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Q:  I am interested in having acupuncture as I am suffering from a dissociative condition called Depersonalisation Disorder at the moment, and - in order to aid my recovery - am trying to reduce my anxiety levels. I am taking some anti-anxiety medication (Venlafaxine) and am on the waiting list to be seen by a specialist at The Maudsley but, in the meantime, thought it worth pursuing some other avenues. I just read the following on your website which prompted me to get in touch:

Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety by:
Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the 'analytical' brain, which is responsible for anxiety and worry (Hui 2010).
Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain's mood chemistry to help to combat negative affective states (Lee 2009; Samuels 2008; Zhou 2008; Yuan 2007). Would you suggest I pursue acupuncture?


A:  The information which you quote is probably the least representative material on our website of what we actually do. There has been a considerable amount of research into acupuncture looking at the effect of treatment on specific chemical and hormone balances in the body, and unsurprisingly sticking needles in people does tend to change these. However, the acupuncture used in the studies is often very much formula/cookbook style of treatment (it has to be to meet the criteria for the gold standard of medical research, the randomised double blind control trial), and our usual take on this is to ask how much better the results would be if the treatment was tailored to the individual needs of the specific patient, as our work always is.

We do treat many patients with anxiety, as you know from looking at the factsheets where the information you quote comes from. However, we always take great care to understand what someone's experience of anxiety is, what it actually means to them to be anxious. Some people find this kind of talk odd, but disease labels like anxiety and depression can mean vastly different things to different people, and the pathological changes in someone physical, mental and spiritual functions can be very different and point in an almost limitless direction of potential treatments.

DPD is an odd condition, but it will not surprise you to know that that ancient Chinese had ways of understanding the feelings with which you may be familiar, such as the dissociation and feeling of being outside oneself. That does not necessarily mean that this offers treatment solutions in the modern world, but the way in which you experience some of the episodes may greatly enhance a practitioner's understanding of what is going on.

We think that there would be no harm in trying acupuncture, but we would very much recommend that before committing to treatment you arrange to meet a practitioner or number of practitioners in your area. You may find that some will be reluctant to take your case on; some may feel that it is not within their scope of practice or limits of competence. However, most will, and it would give you a chance to meet them and see where they work before committing.

A:  This is quite a difficult question to answer without knowing a little more about the swelling. There are all sorts of reasons why a thyroid gland can swell, from a benign cyst which can be drained through to the goitres one would associate with Hashimoto's Disease or Graves Disease. If we are talking about the latter, where the swelling is a part of a larger pattern of pathological changes in the body, then acupuncture may be more relevant but the advice less specific.

If this is a pattern of thyroid enlargement causing hyperthyroidism (over-active thyroid) then the evidence from research for the use of acupuncture is not that encouraging or plentiful. Our factsheet

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

cites three studies which address some of the more common manifestations of hyperthyroidism, but while the results are quite positive the samples are too small to generalise.  there are some Chinese studies of the treatment of benign thyroid nodules, and these again, while encouraging, are quite small.

However, one of the great dangers in trading in symptoms from a conventional medical perspective is that it does not do justice to Chinese medicine theory which has developed over 2500 years. Thyroid problems are not new, and although the ancient Chinese would not have understood hormone levels and thyroid function as we know it, they would certainly have made sense of all of the symptoms associated with thyroid hyperactivity, and would have been able to address them within the system of medicine. That does not mean that they would always be able to treat them successfully, and we have to be very careful not to let our maxim of 'treating the person, not the disease' lead people to believe that anything is possible. However, it does mean that there is a chance of bringing the symptoms under control.

However, without more specific information we would struggle to say more. It may simply be a benign swelling, in which case there may be more cause for optimism about what treatment can achieve. What we always say, though, is that if you are on medication for thyroid malfunction we always tread with great care. It can take a long time to achieve a good working balance from a diseased thyroid, and treatment can affect a good balance which has taken months of establish. We tend to work as closely as we can with a patient's medical team to ensure that everything is managed to maintain a good and stable pattern.

The best advice we can give is that you pop along to see one of our members local to you. This will give you the best chance to describe in greater detail what is going on and to be able to get from them a better idea of what may be possible. 

Q: Two questions; the first, could you tell me the procedure for acupuncture to treat anxiety and second, could you tell me of any specialist acupuncturists that treat anxiety in my area. I live in Newark on Trent NG24.

A:  This may seem a little bit of a non-answer but there are no specific procedures for treating anxiety, nor specific points used for the treatment. The great strength of Chinese medicine is that it treats every person as a unique individual, and treatment is accordingly personalised to the unique needs of each individual. Western disease labels are useful but far too inclusive, and a practitioner of Chinese medicine will want to know exactly how you experience anxiety. There is a cluster of possible symptoms, and seen from a Chinese medicine perspective these will illuminate a diagnosis about how the system as a whole is coping. Treatment is then primarily aimed at restoring balance to the whole system in the simple but effective (from our point of view!) that a system in balance sorts itself out.

