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Q: I've had three acupuncture sessions to try and improve my chances of conceiving. My acupuncturist said this was 'laying the foundations' for improving my fertility. She  recommended fortnightly treatments after that. Could you advise what she might have meant by 'laying the foundations'?

A: It is always a little difficult to be entirely sure what a practitioner was intending, but we think it is highly likely that she is simply describing the way that many of us work with conditions or patients where it would be unrealistic to expect quick fixes for their problems. In the treatment of migraines, for example, we might often treat someone for four or five sessions once a week, and then step back, depending on progress, to a number of monthly sessions and eventually maintenance treatment a few times a year.

 This reflects our overall view of what we are trying to achieve. Traditional acupuncture treats the person rather than the condition, so although each patient comes to us with presenting signs and symptoms our job is to make sense of these within the overall context of their energies and try to restore an overall balance. The challenge is that many of the patterns which people have in their energy systems have become deeply entrenched, so it is as much a matter of encouraging and retaining a change in the face of some resistance as it is of immediately reversing a pattern. In order to do this we often speak of using the first few sessions as a kind of foundation for what follows on which we can then build. One of our old teachers used to talk about watering plants - when you rescue a plant you might have to douse it two or three times but after that you would water less frequently to let nature take its course. Once the tide has turned, so to speak, then you can guide the changes as much as looking for major reversals.

 Fertility problems are particularly challenging in terms of treatment planning because the desired outcome, a pregnancy, is going to be possible only for a few days each month. Many practitioners undertake special postgraduate training to work with these issues, and great care is taken to address the different energetic needs at times of the cycle to encourage the best overall pattern. Early sessions would establish the overall pattern, and involve any major changes which a practitioner might want to encourage, and after that it would it building on this by carefully targeting what the following sessions aimed to do.

 We hope that this makes sense, and also that it reflects what the practitioner intended. We think it may have been to our detriment over the last decade or so to have become more focused on named conditions in our PR and marketing because this inevitably invites comparison with Western medicine which usually has set protocols involving specific numbers of treatments for many problems. In Chinese medicine each patient is unique and different, and the treatment of the same named condition in a dozen patients may be different in every case. Our aim is to restore balance to the whole system in the belief that this enables the body to put right whatever symptoms might have appeared as a consequence. Once you look at treatment in this way the notion of laying foundations makes a great deal more sense.

 

Q: I've wrenched a muscle in the top of my right arm pushing something? I get pain when I lift my arm shoulder height.  I have no pain below or above, just at shoulder height?

A: As you may be well aware, the shoulder can be affected in some very specific ways from injury which restrict movement in one direction only while leaving everything else unaffected. The glenoid cavity in which the head of the humerus sits is a very 'open' socket, and its stability comes from several groups of muscles whose tendons insert in and around the joint. The main issue for you is whether there has been a tendon strain or actual tendon damage.

 You do not mention whether you have seen your GP, but we would advise that it is probably a good idea to follow this route anyway in order to line up a consultant if need be. Our experience has been that if there are tears in the tendons these do not always heal spontaneously, mainly because it is very difficult to immobilise the joint. If there is a need for microsurgery, then you would be well advised to find out sooner rather than later.

 If it is a tendon or muscle strain, it would not take the practitioner very long to determine which groups of muscles and tendons are involved. Although we are committed to treating the individual, not simply the problem with which they attend, some problems are what they are. There may be a background against which one could anticipate that tendon tears were more likely (some people have their muscles at straining point for much of the time) but in the average case attending to the problem directly can be a viable option. This will very often involved needles where the problem is located and along the channels with which these areas connect.

 We tend to take the view that it may be necessary to supplement acupuncture treatment with exercises, and a considerable number of our members are trained in treating sports injuries. We don't keep separate listings of these, but it is usually fairly easy to track down a BAcC member who is suitably trained.

 The best option, and one which we invariably recommend, is to contact a BAcC member local to you and seek an informal face to face assessment. Most members are happy to give up a little time without charge to prospective patients to determine whether acupuncture is the best option. It might also be in your case a way of locating someone known to the local network as a 'go to'person for musculo-skeletal problems. It also has the advantage that you can meet the practitioner and see where they work before committing to treatment.


Q:  Our acupuncturist did micro bleeding on two toes and continued trying to get blood out and now one foot on the side feels numb. The acupuncturist says it is a damaged nerve and will get better? Very worried.

