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 Q:  I have nerve damage following a spinal surgery, which sadly has complications. I now have chronic pain in my right foot and acute pain in my right lower leg. Would accupunture help?

A:  A great deal depends on whether the nerve damage has been shown to be directly responsible for the pains in your right foot and lower leg, or whether they have simply arisen at the same time as a consequence of the operation.

The reason we make this distinction is that traditional acupuncture is based on an understanding of a flow of energy, called qi, in the body whose balance and rhythms are responsible for everything functioning as it is supposed to. When the flow is disturbed by surgery or injury, this can have considerable consequences, often local to begin with and then becoming systemic as the flow to deeper structures starts to become impaired.

The reason for pointing this out is that is the nerves have been physically damaged by the operation, something which a neurologist should have established very clearly, then we would be dishonest if we did not say that there is not a great deal that treatment with acupuncture can do. There is a small amount of evidence from animal experiments, dismissed by many of our colleagues as 'ratpuncture', that acupuncture treatment may help nerve to regenerate, but whether one can take results from rats and extrapolate this to human beings is completely unclear. We tend to take the view that in the absence of any hard evidence to the contrary, when nerves are physically damaged there is not much to be done.

However, the flow of energy in the body is organised in what are called channels, and major surgery is often very disruptive of the flow of these. If you look on the internet you will see diagrams of channels, two in particular, which run down the centre of the back and then continue down the back of the legs to the feet. If there has been a blockage caused by the surgery, this might create long term pain because of the diminished flow.

It is difficult to give you a definitive view at a distance, however, and your best bet will be to visit a BAcC member local to you for an informal, and hopefully without charge, face to face assessment of whether treatment may be of benefit. There is no doubt that acupuncture can provide relief from pain; this has been one of the most heavily researched and documented areas of effect. The question is always how much relief and how sustainable, and balancing this against a long term continuing expense. A well-trained practitioner, though, should be able to make a relatively rapid assessment of whether the treatment may be able to achieve more than this based on a simple inspection of which areas are affected and how these relate to the flow of channels in the body.

 

Q:  have sarcoidosis and get accupuncture once a week at the hospital.  Lately the nurse has put needles near all the way in( i get them in my hands near the thumb and one in each foot).  I have had accupuncture before which was great but after my last couple of sessions I have lot of pain in my hands an don't feel well for a few days.  Is this normal?

A:It is not unusual to feel slightly different for a couple of days after treatment, even sometimes a little worse than before, and usually the effects are transient and wear off. If they continue for more than two to three days it suggests that the treatment is too strong or that there has been some internal bruising which will continue to cause discomfort until it clears. This may take a week or two.

The points you describe suggest that the nurse is using a treatment with which we are familiar which is often used to reduce pain and also used as a general calming treatment for the whole body. If so, unless the nurse is using very short needles there is a possibility that the very deep insertion is causing excessive stimulation, and the simple answer to that is to insert needles to a lesser depth and to do less with them by way of tweaking and twisting when they are in place. Generally speaking we do not favour putting needles in up to the hilt. We always recommend that practitioner use longer needles inserted half way than short needles to their fullest extent.

The best thing, though, is to describe what has happened to the practitioner and ask if he or she can reduce the strength of the treatment a little. Most responsible practitioners are very much guided by the feedback from patients, and there are patients who are particularly sensitive to acupuncture, whether this be traditional acupuncture or western acupuncture.

We are pleased, though, to hear that it has been of benefit and hope that once you have ironed out this slight problem you will experience the same levels of benefit.

]Q:   Do you work with the NHS can any of your associates  work through the NHS System?

A:  A small number of our members work within the NHS, but this is very much to do with local resources and personal negotiation. It is a stark reality that there is not a great deal of speare funding within the system at the moment, and very few Commissioning Groups are looking to import services which will add to their budgetary concerns. We do not anticipate any national agreements within the foreseeable future

There is a certain amount of acupuncture provisions within the NHS from doctors and physios who incorporate it within their work in specific areas such as back pain, but it is not usually possible to seek out an NHS acupuncturist as such.

