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A:  We are not entirely sure at this point whether the treatment and the effect are related. Generally speaking, when treatment causes what we call adverse events, usually transient adverse events, these are very often local to where the needles have been placed. Infection from needles is so rare as to be easily dismissed as a cause; single use disposable needles used properly are as safe as can be. The only other thing we tend to look for is any deep bruising or damage which may not be apparent on the surface, but which may be causing something to happen by impingeing a nerve. However, as we said, it is usually fairly easy to follow the track from where the needles were to where the problem arises, and it would be very unusual to see a bilateral effect from a one-sided needle insertion unless the needles had been placed centrally in the neck or back.

However, this is to look at things from an entirely conventional perspective. When we treat according to traditional Chinese medicine principles we can often remove blockages in what we term the energy flow of the body, and sometimes reinstate a normal flow to the extremities where this had been compromised for a long time. This can sometimes be quite dramatic. We are also aware of the possibility that heat gets released after treatment. There are several ways of understanding pathologies in the system as 'heat being trapped in the interior', and it is not unknown for this heat to clear the system as a generalised feeling of heat or as a red rash.

We are not sure at this stage, and we would probably have to know a little more about what the treatment was and also the context in which it was given. We treat people, not conditions, and this means that the unique balance of the individual is integral to how we decide what to do. There may be aspects from this which would help us to understand what has happened. Clearly the best person to ask is the practitioner who treated you. His or her knowledge of your case history and what they were trying to achieve might be your best and quickest route to finding out what is happening.

We can understand how this is a concern, though. While we expect the problem will have subsided by the morning, if it continues and the skin starts to develop a redness corresponding to the heat you can feel we would be inclined to advise you to visit your GP as soon as possible to get a conventional view of what is happening. It may well be that the problem is unconnected to the treatment, and rather than spending time wondering whether the treatment caused the problem, it may be better to think 'had this happened anyway without a possible cause, what would I have done?'. If the answer is 'sought help immediately' then that is the best thing to do unless someone can give you a reasonable and compelling reason to see what happens.

We suspect that by the time you get this, the problem will either have subsided or be subsiding, or it will be continuing without change. If the latter applies it is important to get a conventional medical assessment of what is going on.

Q: I had my second session of acupuncture for whiplash & sprained back. Afterwards I had  pain in my knee where no needles were placed and a large painful bruise on my back. Is that something to be expected?

A:  We are sorry to hear of your experience.

There are a number of possibilities for the pain appearing behind your knee. The bruise which you have, which sounds very unpleasant, depending on where it is may be impingeing a nerve in your lower back which is creating the sensation of pain in the knee. This may something like a referred pain, where you feel something as though it were behind the knee but it actually comes from pressure on the nerve higher up.

A second, and perhaps likelier, possibility is that the treatment has caused a re-alignment of the back, putting it back into a better position, and as a consequence muscles which have adjusted into different positions are now being forced back into their natural positions and causing a little strain at the insertions of the tendons. We often warn people having treatment for bad backs and necks that this is a strong possibility, and indeed most osteopaths and chiropractors alert patients with these sorts of presenting problems that the first 48 hours after treatment can be a little rocky.

The third possibility is that this is a reaction in an acupuncture point to the problems which you are experiencing. Some points can become spontaneously tender quite some way from the site of illness or injury by a form of resonance between the points and the areas they cover. In some systems of acupuncture, like Japanese Meridian Therapy, this phenomenon is used diagnostically; where the practitioner can find or the patient reports an area of tenderness on the limbs it can often point to an area of weakness inside the body.

In all cases the reaction should subside quite quickly, probably by the time you have received this response. It is very important, though, that you tell the practitioner exactly what you experience, and also make sure that he or she sees the bruise (we are sure that they will, but just in case....). Bruising is a relatively common side effect of treatment (but still rare), but a large painful bruise is not usual. This is something which would usually start within the session, and pressure applied to the point should minimise the effects. If this comes as a surprise to the practitioner it might be good to monitor other points over the next few sessions to see if you bruise very easily. There are both conventional and Chinese medicine reasons for this.

Q:  I have trigeminal neuralgia and have had real succes with acupuncture  in the past but I now live in Waterlooville and he is in Buckinghamshire.  I also have MS and in a wheelchair.  I would be a private patient

A:  We are very pleased to hear that you have had success with the acupuncture treatment of your trigeminal neuralgia. We are often a little cautious in giving advice on this condition because our own clinical experience is a little patchy, but when acupuncture does work the changes can be dramatic.

