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A:  We have to be a little cautious about how we respond to questions like. If you undertake database researches for all forms of prolapse there is very little evidence for the effective use of acupuncture as a treatment. There are many reasons for this. There are some studies, but these are mainly Chinese, have often not been translated, and usually fail to meet the standards of methodological rigour adopted in the West. It is also quite difficult to assemble a trial group; there are many different reasons why prolapse can occur, and for research purposes there has to be complete consistency across all elements of a trial.

That said, Chinese medicine operates from an entirely different theoretical basis involving an understanding of the body as a system of energy, called 'qi', and its flow and balance. The Organs of trhe body (we always capitalise them when we talk about them in the Chinese medicine context) are seen as a group of fucntions which overlap with some of the functions which we recognise in the West but are far more wide in their definition. One of the Organs, the Spleen, is in Chinese thought responsible for the internal gravity of the body, making sure that everything is held up. Not surprisingly, when this is weakened, things start to descend, and prolapses are a well-established consequence in Chinese medicine of weakness of Spleen energy.

Where symptoms appear, though, and what might be causing them are two entirely different issues. The system of energy is one of complex interrelationships, and the fact that a symptom is caused by a weakness does not mean that this is where the weakness originated. The great strength of Chinese medcine is that it seeks to establish which part of the system is the underlying cause. Otherwise, just treatment the symptom, even from a Chinese perspective, will not hold.

The best advice that we can give you is to visit a BAcC member local to you for a brief face to face assessment. This should very quickly establish whether this part of the system is weakened, but also give a better idea of the context in which the symptom is occurring. You may find that the practitioner may recommend that you look at other options to accompany acupuncture treatment. We find that women can often set out to do pelvic floor exercises on a regular basis, but all of us tend to be better at following routines where we are accountable to others, and we find that many patients find Pilates classes very effective as a way of reinforcing improvements gained through treatment.

A:  When someone has a serious neurological disorder like MND it is quite common for nearly every new symptom in the body to be ascribed to this. We have the same experience treating people with MS or Parkinsons. In the vast majority of cases the symptoms will be to do with the primary condition but there are a few occasions where there is no necessary connection between the symptom and the headline condition, and for these acupuncture treatment may be of value.

Certainly the symptom as you describe it could be explained within the system of Chinese medicine. You may or may not know that the theory is based on an understanding of the body as a system of energy, called qi (pronounced 'chee') , whose flow and balance are essential to good health. Qi is said to provide nourishment and warmth to all parts of the body, so if the flow is impaired this can cause areas to become weak, cold and generally less healthy.

An experienced practitioner will be able to assess very quickly from a brief face to face assessment how likely this is to be the case, and if they believe it is something that is amenable to treatment they will be give you a good estimate of how much treatment may be necessary. We believe that with problems like this there is often quite a rapid response or none at all, and two or three sessions should give a clear indication of whether the treatment will work. What we try to avoid is the victory of hope over experience, with people committing to long courses of treatment where there is clearly nothing happening.

Most BAcC members are more than happy to give up a few moments without charge to deal with these kinds of enquiries face to face, and there is almost certain to be someone working close to where your friend lives. The postcode search facility on our home page is very good for identifying the closest member.

Q: Good to have this blog to post questions.  My question is we have consulted a physio for neck pain and the physio instructed that it's due to trapezius muscle knot and he has given me acupuncture treatment. The neck pain has reduced but have the  trapezius muscle pain. I am worrying if its due to acupuncture treatment? What are the side effects for trapezius muscle acupuncture?

A:If we understand you correctly, the treatment for the neck involved releasing the trapezius muscle and now that the neck pain has reduced the trapezius is painful instead.

A great deal depends on how long it is since the treatment was given. Many physiotherapists use forms of what is known as 'trigger point' acupuncture. This is a western acupuncture approach which involves locating and treating tight spots in the muscle fibres which cause pain where they are and also cause muscle contraction which can then cause pain further down the line. Trigger point treatment often involves using longer and thicker needles than we would use in traditional acupuncture, and the treatment itself can sometimes leave a painful area for a few days. There is sometimes a little internal bruising after this technique, and this can also take a short while to go. You could normally expect this kind of pain to go after 48-72 hours, although if the treatment has been epecially vigorous this may be as long as a week.

If the pain persists after this the first person you should speak to is the physion himself; he will be in the best position to assess what is happening because he will know exactly what he has done, and may be able to apply further treatment and exercises to help to resolve the problem. If this does not do the trick then the next port of call is your GP. However, we strongly suspect that the problem will have gone long before you reach this stage.