A: Your practitioner is very probably correct in that this is a temporary problem which should resolve quite quickly.

 It is not for us to make judgements about technique, and we are aware that using bleeding techniques can be a slight problem when people do not bleed easily, especially in some areas of the body like the toes where the circulation can be a little slower. If someone has to be needled more than once it is always worthwhile warning the patient that there is a slightly increased risk of bruising.

 We're not sure about the 'damaged nerve'. In our experience if you needle a nerve the patient knows about it very clearly. What he probably means is that there has been slight bruising within the tissue which is not yet visible at the surface, and may never be, but it is slightly impinging a nerve and causing a loss of sensation. As soon as the bruising clears, which may take a few days or perhaps even as long as a week or more, the normal sensation will return. Many people use arnica in one of several forms to encourage the healing of bruising, but that is not within our scope of practice so you would have to take advice from a pharmacist or qualified practitioner on that.

 In the extremely unlikely event that the loss of sensation continues beyond a fortnight then it would be worthwhile getting a referral from your GP to a dermatologist. Any continuing loss of sensation in the toes needs to be investigated, but we think it is highly unlikely that it will come to this.



A: We fear that you may find it rather difficult to find anyone who offers Japanese acupuncture in your area.

 The major problem that we have is that there are no undergraduate courses in the UK offering training in the various forms of Japanese acupuncture. This means that we have no database entries which means that we can day with confidence that someone initially trained in this style. Even this may not be helpful, however; many practitioners change their focus over time to another style of practice or amalgamate several, and we have not yet come up with a system for being able to provide specific referrals for the public.

 The best that we can suggest is that you use the postcode search facility on our home page to discover which BAcC members work locally to you. It would then make perfect sense to ring them up and ask whether they offer this as an option, or more importantly, whether they know someone locally who does. Their local knowledge is going to be much more precise than our national material, and practitioners often have informal networks in their areas to identify specific styles or specialisms for prospective patients.

 The only other alternative is to contact some of the associations or special interest groups to see if they are aware of people using Japanese acupuncture in your area or have trained people over the years. The Toyohari Association is one such http://www.toyohari.org.uk/. There are also a number of training providers, but we are not able to make recommendations for a number of reasons, so the google search under 'japanese acupuncture training uk' will generate three or four useful hits which you may be able to follow up. It is possible that they have lists of people who trained with them and whom, subject to data protection concerns, they might be able to name for you.

 We do hope that you manage to find someone. Japanese acupuncture is a very gentle form of treatment. However, there are many other styles which borrow heavily from the Japanese traditions, as for example Five Element acupuncture, and you may find that there are local practitioners who can offer something very similar.

 

Q: Your FAQ implies that chronic fatigue is a more difficult condition to treat. How can I find a practitioner who has a lot of experience in this specific condition?

A: We're not sure which specific FAQ you may be referring to, but it is true that the treatment of Chronic Fatigue syndrome can be more challenging than some health problems. We would hesitate to say 'difficult to treat' because in Chinese medicine we treat people, not conditions. That means for us that the overall balance and rhythm of someone's energies can have a profound impact on how a condition manifests and also how easily it may be treated. This can mean on occasion that a seemingly intractable condition can resolve very quickly where an apparently trivial problem can take forever.

 What is clear, though, is that CFS often responds to treatment, as our factsheet shows

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/chronic-fatigue-syndrome.html

 but it can often be a part of a complex overall presentation which may well have emotional as well as physical components. In some cases the emotional and mental issues can be integral to the development of the condition, and in other cases the emotional and mental consequences of the health issues can make it even more difficult to shift.

 We can understand why someone might want to see an experienced practitioner in these circumstances, but the reality is that nearly every presentation is unique, and all of our members are equally well qualified to make informed judgements about how best to treat the specific manifestation. The only reason where seeking a more experienced may have some merit is that treatment of CFS can sometimes take a relatively long time, and someone who has treated many cases will have lowered their expectations a little more than an enthusiastic newly qualified practitioner. On the other hand that enthusiasm is what sometimes achieves the unlikely, so as with all things in life, there are arguments both ways.

 Our members are the best source of advice for you, though. We are not in a position to say who is or isn't more likely to be what you are looking for, but we are pretty certain that if you contact a local BAcC member and ask them who has the most experience locally of treating CFS they are likely to tell you. Our over-riding concern is to do the best we can for prospective patients, even if that means referring them on to colleagues who we think may be better suited to their needs. 

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