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A:  As you can imagine we have been asked this question a number of times, and a typical answer was:

Can acupuncture help with plantar fasciitis?

Plantar fasciitis can be a very unpleasant and debilitating problem, as you no doubt know. There is some evidence for the use of acupuncture treatment, as this paper shows,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3094706

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.

We believe that this remains sound advice. Our own personal experience of treating the condition is that if the treatment is going to work it begins to show evidence of change fairly promptly. The real problem with chronic conditions like this is that it can occasionally lead to a treatment habit developing where hope triumphs over experience and treatment can continue far beyond a time when it is clear that nothing is happening. If you did decide to go ahead it would be wise to identify as objective as possible outcome markers for improvement, something which can be measured, and to ensure that progress is reviewed carefully every three or four sessions.

As an additional aside we have recently heard a number of reports of osteopathy being used to good effect alongside acupuncture treatment to provide better relief, as well as reflexology often being mentioned as a worthwhile option. We mention this because if acupuncture did fail to generate results it is good to know that there are other options for treatment available.  

Q: Throughout this past winter I have suffered with chronic catarrh and an almost permanent cough-particularly in the morning when I bring up lots of mucus. I have a suspicion that I might have allergic rhinittus. I have seen my doctor, and respond well to antihistamine and a nasal spray. However,my GP is reluctant to send me for allergy testing, and therefore I wondered if acupuncture might be useful. Can you advise please?

A: We have been asked about similar problems in the past, and a recent typical response was:

Can acupuncture help chronic rhinitis?

There is a growing body of evidence that acupuncture treatment may help with a number of forms of rhinitis, as our factsheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/allergic-rhinitis.html
 
However, we know from our clinical experience that although there are some, indeed many, presentations which seem to respond well to acupuncture treatment, there are a number which have their root in some physical change or restriction in the nasal cavities, or from long-term sinus infections which have become resistant to treatment. If either of these is the case, there may be much more of a struggle involved in trying to reduce the impact of the symptoms.

From a Chinese medicine perspective, however, there are a number of clearly defined patterns involving a compromised defensive system (the Chinese didn't recognise the immune system as we do but certainly had a concept of defensive energy which when compromised generates the symptoms which we associate with rhinitis) and also digestive disorders which can manifest in the fluids of the body being excessive. A skilled practitioner will be looking at the symptoms someone has in the context of their whole system, and trying to ensure that treatment is aimed at the core of the problem, not simply the way in which it manifests.

Amongst the things which the practitioner would consider are also a number of digestive factors. From the Chinese medicine perspective the intake of too much dairy produce can often produce far too much mucus in the body, and it is not uncommon as a pattern. If this is the case, though, there will be a number of diagnostic signs which point clearly in this direction.

You would be well advised to visit a BAcC member local to you for face to face advice. Most are happy to give up a few minutes without charge to assess whether acupuncture treatment is the best thing for you. 

We think that this remains the most sensible advice that we can offer. It is not surprising to us that your doctor is unwilling at this stage to send you for allergy testing. His reasons may be budgetary or they may be based on his experience that they more often than not fail to provide a clear answer. From our perspective the tests may be useful, but once the immune system has been triggered in this way there is a tendency to see a huge number of short-term sensitivities which have been triggered by the more causally related one. The list of intolerances which people are handed means that they can end up with a serious restriction in what they eat to the point that it becomes difficult to ensure a balanced diet.

We think that it is probably likely to be worthwhile to visit a BAcC member local to you for an informal assessment of what may be possible. From a Chinese medicine perspective each patient is unique and different, so the symptom may arise from a totally different cause from someone with exactly the same presentation. The strength of the system, though, from our perspective is that it treats the person, not simply the condition, and as such offers a better chance of dealing with the symptom permanently rather than turning off the alarm bell which the symptom represents because we don't like the noise.

Q:  I am suffering with bad depression & anxiety related to body dismorphia. I have had it since I was 18 & I am 63 now. It has been triggered again
recently by a tragic loss. I took antidepressants for 2 years and managed to come off them gradually and have been okay until a month ago. Could acupuncture help with my symptoms?

