As our factsheet shows
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/gout.html
 
there have been a number of studies, mainly in China, which seem to show encouraging results in the use of acupuncture treatment for gout. As the sheet sasys, however, these are few in number, and because they were conducted in China, doubt is often cast on their methodological soundness. This is often a little unfair, because the focus of Chinese research is often a little different - they are sometimes less concerned to establish whether acupuncture works than what works best. In the West, the former question is paramount and the inappropriate model of drug testing, the randomised control trial, used as the standard test.
 
Since the factsheet was written there has been a systematic review of trials
 
http://www.ncbi.nlm.nih.gov/pubmed/23424263
 
which again gives some very encouraging evidence that acupuncture treatment may be of benefit.
 
There is no doubt that in conventional medicine the use of allopurinol together with a sensible approach to diet, can minimise the attacks that a gout sufferer has. When we take on patients with conditions like this where the medication works, we are always very careful not to let patients stop medication which has been working well. The danger with stopping allopurinol is that it cannot be used to treat an acute attack, and a sudden rise in uric acid caused by a peremptory break might bring one on. If you were considering coming off long term medication we would advise that you discuss the situation with your GP.
 
In summary, though, you could do well to visit a BAcC member local to you to discuss your specific case. Gout appears in many joints, and some are more treatable than others. There are also on occasion a number of ways of understanding the inflammation from a Chinese medicine perspective which offer more clearly defined treatment strategies than others, but this would require a brief face to face asssessment. 
 

Q:  I completed a course of daily radiology on April 5th 2013 this was successful as on 17th May my PSA was down to 0.38.  I have three monthly hormone injections which keep the prostate cancer under control, the side effects of these is of course hot flushes, my oncologist and the senior oncology nurse feel that acupuncture would help with this problem, please advise.

A:  From an evidence based perspective this is a difficult question to answer. There are very few studies to look at the incidence of hot flushes in post-radiotherapy men, although a considerable number looking at hot flushes in the menopausal woman. There are a number of systematic reviews of acupuncture used  post-radiotherapy over a wider range of conditions, such as
 
http://www.ncbi.nlm.nih.gov/pubmed/23341529
 
but the results tend to be assessed as inconclusive, mainly because the trial designs are regarded as inadequate rather than there being no changes.
 
There are also a number of small studies into the effects of the use of acupuncture to reduce the side-effects of hormone therapy, and the one reported here
 
http://www.sciencedaily.com/releases/2011/04/110421122406.htm
 
can be found at:
 
http://www.redjournal.org/article/S0360-3016(10)00124-0/abstract
 
There are a number of encouraging trial results for using acupuncture for xerostomia, a dry mouth brought on by the treatment, and this is interesting because it is a manifestation in Chinese medicine terms of excess heat in the system causing the loss of body fluids. From this perspective radiotherapy generates a great deal of heat within the body. Stephen Gascoigne, a medical doctor and acupuncturist whose textbooks are used in training institutions, has just written an article for our Newsletter which describes the effects of of cancer treatments in Chinese terms, and talks about the use of radiotherapy as something which 'burns and dries yin and blood'. This would create in the patient the sort of energetic balance which is naturally experienced by a woman entering the menopause, where the yin and blood are beginning to diminish with exactly the same sort of consequence of hot flushes as you are experiencing. When followed up with a course of three monthly hormone treatments, the problem is further compounded. The medications are likely to add to the underlying problem caused by the radiotherapy as understood from a Chinese medicine perspective. 
 
From this perspective, therefore, it should be possible to do something which helps to address the problem you have. The practitioner will, of course, not simply be looking at this symptom but at the whole way in which your system functions. Clearly, however, the oncologist has had good reports and feedback about acupuncture treatment for alleviating the side effects of the hormone treatment, and we are very encouraged by their recommendation.
 
The advice, as always, is to contact a BAcC member local to you and ask for a face to face assessment. Someone who can actually see what is happening in your system will be able to give you a far better idea of what can be done than we can at a distance.     
 
 

It is always gratifying to be able to say very positively that it has been accepted that acupuncture can be used to treat regular/chronic tension-type headaches. The latest NICE guidelines recommend a course of up to 10 sessions to deal with the problem.
 
Although we are very pleased with the acceptance of acupuncture for another 'condition', as our Research Officer Mark Bovey writes in an article here
 
http://www.acnr.co.uk/2013/01/acupuncture-for-headache/
 
we treat a little cautiously, even with such encouraging news. The kinds of research which are accepted by the conventional medical establishment favour trials of a design which we would not use to look at acupuncture. The more the treatments fit the protocol, the less they resemble what a skilled practitioner would do in clinic. Chinese medicine is dynamic and evolutionary; when someone has treatment, the treatment is adjusted for how things progress, whereas in research trials people use the same points formula over and over again.
 
