pain has already started to subside. If it continues, then you need to call the practitioner or your GP soon.

Q: I am seeking help to treat dry mouth (xerostomia). I know there is some research demonstrating that acupuncture is effective in cancer patients. My dry mouth has been investigated, no obvious cause, salivary glands normal. None of the practitioners websites I have looked at specify that they treat dry mouth. Should I be looking for someone with specialist knowledge in this area or would any acupunturist be able to treat it (the research report does specify the areas to insert needles into). 

A:  As you say there has been research into the use of acupuncture for xerostomia arising from cancer treatments, and we touched on this in an answer we gave some time ago

We were asked this question once in relation to xerostomia induced by radiotherapy, and our answer was, taken from our factsheet on palliative care and further supplemented:

Dry mouth (xerostomia)

A systematic review found possible benefits with acupuncture for radiotherapy-induced xerostomia (O’Sullivan 2010). Not all the inter-group differences were significant but this is typical in trials comparing acupuncture with sham acupuncture, for the latter is commonly viewed as being an active treatment itself, not a placebo, and hence may underestimate the effects of the therapy (Lundeberg 2011; Sherman 2009; Paterson 2005).The RCTs to date are few in number and small in size. Although they have produced encouraging results, and are supported by observational studies (for example, Meidell 2009), larger trials are required to achieve more robust evidence. Acupuncture may also help with xerostomia dysphagia (swallowing difficulty) in late-stage palliative care (Filshie 2003).

There is some evidence for the value of acupuncture treatment for dry mouth after radiotherapy, and the two studies below certainly seem very positive.
 
http://www.ncbi.nlm.nih.gov/pubmed/23104718

 http://www.ncbi.nlm.nih.gov/pubmed/22072272
 
Clearly there is a considerable difference between the kinds of functional disturbances caused by disruption of the balance of the body's energies through normal wear and tear and the kinds of damaged brought on by injury or accident. This does mean that it is more difficult to predict whether acupuncture treatment might be of benefit. Treatment of the kind used in the studies tends to be localised or precisely targeted, and this can mean that it does not really conform to the patterns of treatment which a Chinese medicine practitioner would employ. In broad terms, however, acupuncture treatment is aimed at putting the whole system back in balance with the underlying belief that a body in balance tends to deal with symptoms itsef, and on this basis it may well be worth talking to a BAcC member local to you to see if a combination of systemic and local treatment may, in their view, be of benefit. Most BAcC members are more than happy to give up a little time without charge to give a face to face assessment of whether treatment would help.
 

There is a chance, of course, that the xerostomia which you are asking about is not related to cancer treatment. From a Chinese medicine perspective this makes no difference. The understanding of the mechanics of the disruption of the physiology of salivation from within the Chinese medicine paradigm will be the same whatever the cause, although the cause, again seen from this perspective, may have a considerable impact on the treatment. By this we mean that radiotherapy might be seen as a cause of great heat and dryness within the system as a whole or locally, and this would almost certainly feed into the treatment strategy.
 
As we said above, speaking to a BAcC member local to you who can assess the problem face to face may well be the best option for you before committing to treatment.  

We have used bold highlighting for one paragraph because it emphasises the point that from a Chinese medicine perspective there is no single treatment for the problem, and it will be addressed as every other presenting symptom is within the overall context of the patient's health and balance. What this means, of course, is that there is unlikely to be an expert in treating the problem because there is no discrete body of knowledge about this condition alone. In Chinese medicine the relationship between generalist and specialist is the complete opposite of conventional medicine. In ancient times, specialists who only treated a few conditions were regarded as inferior!

The advice we gave before holds good. Our postcode search facility shows a number of members within easy reach, and most are willing to give up a few minutes without charge to assess whether your specific presentation would be likely to benefit from acupuncture treatment. All our members are equally well-trained and qualified, and the choice you finally make may well depend on the rapport you make with the ones you see. This can be quite a positive factor in treatment.

Q:  Can acupuncture treat lump tissue under the skin? I have a lump about 2 inch diameter on my  back, I have been told I can have it surgically removed but it will leave a cavity but it is not cancerous. 

A:  It depends what the lump is. The first thought when asked these questions is that someone may have something like a lipoma, the fatty lumps which sometimes appear for no reason and in no specific places. However, removing these does not leave a cavity once the lipoma has been removed, only a small post-operative scar, and the fact that you have been told that there will be a cavity indicates that there may have been some changes to the tissues immediately beneath the skin.

From a Chinese medicine perspective, anything which manifests in this way is simply seen as a change in the energetic flow of the body, and in theory anything which manifests because of energetic blockage should be able to be dispersed by using needles to get the energy flowing. A very common presentation in clinic is Dupuytrens contracture where a fibrous lump gathers on the tendons of the palm of the hand causing the fingers  to be permanently hooked, and there are many case studies of people having successfully used acupuncture to treat this. The treatment is usually quite local rather than systemic, and very often more 'aggressive' than we would normally perform. However, you only ever read case studies which work, and we suspect a far greater number have failed. Everything works for some people, but it is rare for something to work for everyone.