A:  As you can imagine we have been asked about both anxiety and depression a number of times, and a typical, if rather long answer, was:

Is acupuncture any good for relieving depression or anxiety?

A:  We have produced factsheets on both of these areas:
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html
 
and

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/anxiety.html
 
which give some cause for optimism, as does a heavily publicised research trial by BAcC member Hugh Macpherson and colleagues published very recently
 
 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001518

There is also a link on our home page today to a new study about anxiety

http://www.acupuncture.org.uk/public-content/public-pr-press-releases/3546-anxiety-the-silent-sufferers.html

However, we could do worse than reproduce the text of a piece we provided for Anxiety UK some months ago.

ANXIETY AND ACUPUNCTURE

 

Anxiety is more than just being anxious. Just as migraine sufferers get righteously indignant when someone claims to be a fellow sufferer but can still get to work, eat and stand the daylight, so anxiety sufferers know that they bear only the slightest resemblance to people who feel a bit nervous or have ‘butterflies in the tummy.’ Clinical anxiety is a crippling affliction which can sometimes defy all of the medications and talking therapies that someone can throw at it.

Why, then, has acupuncture been found to be successful in treating it? The main reason is that in conventional medicine, there is no single treatment for each sufferer as each person has differing symptoms. However, in traditional acupuncture every patient is considered to be unique, and this means that the practitioners will be looking and listening very carefully to everything that the patient says to establish a diagnosis and find the specific keys to unlocking the patterns of the symptoms the patient is suffering. They will aim to identify the imbalances which cause the symptoms of anxiety, not just treat the symptoms themselves. This whole ‘package’ – taking the patient’s individual story seriously and giving them time to tell it, trying to hone precisely the diagnosis, and selecting the optimum way to use the least needles to achieve the greatest effect – has been found to be very effective.

The theory of traditional acupuncture is very straightforward. The free flow and internal balance of energy (Qi) is seen in eastern medicine as essential for good health. Any prolonged exposure to extremes or intense situations, be they physical, mental, emotional or spiritual, will cause the flow and balance to be affected. This disruption in balance then ripples through the whole system, causing symptoms which sometimes bear little apparent relation to the underlying causes. An acupuncturist’s skill lies in making sense of seemingly unconnected symptoms and understanding the unique nature of someone’s energies in such a way as to restore balance. A treatment plan may simply involve needles and moxibustion, the use of a warming herb, and tui na, a form of traditional Chinese massage, but can extend to address issues in someone’s diet, their exercise patterns and their lifestyle.

People sometimes ask why, if acupuncture is so successful, there isn’t much research to back up its claims and make it more freely available within conventional care. A major reason for this is the unique nature of treatment which resists putting people in pigeon holes and which changes as the person’s balance begins to improve. Both of these confound attempts to organise research according to western models where a named condition receives a single treatment and all other variables are taken out of the equation. In Chinese medicine the variables are called patients!

Where do our patients with anxiety come from? Word of mouth still remains the most common and most reliable form of referral, and more people have had acupuncture than you think. If you ask around your support groups you are almost certain to find someone who has tried acupuncture and found that it works. Perhaps this time it’s your turn!

People also usually want to know whether the treatment will ‘stick’, whether they have to keep on having acupuncture. Some don’t – a single course of treatment can set them on a good path which, as long as their life remains well-balanced and relatively stress-free, means that they will stay anxiety-free. Many, though, like to keep ‘tuned up’, and realise that spending a fraction of what they spend on keeping their cars roadworthy keeps the driver in good shape too.

As always, though, we still think that the best advice we can give is that you contact a BAcC member local to you to see if acupuncture would be appropriate for your own unique circumstances. 

