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Q: I have focal dystonia affecting the middle finger of my right hand brought on by repetitive strain as I have been working as a secretary for about 40 years. Physiotherapy has not really made any improvement. Would acupuncture help?
A: Focal dystonia is an unusual problem. We are not sure how much you have been told about its causation, but although it has the characteristics of a repetitive strain injury it actually has a great deal more to do with the wiring in the brain brought on by the repeated actions. Musicians are particularly prone to focal dystonia, and sometimes the patterns are very predictable. In guitarists, for example, the third finger is most often affected.
This may explain to some degree why the physiotherapy hasn't been particularly helpful. However, although one might think that acupuncture would be similarly ineffectual, this is where the entirely different theoretical basis of the system of traditional acupuncture may yet offer some hope. As you have probably read, acupuncture treatment is based on using needles to influence the energy of the body, called 'qi'. It is the rhythm, balance and flow of this energy which determines the health and efficient function of the system as a whole and all the individual parts of it. When the flow is impaired for any reason pain and changes in function result.
Had this been an RSI type of problem we would have said with some confidence that acupuncture treatment could well help to restore the local flow and reduce the impact of the problem. This may well still be the case; the diagnosis of this condition can be rather imprecise and unless you have had a scan it might well be an RSI-related problem. If, however, it has a more systemic root then treatment may well be effective on a slightly wider basis, helping to improve overall function.
With conditions like this, however, it is very difficult to say that this remove whether treatment will be of possible benefit. This is why we always recommend that someone visits a local BAcC member for advice and guidance. Most are more than willing to give up a little time without charge to give a face to face assessment of what may be possible. The only thing we would say is that if you do decide to go ahead it is important to set clear review dates for progress and try to sort out an objective measure of improvement.
Q: My mother and I have been seeing an acupuncturist weekly for about a month. We are both experiencing good results, but the sessions are often very painful. My hearing has improved in left ear after 2 sessions. I believe it is about normal and prior I really should have had a hearing aid. My mother suffered hearing loss and left eye kept closing after Bell's palsy and 2 neurosurgeries. The pain in her face has improved, hearing is better and her eye is staying open. The Dr. Is very nice, but sometimes pain from needles going in and being removed is extreme. Is this normal.?
A: We are extremely pleased to hear that you and your mother are making good progress, and we have to say that given the nature of your problems this really is good progress. We are sorry, though, to hear that the treatment is painful. The most that people should experience is a slight and transient discomfort.
One possible explanation is to do with the sensitivity that people have to being needled. The sensations are not purely physical, and there are some reactions to needling which are what we would describe as energetic, usually a dull aching sensation or a mild electrical shock sensation. These tend to pass quite quickly, and are not really what one would call painful. We have seen this kind of sensitivity run in families, but the fact that a friend experienced the same problems suggest that it is the practitioner's technique which is the problem.
This really only leaves a couple of options. Most practitioners can adjust a number of factors in how they work. This can range from using finer needles to using less manipulation of the needles when they are inserted and inserting to less depth. This can often reduce the impact of the needles being inserted, and can make the difference between someone continuing treatment and deciding that it is too unpleasant to continue.
You will find that most, if not all, practitioners are perfectly willing to discuss this with their patients, so you shouldn't feel any embarrassment at asking. However, if the answer is that this is the way that he works and he can't change it, then we're afraid that the only other options are to grit the teeth and accept that this is the price of making improvements or stop having treatment. We suspect that you are doing so well that it would be a shame to stop, so we rather hope that the doctor can adjust his treatment to make it a little less uncomfortable while still giving you the same level of improvement.
Q: My father suffered from brain stroke 5 yrs ago. He is getting physiotherapy but his left hand is still not working. Can he have acupuncture therapy for this? Does this procedure have any side effects?
A: We are sorry to hear of your father's continuing problems.
Let's deal with the easy answer first. There are very few side effects from acupuncture, and the vast majority are transient. We put together a safety website with the two leading medical acupuncture organisations (www.acupuncturesafety.org.uk) which quotes a number of research studies. These show that acupuncture ranks as one of the safest therapies around. There are occasionally minor reactions to treatment, like headaches or tiredness, and very rarely an injury caused by the needles, but when you consider that there are over 4 million treatments being given each year the number of these is remarkably low.
The other side of your question is more difficult to answer. We have on the BAcC website a very thorough review paper
as well as a simpler factsheet
which are both very encouraging about the use of acupuncture for the after effects of stroke. In China, however, it is common practice to start treatment on the day of the stroke itself and to treat daily or more to try to restore the 'lost' functions as quickly as possible. The received wisdom is that if the treatment is delayed it becomes progressively more difficult to achieve the same level of result and the final outcome may not be as good. This is paralleled by some treatments in the west, where drug intervention on the day may work when a gap means it won't. The fact that your father is now five years on from his stroke suggests that where he is now may not improve a great deal.
