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Q: I have a really nasty trigger point in one of my scalene muscles. I'm a physio myself and I have tried treating it with many techniques but nothing I try seems to help. When it's aggravated (usually by faulty breathing patterns and stress) it causes excruciating and nauseating pain mainly down the medial border of my scapula and has been a problem for years.
I know acupuncture can be an effective way of treating trigger points but I wonder if it would be of any help for a scalene trigger point given the difficulty in locating it in amoungst the other vital structures in the neck. Is acupuncture an option for me or should I look for a different treatment?
A: A very nicely technical question! Trigger point acupuncture is usually associated with western medical acupuncture where it remains one of the primary modes of intervention. Although many of the trigger points equate directly to Chinese acupuncture points, it would be unusual for a Chinese medicine practitioner to use points as vigorously, although some undoubtedly do. There are similar points in Chinese medicine, called Ah Shi points, which are located by palpation (it literally means 'it hurts here') and needled to disperse local stagnation and blockage.
However, the strength of Chinese medicine lies in its theories of interconnection and action at a distance, and it is not uncommon in cases like yours for the treatment to be a mixture of local and distal points which lie on the same channel through a knotted area or point. Quite often the local needles are used very gently as well; there is a school of thought that jamming a needle hard into a knotted area simply makes it even more uncomfortable, and Japanese acupuncture practice, for example uses very gentle superficial needling to effect some very profound changes.
The short answer, then, is that we think it is worth a go, but probably only a couple of treatments, given that you have been working on yourself already without success. If this does not work we wonder whether cranial osteopathy may not be a good technique to explore. Although it is at the slightly more outre end of the complementary medicine spectrum we have also had several patients who have used Bowen Technique for similar problems, although we are aware that there is considerable scepticism about its theoretical basis. Patients are less interested in this than in what works, though, and we have had a number who have used this therapy to good effect.
Q: have been diagnosed with arthritis in my back and neck and spondulosis in my neck my arms and fingers are also painfull and stiff. Will acupuncture help?
A: The pains and discomfort you describe are familiar to us; a great many patients present with arthritic pain in the back and neck, and secondary problems in the arms and fingers. There is certainly a growing body of evidence that acupuncture can be very beneficial in helping with the pain and discomfort of arthritis, as our factsheet shows
and you are also probably aware that acupuncture is now one of the treatments recommended in NICE guidelines for back pains which have gone on for more than six months.
However, the mention of spondylosis adds a slightly different dimension to what we can say. If the deterioration and fusing of the vertebrae has been quite considerable this will seriously limit what acupuncture treatment can achieve. In 'straightforward' arthritis, there are a number of protocols in Chinese medicine which help to explain the swelling, heat and pain in a joint, and with the explanation come a variety of treatment options. Once there has been a physical change in a joint, however, or the fusing which is common in spondylosis, some of the treatment options are not likely to offer much relief, and pain management may become the name of the game. Acupuncture does have a deserved reputation for pain relief, but the critical question is always how much relief and how sustainable it is.
However, Chinese medicine operates from an entirely different theoretical basis which sees the health of the body as being dependent on a good flow of energy, and understands illness and disease as arising from an impairment in the flow. There may be ways of interpreting what is happening to you in terms of Chinese medicine which sound a little more hopeful than the picture we have painted, and the best advice we can give you is to visit a BAcC member local to you for a much more informed assessment than we can give at a distance. We are confident that they will give you an honest assessment of the possible benefit of acupuncture treatment and a number of suggestions for alternative approaches if acupuncture seemed to be not the best way forward.
Q: I am enquiring which is the best acupuncture training course in London. I already possess a Bsc Hons in Complementary Therapies and looking to do a post graduate course.
A: We are afraid that we are not in a position to say which is the best acupuncture course in London. Clearly we believe that the courses accredited by the British Acupuncture Accreditation Board
which offer automatic eligibility for entry to the BAcC are all of a comparable high standard, but there are others on whose standards we are not able to pass comment.