Finding a new practitioner in the Waterlooville area couldn't be easier. If you go to your home page you will find a postcode search facility. This is by far the best way to find the geographically nearest practitioner. There is also a 'search by other criteria' function which means that, for example, you could locate someone in a town nearby which you visit regularly.

Access may be a little bit of a problem. Many of us work in premises which are not wheelchair friendly because wheelchair friendly means ground floor which can mean more expensive. We have a responsibility under the Equality Act, however, where we cannot provide treatment ourselves to locate or be aware of suitable local provision of a similar kind. Most BAcC members will know which colleagues locally have the most suitable premises for wheelchair access. If there are none then it is a matter of finding someone who is prepared to undertake a home visit. Again, not everyone does this because it can mean having to charge up for travelling time, and in our experience members don't like to appear to be money orientated, but we generally have a number of people in any area who are happy to visit people where they live if there is a suitable area for working.

We hope that you manage to find a suitable practitioner.  

Q:  I went to an acupuncturist for the first time,  I was being treated for weight loss, infertility and stress. At first, I was very relaxed. Then I started going through emotions of upset, then irritability, and then about 20-25 min into it I literally felt like I was going into a panic attack. Is this normal? He made it sound like it wasn't common, but both my nephew and his wife said the same thing happened to them. What would cause this weird sensation and rapid heartbeat panic attack stuff? Just part of the treatment?

A:  We are sorry to hear that your treatment was something of an experience.

Many people find that the first session is a deeply relaxing one, but a small minority find that it can stir up a lot of things. Sometimes this can be at a physical level, where there can be changes to heart rate and breathing, and what feels like the beginning of a panic attack. As often as this are emotional effects, where people find that they experience some moods which appear to come from nowhere, like irritability or anxiety.

From a Chinese medicine perspective all of this is perfectly possible. The practitioner's main aim is to restore balance in the system, and this can mean unblocking energetic blockages which in turn can mean the start of the clearing of pathogenic factors. This can range from straightforward physical stuff, like internal heat being cleared, to emotions  which have been 'stored' and repressed. We have to say, however, that this is not a frequent occurrence, certainly not frequent enough where we would feel that we had to alert someone to it happening before a first session.

There may, of course, be factors in the treatment itself which make a difference. Some people are just very sensitive to needles, and this sensitivity can run in families. In such cases, there is a risk that using too many needles or using to much manipulation of the needles after insertion can make the system go a little haywire. A practitioner will always take note of this reaction and tune down the treatment for the second session to see if that makes a difference. Usually it does because the excessive reaction is a perfect storm of anxiety at a first session, energy unblocking and sensitive system where all three combine to have an effect. Rarely there are cases where someone is always highly sensitive but we have managed to treat people successfully by using a very small number of needles per session. Such patients tend to be very effective responders if one can get the balance of treatment right.

The best thing to do, though, is to talk to the practitioner about your experience. He should be able to make sense of what has happened because he will not only know what he did but also have a good case history in front of him which will allow him to make sense of what has happened.

We hope your subsequent sessions are more relaxing and help you to address your health problems.

Q:  Scalp acupuncture for a child with cerebral palsy.  I need a practitioner in UK with scalp acupuncture..

A:  Scalp acupuncture is a fairly recent development, rather similar to ear acupuncture which was first introduced by Nogier in the 1950s. The main proponent of scalp acupuncture was a Japanese practitioner called Yamamoto, and there are a number of UK practitioners who use his techniques. More recently we have seen training courses run by Suzanne Robidoux who is explaining and promulgating the systems developed by a Chinese practitioner called Dr Feng.

In both these cases, however, the training is at postgraduate level, and there are no agreed standards for what counts as a 'scalp acupuncturist', and therefore no way that we could begin to recognise whom we could recommend. All that we can say is that if you use a search engine like google and type in 'scalp acupuncture' and your city or town, you may find someone who has trained in one of these systems.

There are a number of case reports like this one

which offer considerable encouragement, although we have to say that case studies stand a long way down the chain of evidence because there are so many confounding factors which might skew the results. That said, we are aware of considerable excitement amongst our members at the possibility that scalp acupuncture may offer a treatment for a number of intractable conditions like Parkinsons disease. 

We always advise caution, though: if something is really effective its use tends to proliferate very quickly. We have seen a number of claims for the treatment of degenerative eye conditions, for example, in two clinics in USA and India but nowhere else. That said, this 'expert' had a go at being treated by someone who had just undertaken some training, and it was a remarkably powerful effect which, given some of the traditional points used, is not entirely a surprise.

It is best to be wary of unrealistic expectations, therefore, and the best way to address this is by having clear and measurable outcomes, and by setting clear review dates after each group of four or five sessions to see if there is or has been sustainable change. 



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