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Q:  Scalp acupuncture for child with cerebral palsy. i need a practitioner in UK with experience..in 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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833473/


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. 

Q:  Do you have to have a sink in the same room as the treatment or can there be one out in the corridor or near to the treatment room?

A:  The law in the UK, which for practitioners outside Greater London is the Local Government Miscellaneous Provisions Act 1982 as modified by the Local Government Act 2003, simply says

suitable and sufficient washing facilities for the sole use of operators, including hot and cold water, sanitising soap or detergent

without further stipulation. The more recent legislation in Scotland seeks:

the room to be used for the purposes of carrying out the skin piercing or tattooing has the following facilities– (i) a sink with hot and cold running water and which uses non-hand operated taps;

The London Local Authorities Act 1991, as interpreted by the Special Treatments Working Group suggests

2.11. WASH BASINS

a) An adequate number of wash-hand basins must be available and suitably located in every treatment room or adjoining room and toilet facility;

b) A separate wash-hand basin must be available for the toilet facility;

c) Wash-hand basins must be properly drained and provided with hot and cold mains water.

 

Having taken stock of all these the BAcC decided to opt for:

You must have a washbasin with a clean running hot water supply, preferably wrist, arm or foot operated and for your and other practitioners’ sole use. This must be located in or in the near vicinity (ie not necessitating opening and closing of doors with your hands) of the treatment room. 

We have taken the pragmatic view that with the use of guide tubes for needling and single use needles the risk of infection or cross-infection has been reduced to the extent that suitable care and attention when the sink is outside the room is adequate. One could argue, for example, that even with a basin in the room there are plentiful ways to compromise clean hands - lifting a pen, answering a phone, etc etc - and we have to rely on the fact that most practitioners recognise the risks that exist and take appropriate steps to address them.

We have encountered a small number of Environmental Health Officers who have refused registration to members who do not have a sink directly in the treatment room, and in these cases there are a number of portable sinks which completely satisfy the basic requirements. However, most accept that as long as a practitioner does not have to travel far from the treatment room, and can also regain access without touching the door handles that will pass muster.

Q:  My question regards as to what I should do in between my acupuncture treatments to prolong it's effectiveness? Should I carry on with my regular routine or should I change my daily routine? Also as acupuncture makes me feel more relaxed, can the effects of relaxation be undone if I undergo any stressful activity? Lastly after I finish my acupuncture sessions , will the effects be long lasting or will I need to go for more treatments as I suffer from anxiety?

A:  Good questions!

As far as doing other things is concerned it is really important to discuss with your practitioner the sorts of things which might help, and also to let them know what you are doing. One of the problems we sometimes have is that people tend to throw everything at a problem, and in the end it becomes almost impossible to know which elements of the whole are giving benefits. More importantly, though, traditional acupuncture treats the person, not simply the condition, and so most of us have a considerable number of skills in understanding the overall functioning of the body. This might mean, for example, that we advise someone to avoid certain types of food, or certain types of exercise. In that way the additional things which someone does can all work together to help someone's health.

From this it follows that you should just carry on your daily routine as much as possible. This means that any changes in your system will be very obvious. This often applies to with medications. If someone is taking painkillers, for example, the last thing we want is that they reduce the tablets to see if the treatment is working. Most people take over the counter medicines when they need them, and so it can often be great feedback when the need doesn't arrive as often.

Stressful activity can have an impact on the effects of treatment, but the reality of most modern life is that stress goes with our work and family life, so trying to ask someone if they can avoid stress is a waste of time. We simply have faith that over time someone's reaction to stress will change, whether this be not getting wound up by things that used to be a problem or simply deciding not to put with stressful situations and walking away from the avoidable ones.

The last question is the most important and the most difficult to answer. With problems like anxiety it is often possible to lessen the effects on the person, but there are people who are always going to have a slightly nervous disposition. For them, it may be a case of reducing the effects rather than removing them entirely, so it would not normally be the sort of condition where we would expect a patient to say 'I used to be anxious and now I'm not'. What we very often do is to treat someone weekly for a while to establish a better balance, and then treat them four or five times a year to keep the balance as good as it can be and to help people adjust to the changes in the year. In ancient times the Chinese doctors were paid to keep their patients well rather than treating them after they had become ill. This was dismissed as 'digging a well when you were already thirsty or forging a spear after the battle had started.' Chinese medicine was largely preventive, and we find that patients who take this on board are often able to keep dispositions to anger or anxiety in check. If things go bang, of course, it is just a matter of coming in as and when needed.

The best person to talk to about this is the practitioner. He or she will have a very good idea of what would and wouldn't be a good thing to do, and can work with you to design a programme which really helps the treatment along.

Q:  My daughter (age35) suffers with Ehlers-Danos vulnerability, anxiety and fibromyalgia. Could she be helped by acupuncture?