What this means from our perspective, though, is, to use the quote from George Orwell's famous novel Animal Farm, 'two legs good, four legs better'. If sub-optimal treatment, i.e. formula treatment has been shown to work for treating headaches, specifically designed treatment is likely to be more effective still. The match between western named conditions and Chinese medicine diagnosis is often not a precise one. A single symptom like a headache could result from dozens of different causes as understood by Chinese medicine, and the skill and art of the practitioner lies in assessing the unique balance of the patient to determine how to deal with this unique presentation.
 
Our factsheet on headaches
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/headache.html
 
also gives some useful background on headaches and research, but our advice remains the same as we would give for any condition for which the evidence was not necessarily as strong: visit a BAcC member local to you and ask for a brief face to face assessment of whether acupuncture treatment may be beneficial to you. There are occasions, for example, where someone may feel that cranial osteopathy or another form of treatment was more appropriate, and we trust our members to do what is best for the patient, not simply to book patients in willy-nilly.     

Long gone are the days when the treatment for a ganglion was to lay the hand flat on the table and drop the family bible onto it. Current conventional medical treatment is to aspirate the rather thick, clear jelly-like content from the cyst at a GP surgery or occasionally to have a minor operation in the hospital day surgery unit. These latter are less frequent because they are regarded as relatively low priority, and also can be quite complicated if the cyst is entwined with nerves and blood vessels, as is often the case in the wrist area.  We are assuming that you have seen your GP and had the options explained to you. If yoyu haven't this is always a worthwhile thing to do. GPs are very adept at making judgements about what may appear to be simpler conditions which in reality aren't, and having your GP take a look is a wise move.
 
From a Chinese medicine perspective any accumulation and thickening of fluids in the body points either to a local obstruction in the flow of energy, called 'qi' in Chinese medicine, or to a systemic problem which manifests in a number of problems across the body and mind as a whole. A skilled practitioner can quickly make this determination, and treat accordingly. The greater majority of cases we come across are local problems, often caused by muscular tensions which constrict the flow of fluids and blood. Treatment can help to reduce the tension and encourage flow, but can also help to disperse the thickened fluids. From a Chinese medicine point of view these are 'stuck' qi, and needling moves the qi and reduces the lump.
 
You won't, of course, find any clinical evidence for this; it is one of the least likely problems to be researched at great expense. Our experience, however, is that acupuncture may be helpful, but we always taken into account the other factors which may have contributed to the cysts' occurrence. There may be postural reasons - work stations, frequent use of the joint in a skilled operation - which mean that the cyst will return. There may also be wider tensions and stresses in the system which again may result from lifestyle. Addressing a small problem like a cyst may not work if it is part of a wider pattern of disharmony.
 
The best advice we can give you is to seek the face to face opinion of a BAcC member local to you. Our own feeling is that if you did decide to have treatment, the results would manifest relatively quickly or not at all, and you should not get tied into a long sequence of treatment. If it does work, the question then remains about how sustainable the improvement is. If treatment is only successful for a short time, then it may be worth discussing with your practitioner whether some forms of massage may be a more effective way of addressing the problem, either Chinese massage such as tui na or orthodox massage.  
 
  
 
 
 

Q:  I have had a question from one of my OT colleagues regarding acupuncture for facial tension/pain. She is seeing someone who can manage all other muscle tension using stretches but struggles with facial tension and pain.   Is there any evidence for the use of acupuncture in facial tension/pain?

A:  There is some evidence for specific types of facial pain, as our factsheet
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/facial-pain.html
 
shows.  We have also come across specific examples of facial pain, and even been asked on this site about them, as you can see at:
 
http://www.acupuncture.org.uk/public-content/public-ask-an-expert/ask-an-expert-neuro-and-psycho-logical/ask-an-expert-neuro-and-psycho-logical-neuralgia/i-have-nerve-face-pain-would-acupuncture-help.html
 
and
 
http://www.acupuncture.org.uk/public-content/public-ask-an-expert/ask-an-expert-general/can-acupuncture-help-facial-pain.html
 
Looking at the range of different pains and causes mentioned in these examples, we think that your colleague may be best served by visiting a BAcC member local to her and asking for a brief face to face assessment of whether acupuncture treatment might be of benefit. There may be systemic problems which a practitioner could quite quickly identify, or it may simply be due to blockages in the local flow of energy, called 'qi' in Chinese medicine. In either case, a practitioner would tend to be careful in over-estimating what might be achieved, and if treatment was chosen as an option, there would be regular reviews of progress. In our experience problems like this respond relatively quickly or not at all.
 
The one caution we would offer is that there is currently a great deal of publicity about cosmetic acupuncture, using acupuncture as a means of reducing wrinkles, firming up muscle tone, relaxing tension, and so on. Not all of this is being offered by responsible and well-trained practitioners. To put it bluntly there is a huge market out there, and a very cash-rich one, and we have seen examples of extremely high prices being charged for what we would consider to be routine acupuncture work. In our view the local treatments offered need to be underpinned by systemic treatment to have any chance of the effect being maintained. This is in keeping with our overall philosphy of treating the person, not their constituent parts. We remain concerned, however, that there are sectors of the acupuncture-using world where people take advantage of someone's vulnerability and concern, and we advise people to exercise caution when offered unlikely outcomes.