We think that this covers most of the basics. Your case is obviously a little different, with a much more specific cause, and it also appears that you have a strategy from previous episodes which works, albeit slowly. We do not think that there would be any disadvantage to trying acupuncture treatment, and it may well be a suitable alternative to medication. However, if medical advice is to proceed with medication again there is no harm in having acupuncture at the same time; the two systems of medicine are like apples and oranges, so there is little or no chance that either will interfere with the effects of each other.

A:  It depends on which professional association, if any, the practitioner belongs to. If the practitioner is a BAcC member, then this link

http://www.acupuncture.org.uk/public-content/about-the-bacc/3828-complaints-complain-about-a-practitioner.html

will direct you to the appropriate people within our organisation to whom you can address your complaint and from whom you can receive advice. In your case, the first step described of contacting the practitioner directly will clearly not apply.

If the practitioner does not belong to the BAcC, it is usually a fairly straightforward matter to establish which body they belong to, and to work out where the chain of responsibility for their conduct leads. If they do not belong to a professional body, there are other slightly more indirect ways of pursuing the matter.

However, we believe that you should probably be addressing your concerns to the police as well, or most probably first. The Sexual Offences Act 2003 made healthcare professionals much more easily accountable for their actions, and shifted the emphasis from what the practitioner intended to how the patient perceived what was happening. If a patient believes that they have been subjected to inappropriate actions, then it matters not that the practitioner did not intend them to be interpreted in this way.

If there is a substantial basis for a complaint, it is highly likely that the police would not want a professional body starting its own investigations and potentially prejudicing what they might wish to do. This is something on which our specialist BAcC staff can advise you.

We have copied this reply to our Professional Conduct Officer. If the practitioner belongs to the BAcC she is the person with whom you will establish contact, but if the practitioner is governed elsewhere we are sure that she will be happy to help you take your next steps.

Q: I'm wondering if acupuncture with eg Allegra Wynt, Oxford who is experienced with cancer patients, could help with peripheral neuropathy in hands and feet: side effects from my chemotherapy (incl Cisplatin). This finished in January, but side effects persist. May disappear within  6 months. Can acupuncture help? Would it interfere with ongoing Herceptin (I/V) 3 weekly, which will hopefully keep cancer cells at bay ? Don't want to jeopardise my treatment. I have cancer of unknown primary (? upper GI tract) with secondary in lymphatic system. Chemo is successful.

A:  We have been asked a number of times about peripheral neuropathy, but this has mainly been where the problem has arisen of its own accord or where it forms part of a broader medical condition like diabetes or Charcot Marie Tooth disease. Clearly this places limitations on the potential outcome, since these conditions are not usually reversible, and the practitioner is usually limited to 'things getting worse slower'.

However, there is a growing body of evidence which suggests that acupuncture can be very effective in helping to reduce the severity of peripheral neuropathy (PN) induced by chemotherapy and to speed up the rate of recovery. If you search on google using the terms ' ncbi acupuncture neuropathy chemotherapy' you will access a major American research database gathering studies from all of the established online collections like PubMed and Medline. The first half dozen results point to a number of recent studies which show very encouraging results, but most of which conclude that a much larger study is warranted before any definite conclusions can be reached. This is not uncommon; research funding for acupuncture is not that freely available in the West, and Chinese studies are often regarded as methodologically unreliable. There is certainly enough to say that acupuncture treatment will probably help.

As for interfering with your current treatment, there is no evidence of any kind that acupuncture treatment can interfere with the function of medications which people are prescribed for cancer treatment. Indeed, there is no evidence from outside the acupuncture profession that treatment can interfere with any drug regimes, although we are understandably careful where we use points which are said in Chinese medicine to affect the blood flow, blood pressure and the like when someone is on medication to try to achieve the same result. Our usual response, however, is that the treatments are apples and oranges, two entirely different ways of treating the person which do not interfere with each other. There are even advantages to acupuncture treatment alongside western medication routines where unwanted side effects, like PN or nausea, can make a patient's life difficult, and treatment can make the regimen more bearable.

We tend to avoid comment on individual practitioners, but we are happy to say that Allegra is a vastly experienced practitioner, and you could not wish to be in safer or more experienced hands.

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