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Q: I'm in really desperate need of acupuncture.  However i am on single parent benefits with three children and suffering. Can someone tell me if I can get some kind of free treatment on the NHS?  Anxiety attacks are leaving me with physical reactions whereby I cannot function, I shake and it's getting worse. The doctors don't know what's wrong with me but acupuncture has really helped in the past.  I don't have enough money, two of my children do music lessons, football and other after school things throughout the year but I really want to try a course of treatment. Can anyone help me please?

A:  We are sorry to say that your chances of getting acupuncture free at point of delivery inside the NHS are a bit slim. Although many physios and doctors offer acupuncture alongside or within their normal work, they are usually restricted to what is called 'scope of practice' and conditions which have a reasonable evidence base. Physios wouldn't normally treat anxiety, and doctors usually have to follow the care pathways advised by NICE which usually involve medication. To be honest, most GPs don't have the time to offer treatment; the ten minute slot does not really allow for good treatment.

However, don't despair! Many of our members are usually amenable to negotiation in cases of real need, although all of us have at one time or another treated at way below our usual rates and then hear of the patient booking a holiday to Barbados. If you contact a BAcC member local to you you may well find that they, or someone they can recommend, is able to offer treatment at the sort of rates you can afford. We all like to charge something; it is an almost universal experience that offering free treatment doesn't work because patients feel no compunction about cancelling at the last minute or not turning up.

Alternatively, depending on where you are, there is a growing number of what are called 'multi-bed clinics' where our members offer treatment at much reduced rates for working in a room with three or four patients on couches at the same time. This was a model developed in the States to make acupuncture accessible by people without a great deal of money, and seems to have taken off rather well. There is a group called ACMAC whose website will direct you to the nearest multi-bed facility to you. (http://www.acmac.net/)

We hope you manage to find something which can help you.

 

Q:  I have had  three  acupunture  treatments for chronic back pain.  I had needles placed in my lower back,  my ankles  and hands hands.  New  this week I had numbness in my back for a few hours, severe nausea for two days with sweats and light headedness also my hands have been very painful.  Is  this normal?

A:  We would never say that pains  and discomfort such as you have suffered are 'normal' but they are not impossible, and there are a number of occasions each year when we hear from people who have suffered a disproportionate reaction to treatment.

The numbness in the back we can easily make sense of; there are several points in the back which are very powerful and can sometimes cause a mild anaesthetic effect which wears off after hours, but can last for a couple of days. The pain in the hands might also be a reaction to the needles. Aside from any local damage which needles can do by causing internal bruising (where someone experiences pain but with no immediate visible external signs) there is sometimes an element of discomfort as the flow of energy improves and subtle changes in the structure start to take place as the muscles and tendons return to proper use.

The severe nausea and lightheadness are another matter, though, especially lasting for two days. One obvious explanation is that the treatment and its  after effects coincided with a bug. We never say this to avoid responsibility, but we have to be realistic that with over 2.5 million treatments a year it could well be that something which happens after a treatment has nothing to do with it. We emphasise this because it sometimes stops people from seeking conventional help, and we always advise people to get conventional treatment where necessary. This usually establishes what the cause of the problem was.

The other possibility is that the treatment may have been too powerful for you. Some people are quite sensitive energetically, and treatments for things like back problems can often mean the use of some very powerful points and some quite strong manipulation of the needles. For some people this can be too much, and the system can become quite disordered for a while. Symptoms like nausea and lightheadedness are often a part of this kind of reaction. You need to discuss this with your practitioner to find out whether the treatment can be adjusted, or to look at what other factors might have been involved. Sometimes people can be quite badly affected by treatment if they have specific foods, drinks or exercise too soon after a session.

However, if the problem has persisted even to a small degree by the time that you receive this reply you would be best advised to pop along to see your GP in case you do have some kind of bug and need conventional treatment. There are quite a few of the norovirus-type bugs going around at the moment, and in their milder forms they can often create these kinds of symptoms.

We do hope, though, that these effects were transient, and that you can work with your practitioner to make sure that your progress is less hampered by side effects.

Q:  I've had a small epididymal cyst (spermatocele) in each testicle for a few years now and while they cause constant mild discomfort I'm hesitant to look into surgical options. I've been checked out by my GP and had diagnostics to rule anything else out.  Do you think acupuncture could be of help and, if so, would it likely just treat the symptoms, ie. the discomfort, or is there any evidence to suggest it could help shrink the cysts themselves?

A:  This is the first time we have been asked about epididymal cysts. We have trawled the research literature for any evidence of research trials but there is nothing of consequence except for a few studies of epididymitis, which isn't close enough to warrant citing. Even acupuncture sites do not offer a great deal. We suspect that there are probably Chinese studies, but only a minute fraction of these are translated each year.

However, from a Chinese medicine perspective all cysts are simply accumulations of fluid which indicate a weakness of flow, either in a specific channel of energy or more systemically in one of the Organs responsible for the free flow of fluids (note the capital letter - Organ in Chinese medicine is not the same as organ in western medicine). If this is the case, then there should be some clear diagnostic signs pointing to the weakness or imbalance, and a practitioner might feel fairly confident that this would point to a potential change.