We suspect that the best and only advice we can give is to visit a BAcC member local to you for a more informed view of what may be possible. The fact that the removal will leave a cavity suggests that there has been permanent change to some of the adjacent tissue, and there are limits to what any form of therapy can achieve. However, at very worst you would get to chat to a helpful acupuncturist  for a short while, and have a much clearer idea of not only what they can offer, but what else they may recommend based on what they can see. We often network with fellow professionals to ensure that patients find the most appropriate care and interventions for their problems

Q:  Three years ago my partner had 2 discs removed from his spine and has been in severe pain in his back and legs ever since. Would acupuncture help him ?

A:  A great deal depends on the extent of the physical changes which have occurred in the operation and whether the vertebrae have been fused. If the physical structure is now such that the spinous processes constantly  impinge nerves then the chances are that the best one could hope for is to turn down the volume a little.

This is certainly an aspect of acupuncture practice which has been thoroughly researched since Nixon's visit to China in the 1970s. The sight of people having operations without anaesthetic meant that there was an upsurge of research into acupuncture for pain relief, and quite an impressive amount of research into the effects of acupuncture on the release of endorphins and enkephalins, the body's natural painkillers. Of course, the issue with this kind of treatment is that like all painkillers they wear off, and the rather unfortunate equation is between cost and effectiveness. If treatment can reduce pain for a significant time then the cost of doing this on a regular basis becomes the main issue.

This kind of use of acupuncture is not really traditional acupuncture, though, and we would have perhaps one or two ways of considering what is happening based on our view that the body is a system of energy in movement and that pain arises where the energy (called 'qi' in Chinese medicine) does not flow as it should. This can mean in some cases that post-operative pain can have as much to do with the blockage in the flow of qi caused by the surgery as  the problem which the surgery was intended to correct.  Even scar tissue can act as  a block.

However, we would not want this to be read in a way that gives unrealistic expectations. Some people do respond well to post-operative treatment, but again, a great deal depends on the state of the whole system. If a chronic problem sits atop a history of other chronic health problems then the potential for recovery may be less. The strength of Chinese medicine, though, is that it looks at the person as a whole, and tries to make sense of why this person has these particular problems.

This is why we most frequently advise people to visit a BAcC member local to them for advice on what may be possible given their own unique balance. There may be aspects of the presentation which will inform a practitioner about the likelihood of successful treatment, and most members are happy to give up a little time without charge to make this assessment. Our postcode search facility on the home page will show you the practitioners working closest to where you live or work. 

 

Q:  Please can you suggest the best type of acupuncture for vestibular migraine? I have no headache but daily vertigo/dizziness symptoms.

A:  Acupuncture has a surprisingly good record with treating the different varieties of vertigo/dizziness/Menieres kinds of problems, as our factsheet on vertigo shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/2599-vertigo.html

The evidence is not quite robust enough for us to be able to make claims for success, but this is more a reflection of the type of evidence sought, by which acupuncture treatment is not, in our view, appropriately tested. We treat many people with these types of problem, and we have to presume that the fact we keep getting referrals indicates that we must be doing some good.

We think we are probably helped by the fact that there are some clearly defined functional elements as defined within Chinese medicine which are responsible for the sense of balance in the body, and this makes tracking the pathways of imbalances a great deal easier. This means that there are some short term treatments which one can apply in a slightly less holistic way to bring things under control while spending time on the underlying patterns of imbalance from which the balance problems usually emerge as a secondary phenomenon. You have probably read that twenty people presenting with the same  symptom might be treated in twenty different ways because each has a unique balance which needs to be adjusted. This holds true, but doesn't preclude direct help to one of the secondary manifestations if we need to help someone as best we can.

You ask about types of acupuncture, and we have to be honest and say that within traditional acupuncture any of the systems will be equally effective in addressing your problems. Seen from the perspective of balancing the system as a whole, there have been dozens of variations on the basic themes in the 2500 year history of the tradition, and all are equally valid ways of elaborating the core concepts. We would be less optimistic about modern traditions, as you could imagine from what we have already said. Treating the symptom as the source of the problem will obviously work in cases where there is nothing else out of kilter, but our experience is that there usually is, and just using formula treatments for problems often leads to short term gain followed by a return to the status quo.

We have checked our database by using the online search facility and have found a number of people working very close to where you live. The postcode facility is even more precise, so we have no doubt that you will be able to find a well trained and qualified practitioner near to where you live. Most offer a facility of dropping in for a chat before committing to treatment, and this might be a good route to pursue, giving you a chance to meet them and see where they work.

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