A:  Ehlers-Danlos Syndrome is one of a number of genetic connective tissue disorders which manifest in a wide array of symptoms and as congenital degenerative conditions are not likely to change or improve. In these circumstances the best that one could hope to achieve with acupuncture would be to relieve some of the symptoms which are manifesting your particular case, and perhaps to slow down the progressive deterioration.

There have been attempts to use acupuncture as part of a package of measures to help people deal with the condition, but no research on the use of acupuncture with conventional treatment in contrast to conventional treatment alone which would allow us to make specific claims. From a Chinese medicine perspective, however, there are a number of ways in which treatment is pitched at systemic problems rather than unique symptoms themselves, and sometimes ways of making sense of a collection of disparate symptoms in a way which Western medicine might not recognise. There may well be some merit in asking the advice of a BAcC practitioner local to you about whether the way in which EDS presents in your particular case makes sense from a different medical perspective.

One caution for possible treatment, however, would be the tendency to bruise and the effect on wound healing. Acupuncture is a remarkably gentle treatment, with especially fine needles being used at relatively shallow levels, and only in severe cases of blood thinning through illness and medication is it contra-indicated. Any practitioner worth their salt will always treat conservatively in cases like yours to gauge how well the body responds to the physical process of treatment.

 
This seems a little more downbeat than we might be tempted to answer now, but we are always very careful not to generate false expectations about what might be possible. We have reviewed the research literature and found nothing which suggests that the situation has changed.

However, we have always found that when someone has a 'headline' condition, like MS, Parkinsons and similar, there is a tendency to see this as the root cause of all afflictions and to use this as the barometer for potential improvement. This particular 'expert' had, many years a ago, a patient who was believed to have MS but resisted definitive testing because her career would have been almost certainly affected by this, the glass ceiling which appears when someone has a chronic degenerative problem. Instead of talking about MS we simply addressed the issues as they presented and made a considerable difference to her health and well being without ever using the words MS as her definition of herself.

Acupuncture has an increasingly encouraging evidence base for treating anxiety, and fibromyalgia can be understood and treated within the conceptual framework of traditional Chinese medicine, 

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

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

so we would say that there is certainly no reason not to try acupuncture treatment. It will not do any harm, and may well help to improve some of the problems which your daughter is experiencing.

Most BAcC members are very happy to give up a little time without charge to discuss with a prospective patient what might be possible, and this also gives the patient a chance to meet the practitioner and see where they work before committing to treatment, which is often a very valuable tool for reassurance.

Q:  I have had three sessions now for neck and nerve pain.  My practitioner  says I am a strong responder. I had a strong flare after the first session, second one was five ,not as many needles, third session( today) very strong reaction ,feeling faint, I am now worried that this will result in a flare from the nerve pain.  What should I do if this happens(.this was my last visit to the therapist).

A:  We are not quite sure what to make of the phrase 'last visit to the therapist'. If we read this correctly it is that someone has done a short course of treatment rather than that you have had enough!

Treating neck and nerve pain can often cause some very strong reactions. There are dozens of nerves travelling up through the neck and into roots within the cervical spine, so treatment aimed at correcting the structure of the upper spine which can often be the source of the pain will have some profound effects. All of the reactions which you have described fit with this, and for neck and lower back pains we often tell new patients that for the first two or three sessions they might often feel a little worse for a day or two after treatment before the pattern of recovery is established.

If you are indeed a strong responder then this may be doubly the case. We do find from time to time that we take on patients who react incredibly strongly to the needles, and the only sensible thing to do is to reduce the number of needles used and to apply less manipulation to the needles. Treatment can be very very gentle if need be, and with strong responders that is often all that you need to achieve a result.

Where people do experience strong reactions, as you have done, these almost invariably wear off within 24 hours, usually after someone has rested or slept. It would be very unusual to find that a pain had been brought on by the acupuncture, and unless there had been physical damage from the needle insertion, itself quite rare, most of these reactions are simply to do with the readjustments which the treatment is trying to achieve. Osteopaths and chiropractors offer similar advice to their patients when they treat backs and necks; as the body is out back into proper shape there will be some pains caused by muscles re-arranging themselves. We deal with energies, and for us this kind of treatment can often cause slight light-headedness and feeling faint if the treatment has been strong.

If this was a fixed course of treatment and you can't go back to the practitioner (possibly an orthodox medical professional working to a fixed plan?) then you could certainly visit a local BAcC member for advice if the symptoms continue. However, we are pretty confident that they will subside, and the fact that acupuncture rarely causes serious adverse events makes us equally confident that there is no reason for your nerve pain to return. If it does, then it may well be worth dropping in to see your GP if the problem persists for a week or more. 


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