Most people look for NHS provision of acupuncture treatment because of the cost, and it is important to point out that most BAcC members are prepared to reduce fees if someone faces genuine hardship in trying to meet the standard rate. There are also a number of facilities called multibed clinics which have been set up with the express inention of making acupuncture more widely available to a wider target group. Details of these can be found at www.acmac.net.

Q:   My uncle has just completed treatment for bowel cancer and he's suffering really badly with burning hot feet. I asked a family friend, who is an acupuncturist, if she thought treatment would help. She seemed to know the symptoms I'd described and called it 'something' syndrome (I can't remember what the name of it was and now I'm not able to get back in touch with her to clarify). Is this something that you are familiar with and could you offer any advice - including if there are any specialists in this area in the north west of England?

A:  While we admire our colleague's diagnostic prowess (!), we'd have to say that the symptom has to be seen in the wider context of the patient's overall patterns of energy. While there may be one or two syndromes where this symptom is central to the diagnosis, it is always possible that it is a secondary reaction to a deeper underlying pattern which could only really be identified by looking very carefully at all aspects of someone's functioning.

We don't know exactly what treatment your uncle has had, although very often it involves surgery and chemotherapy, and occasionally radiotherapy, but we do know that it usually has significant effects on the whole system, and that includes body, mind and emotions. It is really important to be able to assess first hand what effects it has had. This is why in Chinese medicine the same symptom can be treated in dozens of different ways. Even in conventional medicine the great Canadian physician William Osler famously said 'it is more important to find out what patient has the disease than what disease the patient has.'

The best course of action for your uncle is to visit a BAcC member local to him to see if they can give him a brief face to face assessment of whether in their view he would benefit from treatment. The great majority are willing to do this without charge in order to give the patient as much information as possible before they commit to treatment. There are no specialists in this field, but this is not because of the field but because of the nature of Chinese medicine which treats the person, not the named condition. In reality, though, so common is cancer and its treatment in modern times it would be unusual to find a practitioner who has not had experience of treating someone who is recovering after cancer treatment.

Q:  I suffer from recurrent episodes of sinusitis, which leaves me with a blocked nose and extreme headache and facial pain, often for several days/weeks at a time. I am reluctant to use medication and prefer to treat with menthol and steam which is time-consuming and often inconvenient. Can you tell me whether acupuncture has been proven to treat sinusitis?

A:  We sympathise; this 'royal we' used to suffer similarly as a child, and it is surprising how little other people regard this as a debilitating problem, preferring to see people as 'a little blocked up.' It's far worse than that.

We have produced a factsheet

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

which is disappointing in terms of hard evidence, because there isn't really very much. What we do find in clinical practice is that this sort of problem is very often to do with an underlying systemic problem with the fluids of the body as a consequence of which really bad blockages occur locally. Treatment, therefore, involves trying to use needles where the problem is to restore the proper flow of energy and then treating the system as a whole to ensure that what has been unblocked stays unblocked.

Chinese medicine has a very sophisticated view of the workings of the body mind and spirit as an interconnected flow of energy, and the practitioner's role is to look at the whole picture to find out what is going on. Symptoms are rarely the same as the problem itself, more often than not being alarm bells for problems elsewhere. Chinese medicine also extends to looking at the factors which contribute to problems, especially to do with diet and lifestyle, and it is highly likely that a practitioner would look at issues like this to be taken into account alongside treatment.

The best advice we can give, because each person is unique and different, is to visit a BAcC member local to you for advice. What we would say, though, based our own clinical experience is that this is the sort of problem which can be difficult to shift with acupuncture treatment, and it is very sensible if you decide to go ahead to set very clear review periods to assess what change there has been and to try to agree measurable outcomes for improvement. This helps to ensure that the treatment doesn't run away unchecked to twenty or thirty sessions without result because a kind of 'habit' sets in.