Even were this not to be so clear cut, Chinese medicine was and remains premised on the simple belief that a system in balance corrects itself, and we have seen many many cases over the years where there has been no clear diagnostic patterns but where problems have been resolved, even sometimes when no-one in conventional medicine knew what they were. Quite disturbing when no-one, western or eastern, can tell you what you used to have, but in then end gone is gone.

However, the danger with treating problems like yours where there isn't a substantial volume of case work to show that it might resolve is that treatment can sometimes extend much longer than is warranted by the returns. It is very useful to have some kind of measurable outcomes, and to review any progress on a regular basis (every four or five sessions) to keep an eye on how much the treatment.

The first step, though, is to see a local BAcC member for a brief informal assessment of what may be possible. Most are more than happy to spare a few moments without charge to see whether there are clear diagnostic signs which would underpin a slightly more precise assessment than we can give at this range.


a:

A:  This is a very interesting question!

There are two possible ways of looking at this. First, could you have both treatments at the same time and would they both work? The answer is that you can have as many treatments at the same time as you wish. There are very few where there is some risk from interactions between treatments, and these usually fall at the supplement/tablet/herb end of the range. The biggest problem lies with the practitioner. If someone is using acupuncture and reflexology it is often quite difficult to decide which is generating positive results. This can have quite an impact on how a practitioner refines their diagnosis because although there are diagnostic signs which are independent of what the patient reports the reports themselves are often the only way to assess whether a treatment was heading in the right direction. 

Obviously if someone has deep pockets and wants to throw everything at a problem that is up to them, but we often find it easier to have a period where acupuncture is the only or main treatment to get a really clear idea of what is going on. This is especially the case with treatments like homeopathy where there is a similar focus on body mind and spirit. Feedback can get quite difficult to interpret. That said, the impact of reflexology is often at a physical level, and the experience is a very relaxing one, so it is probably at the least problematic end of the range.

The second way of interpreting the question is whether the differentiations of the foot which feed the diagnosis in reflexology are at all similar to the way that the points and channels of acupuncture work. Although there are some acupuncture systems which are premised on the whole reflected in the part, like auricular acupuncture, there is only one system, Korean Hand and foot acupuncture, Su Jok, which uses the feet as a basis for treatment the whole system. As far as we can see this does not overlap significantly with the zones of reflexology, although we would be the last to claim expertise in reflexology. Our reading of the charts suggests that the point locations on the feet are in a distinctly different arrangement based on the acupuncture channels rather than on areas affecting specific organs. However, we have little doubt that someone somewhere has tried to combine or overlap the two.


Q:  I have had two treatments for mild anxiety which included needles and burning of moxi around my ankles.Prior to the treatments my anxiety had been reduced thanks to counselling and reading books that made me understand the cause etc.After the first treatment it returned that night and led to a woolly headed and dizzy feeling and heart palpitations.These lasted for a few days and then subsided.After my second treatment the feeling returned (again during the night following) although this time I  worked out the cause so have not felt anxious.I am annoyed that the accupuncturist did not warn me of these side effects and am concerend as to whether they are normal .Please let me know if these are normal side effects as so far I have paid £100 for nothing but a whole load of additional anxiety.

A:  It is not unusual when someone has treatment for the first time that in the first few sessions there can occasionally be a rebound effect where the symptoms can be more pronounced. This is much more likely with musculo-skeletal problems like back and neck pain, and we routinely advise patients that things are very likely to get a little worse before they get better. We tend to speak of 48 hours of disruption, and while there is no conclusive explanation of why this happens, there are several theories about re-arranging of the structure which are plausible. Certainly osteopaths and chiropractors tend to offer the same kinds of advice.

When it comes to problems like anxiety or depression this is more of a professional judgement call. One of the terrible things about anxiety states, as you probably know well, is that they tend to feed off themselves, so that the first hint of anxiety causes fresh anxiety and a vicious spiral can kick in. If you tell a patient with anxiety that things may get a little worse it is almost a guarantee that things will get worse, and given the circularity of the problem this can sometimes precipitate a sharp attack. Our experience is that for the small number of people who, when not alerted, have a panic attack are far outweighed by the numbers who find the treatment very relaxing and find immediate benefits with a reduction of their anxiety levels.

We cannot speak for why your practitioner did not alert you, but it is quite probable that he or she felt that your situation was not such as to warrant a warning. Your feedback is essential, however. If someone has a very powerful reaction to treatment, then there may be aspects of the treatment which can be adjusted to reduce the chances of the same thing happening again. Some people are highly sensitive to treatment, and have very marked reactions which can be quite unpleasant. It can sometimes simply be a matter of reducing the number of needles or of using less manipulation to make the side effects more tolerable or even disappear.

As for whether the situation is normal. We are always reluctant to say ‘normal’ because this implies that it happens on a very regular basis. ‘Not unknown’ is a better way of putting it, but what we can say is that when people react strongly it does suggest that the treatment may well have a beneficial effect. Had you had two sessions with no reaction at all it might have been more puzzling. We suspect that further sessions from now on will start to generate positive benefits. There is certainly a growing body of evidence that acupuncture can help with anxiety states, and the BAcC has been working with Anxiety UK on some research into the positive benefits of treatment.

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