There are obviously some parts of the system which are more likely to be implicated in the usual suspects of anxiety, like palpitations, insomnia or panic attacks, but in Chinese medicine the symptom and the cause are rarely the same thing. Treating symptoms after a cook-book formula style may buy someone a little bit of remission, but will not be as effective as treating the underlying problem. This is where the true skill and art of the practitioner lies.

It also follows that there are no specialists in this area. We are all equally well trained to treat people, whatever their specific symptoms. There is a small number of areas like paediatrics and obstetrics where we are in the process of recognising what counts as expert practice, but we do not anticipate defining expert practice in areas like anxiety or depression for the foreseeable future. In fact in ancient China the specialist was somewhat looked down on for only treating a small range of problems, and the generalist was the most highly esteemed.

If you use the postcode facility on our home page you will be able to find a number of practitioners who are geographically closest to where you live. Most are more than happy to afford you a short time without charge to discuss how acupuncture may be of benefit to you, and this will give you an opportunity to meet them and see where they work, which many prospective patients find very reassuring.

 

Q:  I had acupuncture as part of my physio session on Monday.  I willl be honest my back ache since being treated has got worse.   I've  also developed a pulsing sensation in my top lip but only on one side.  I have  also suffered a partial loss of feeling to this area. I can bite it and I can feel the pressure on my lip however it doesnt hurt whereas if I bite the other side it does hurt.

A:We can understand the increased pain in the back. As we have mentioned many times before we, in common with osteopaths and chiropractors, often warn patients with back and neck problems that their symptoms might be more exaggerated for about 24-48 hours, after which they will subside and usually improve. There are all sorts of possible explanations for this, on none of which is their agreement, but the phenomenon is well enough known to make the warning a normal part of practice.

We are a little more concerned by the strange symptom that you now have. A great deal depends on where needles were inserted, and we have to assume that nothing was placed in the face proximate to what is happening. There is a very remote possibility that a needle in the head or neck might have generated the loss of sensation, but it would be a very remote possibility and the chances are that you would have felt something while it happened.

While not wishing to be alarmist, we think that you should really get this checked by your GP pretty quickly. It may just be that the symptom's appearance is entirely coincidental and has nothing to do with the treatment itself. Rather than let people get involved in pointless arguments of the 'you did this, no I didn't' kind we always advise patients to get things checked and addressed first. This usually establishes causation pretty quickly, and with it any possible liability. The key thing is to get the symptom checked as soon as possible.

We do have, and always have had, a few misgivings about western medical acupuncture sometimes generating symptoms by working from an entirely different theoretical basis which of necessity does not take into account the energetic connections on which our work is based. There is a point used for the treatment of tennis elbow, for example, which can drastically lower blood pressure in our system, and if it is treated over-vigorously could have serious consequences in some patients. However, without knowing which points were used it is difficult to say, and even then we are hard pressed to think what might have been needled which could cause this to happen.

Of course, the other person you could contact is the physio him or herself. We are completely confident that they will respond to your problem and can work work with you to find out what has happened, with the obvious advantage that they know what they have been needling and any possible neurophysiological causes it may have.

Q:. Two questions; the first, could you tell me the procedure for acupuncture to treat anxiety and second, could you tell me of any specialist acupuncturists that treat anxiety in my area. I live in Newark on Trent NG24. 

A: This may seem a little bit of a non-answer but there are no specific procedures for treating anxiety, nor specific points used for the treatment. The great strength of Chinese medicine is that it treats every person as a unique individual, and treatment is accordingly personalised to the unique needs of each individual. Western disease labels are useful but far too inclusive, and a practitioner of Chinese medicine will want to know exactly how you experience anxiety. There is a cluster of possible symptoms, and seen from a Chinese medicine perspective these will illuminate a diagnosis about how the system as a whole is coping. Treatment is then primarily aimed at restoring balance to the whole system in the simple but effective (from our point of view!) that a system in balance sorts itself out. 

There are obviously some parts of the system which are more likely to be implicated in the usual suspects of anxiety, like palpitations, insomnia or panic attacks, but in Chinese medicine the symptom and the cause are rarely the same thing. Treating symptoms after a cook-book formula style may buy someone a little bit of remission, but will not be as effective as treating the underlying problem. This is where the true skill and art of the practitioner lies.

It also follows that there are no specialists in this area. We are all equally well trained to treat people, whatever their specific symptoms. There is a small number of areas like paediatrics and obstetrics where we are in the process of recognising what counts as expert practice, but we do not anticipate defining expert practice in areas like anxiety or depression for the foreseeable future. In fact in ancient China the specialist was somewhat looked down on for only treating a small range of problems, and the generalist was the most highly esteemed.

If you use the postcode facility on our home page you will be able to find a number of practitioners who are geographically closest to where you live. Most are more than happy to afford you a short time without charge to discuss how acupuncture may be of benefit to you, and this will give you an opportunity to meet them and see where they work, which many prospective patients find very reassuring.

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