The other possibility to consider is that sometimes a severe pain can overshadow another pain in the same area, and when the primary pain goes, the second one becomes more noticeable. This is very common in feedback when people have multiple problems. Here again the physio is the best person to speak to. If he has managed to reduce the neck pain, then he can probably release the trapezius pain too.

There shouldn't be any especially noticeable side effects from this treatment. Clearly if the treatment is vigorous you may feel a little bruised in the area for up to 48 hours, but if the physio recognises from your first session that you are quite sensitive to the needling he may well reduce the intensity of the treatment to make the after-effects a little less noticeable.

We hope that this reassures you.

A:  We drew up a review paper some years ago

http://www.acupuncture.org.uk/arrc/public-review-papers/substance-abuse-and-acupuncture-the-evidence-for-effectiveness.html

which summarises the use of acupuncture treatment for a number of substance abuse problems, and as you can see in the paper, the evidence for the use of acupuncture is relatively positive, although the trials undertaken are often methodologically flawed and rather small to be used as a basis for definitive statements. The most recent systematic review in 2009 reached this conclusion, and nothing significant has been published more recently to change this view.

However, although mainstream acupuncture treatment is used to deal with the problems of alcoholism, there are a great many projects which use a more limited form of acupuncture, ear acupuncture or auricular acupuncture as it is often known. There are two very large national groups, NADA-UK (http://www.nadauk.com/) and SMART-UK (http://www.smart-uk.com) whose members offer the five-point protocol and other formula treatments for helping people to deal with the problems of alcohol, and details of where practitioners can be found are on both websites. A great deal of their work is done in drop-in facilities, and some provide additional support and counselling as a part of the service.

There are also a substantial number of practitioners who belong to the Microsystems Acupuncture Regulatory Working Group which is registered with the PSA-accredited Complementary and Natural Healthcare Council. This group includes a number of organisations whose members offer more sophisticated auricular treatment than simple protocols, and their details can be found here (http://www.macrwg.org/).

This does not mean that the ordinary BAcC member does not treat people with alcohol problems, and many do to great effect. Our experience, however, is that the group setting of the detox projects often adds considerable value to the treatment through the peer pressure and encouragement which abounds. It may still be worthwhile seeking the advice of a local BAcC member, however. There are huge variations in the experience of alcoholism, from falling down drunk to a simple realisation that the end of work day drink is becoming a necessity rather than a treat, and our members may well be able to provide exactly what someone needs.

 Q:  I have nerve damage following a spinal surgery, which sadly has complications. I now have chronic pain in my right foot and acute pain in my right lower leg. Would accupunture help?

A:  A great deal depends on whether the nerve damage has been shown to be directly responsible for the pains in your right foot and lower leg, or whether they have simply arisen at the same time as a consequence of the operation.

The reason we make this distinction is that traditional acupuncture is based on an understanding of a flow of energy, called qi, in the body whose balance and rhythms are responsible for everything functioning as it is supposed to. When the flow is disturbed by surgery or injury, this can have considerable consequences, often local to begin with and then becoming systemic as the flow to deeper structures starts to become impaired.

The reason for pointing this out is that is the nerves have been physically damaged by the operation, something which a neurologist should have established very clearly, then we would be dishonest if we did not say that there is not a great deal that treatment with acupuncture can do. There is a small amount of evidence from animal experiments, dismissed by many of our colleagues as 'ratpuncture', that acupuncture treatment may help nerve to regenerate, but whether one can take results from rats and extrapolate this to human beings is completely unclear. We tend to take the view that in the absence of any hard evidence to the contrary, when nerves are physically damaged there is not much to be done.

However, the flow of energy in the body is organised in what are called channels, and major surgery is often very disruptive of the flow of these. If you look on the internet you will see diagrams of channels, two in particular, which run down the centre of the back and then continue down the back of the legs to the feet. If there has been a blockage caused by the surgery, this might create long term pain because of the diminished flow.

It is difficult to give you a definitive view at a distance, however, and your best bet will be to visit a BAcC member local to you for an informal, and hopefully without charge, face to face assessment of whether treatment may be of benefit. There is no doubt that acupuncture can provide relief from pain; this has been one of the most heavily researched and documented areas of effect. The question is always how much relief and how sustainable, and balancing this against a long term continuing expense. A well-trained practitioner, though, should be able to make a relatively rapid assessment of whether the treatment may be able to achieve more than this based on a simple inspection of which areas are affected and how these relate to the flow of channels in the body.