However, there's no point in being unduly pessimistic. All of us have taken on cases like this and managed to achieve a great deal more than we expected. The great strength of Chinese medicine is that it treats the individual, not the condition, and there is always a chance that if someone's baseline constitution is strong they may be able to achieve quite a great deal of improvement. Full restoration of function would be a stretch, but some gain may be possible.
The best advice, which we invariably give, is to visit a local BAcC member with your father to get a face to face assessment of what may be possible. Most of our colleagues are more than happy to give up a little time without charge to see whether acupuncture treatment may be of benefit.
Q: I get muscle spasms daily, every morning, in a very specific place, left side lower back, suspect the QL muscle. If allowed to rest, it relaxes and pain disappears after about 15 mins. I am 56 and have had this problem for 40 years but never as frequently as recently. I've had xrays, mri scan but nothing showing up. Would acupuncture help?
A: We are always a little cautious when we want to make comment about western diagnostic techniques, but one of the sayings in one form of psychotherapy is that if the only tool you have is a hammer then the only thing you'll find to hit is nails. X-rays, MRI scans and CAT scans are wonderful devices, but there are always going to be injuries and problems which they cannot identify.
Obviously we say this from the perspective of practitioners of Chinese medicine whose system is based on an understanding of energy, which the Chinese called 'qi'. The rhythm, flow and balance of the energies in the body is what determines our overall health, and whenever there are blockages and distortions in the patterns of flow, pain will result. Exactly what these disruptions are and how they are best addressed is where considerable skill comes in, but in essence it is a very simple underlying premise from which we work. We are not alone in having a different perspective on health, however; cranial osteopaths and chiropractors have complex systems which can understand pathologies in terms which are not always reducible to the testing systems of western medicine, and even the herbal medicine and homeopathic practitioners have ways of addressing issues like these.
We think the best advice that we can give is to visit a local BAcC member for a brief face to face assessment of whether they think they can help. Most are happy to do this without charge to ensure that the therapy is a good 'fit' for the presenting problem. It really benefits no-one if we take on cases where our professional judgement is that our system of medicine is not the best way of going after something.
What, we are sure, will interest the practitioner is what was happening at around the problem started to manifest, albeit a long time ago, and also what the overall underlying pattern of your constitutional energy is. They will be intrigued, as would we be, by the fact that this has persisted so long, and wonder what has prevented the body from healing itself.
We do hope that you find someone who can help you. 40 years is far too long to be in discomfort every morning, and we applaud your stoicism.
Q: Over the last year I have had a lot more problems with cramps. I am only 27 years old and this year. I have had several serious cramps on my quads, hamstrings and calves simultaneously. The cramp in my quads are the worst and the latest time last for 2 and a half hours of intense cramp. Since then my legs have never recovered. I cant really run or doing any leg movements without them tightening up and feeling like they are going into cramp. It almost feels like constant DOMS for months. I was just wondering would acupuncture be effective as the GP's and phyiso have no answer for what I can do?
A: On the face of it it would seem very likely that acupuncture treatment might well be able to help you. The theories and practice of traditional acupuncture rest on a concept of energy, called 'qi', and its flow, rhythm and balance in the body. When the flow is compromised for whatever reason the resulting blockage or stagnation will cause pain which will continue until the blockage is released. We find that there are many conditions which demonstrate this kind of pathology, notably a great many of the repetitive strain injuries, and the use of needles together with ancillary techniques like moxibustion (the use of a warming herb) and cupping can make a huge difference.
A practitioner would be very interested to take down a great deal more case history before being certain about this as a diagnosis, however. DOMS was always thought to be a consequence of the build-up of lactic acid in the body, but more recent assessment seems to suggest that microtrauma to the muscles and tendons can be a contributory factor. The problem with microtears and the inflammatory response which they provoke is that most athletes tend to try to work through the pain, regarding this as likely to improve their overall fitness. The reality appears to be that the microtears never get a chance to settle, and simply become worse and worse. It would be essential to establish whether you had now ceased from all forms of exercise, or whether you were still training, even to a minor extent. If so, then a part of the rehabilitation programme might involve extended rest, together with other treatments.
There is certainly a growing number of acupuncture practitioners who specialise in sports injuries, and if you manage to track one down near to you then it may be worthwhile making a slightly longer journey to someone with this kind of background even though there may be other practitioners who are nearer. Our experience is that it really does help to be able to talk the language of training and understand the specifics of an exercise programmes which may have been a contributory factor. That said, Chinese medicine has existed for 2000 years longer than the average gym, and has addressed the same problems brought on by over-work in an unkind climate effectively. All of our members will be able to offer the same level of acupuncture skill.
Our best advice is to find a practitioner local to you and ask for a brief face to face assessment before committing to treatment. Most of our colleagues are willing to give up a little time without charge to offer a better judgement than we can make at this remove and to advise you on whether acupuncture is the best modality to pursue.
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