The problem may well be to what extent you can have your current BSc taken into account in seeking an exemption from parts of the training. The degree level training which all accredited courses offer does contain at least two thirds of the full time training in the study of acupuncture. It is possible that you may be able to gain an exemption from the western medical component if your training already covered this, but whether some of the skills in your existing degree are generic and could be offset against the requirements of the teaching institution for the training is not clear.
What we can say with certainty is that there are very few postgraduate courses in traditional acupuncture which would enable someone with a health-related degree to become a BAcC member on completion. Most that exist are only provided for western medical acupuncture, which is seen as self-contained module and added to an existing scope of practice as another tool in the toolbox.
Your best bet is to establish contact with course leaders in the London area or easily commutable courses and discuss your individual case with them. We are aware, for example, that one of the university based courses in the capital did have an acupuncture programme running alongside a complementary therapy degree, and there were students who crossed from one course to another by virtue of the modular structure of the training. We understood that this has now ceased, but we may be wrong, and a direct approach to the courses may well be the best way forward.
In our view, the most likely outcome is that it may require another two years training to achieve the same entry level as the average degree entrant to the BAcC unless some of the components of your first degree are clearly replicating large chunks of the timetable for the dedicated acupuncture courses.
Q: 12 months ago I suffered from a herpes simplex infection on my face, it was severe and my face was very swollen. It was treated with antibiotics. Since then I have had very very dry skin on my face and for the last few months a very dry scalp and now my hair is thinning. The lotions/shampoos have been prescribed but I am still suffering. I am now feeling very low, especially with the hair loss. I have just suddenly thought of acupuncture, which I have had successfully before for stressed shoulders, could it possibly help my dry skin?
A: Acupuncture treatment certainly wouldn't do any harm, but whether it might definitely do any good is more difficult to say. We have a factsheet on another variety of the herpes virus, herpes zoster or shingles
which gives some encouragement, but the evidence for the treatment of herpes simplex is a great deal thinner on the ground and dates back to nearly twenty years ago, at least what we could find.
From a Chinese medicine perspective, the name which one gives to a condition is less important than the symptoms which the patient has and the diagnostic signs which in tandem with them enable a practitioner to identify what is happening from a Chinese medicine perspective. The dryness which manifests on your face and head may be a local problem which results from the virus you have had, or it may be the local manifestation of a much more general systemic problem. The skill of the practitioner lies in being able to ensure that treatment is aimed not simply at eradicating the symptom but ensuring that it does not return.
The best advice we can give is that you seek a brief face to face consultation with a BAcC member local to you to see whether acupuncture may be a good option for you. We do need to note a slight caution, however, and that is that we think that if you have not done so you should make sure your conventional medical practitioner is aware of what is happening.
Q: I am considering having acupuncture re non surgical face lift, would you like to recommend a qualified person and what qualifications should they have?
A: The advent of facial or cosmetic acupuncture is one of a number of areas where members undertake postgraduate training in a specific field to treat a particular group of patients. There are, however, as yet no agreed standards for each of these fields, of which cosmetic acupuncture is one.
All that we can say at this stage is that there are a number of courses which members and other practitioners offer in facial or cosmetic acupuncture which offer qualifications but none of these is as yet officially recognised. What we feel is that the use of these specific treatments is most effective if it is accompanied by treatment of the person according to traditional acupuncture principles. There aren'y different forms of acupuncture, and cosmetic acupuncture is not a separate field. The points uses are often in classical locations but there are a number of techniques which are not usually applied and for which people do have extra training.
As such there is no-one we can recommend as such, not any one qualification which we can vouchsafe. The best advice is to undertake a google search with the label 'facial acupuncture' or 'cosmetic acupuncture' and your area, and you will undoubtedly find one or two names. All that we can say is that you should ensure that anyone you go to belongs to a professional body and holds proper insurance. We have heard of beauty consultants undertaking weekend or day training, and we do not believe that this is adequate preparation for the safe and competent practice of acupuncture, nor that the techniques should be used without an underpinning of proper treatment.