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Q:  I have arthritis  in my hip.  I had accupuncture yesterday for the firs time  which was fine.  Today the pain in the affected leg is worse than before.  Is this normal as I have more booked next week.  How long should this pain last? 

A:  There are no hard and fast rules but we would be surprised if the pain lasted for more than 48 hours. It is not at all uncommon for pain to increase slightly after a first treatment for musculo-skeletal problems, and most of us tell our patients to expect a slight increase for the next day or two. If the pain continues for longer than that at the same level of intensity then it is certainly worthwhile giving the practitioner a ring to see what they make of it. They will know your case history well and also know what they did, which will make them best placed to tell you what is going on.

Aside from the energetic effects of treatment there is also the possibility of a slight bruise deep within the tissue which can sometimes occur if the needling is slightly deeper. There may be no external signs, but these can cause nerve impingement which can last for a few days.

Most likely, though, is a treatment effect. This can either be because of the restoring of energy to an area, and equally to the effects of the treatment encouraging better structure. This can often cause a re-alignment of muscles and their relative tensions, which can result in discomfort as the body starts to find its correct position.

Q:  Because it seems that nothings really helped me relieve my sciatica pain caused by a very small disc herniation (L5- S1) I had already 2 acupuncture session. After the  first, i was feeling good but during the second on when the doctor inserted a needle down the buttocks I felt an enormous pain. I asked him if he just hit the nerve but he is said it's "the energy flowing". Is it normal to be that painful when the energy is flowing?

A:  'Normal' is not quite how we would describe what has happened to you, but certainly a reaction like this is within the range of possibilities. There are a great many unknowns, however, which means that we can't be precise. For example, when you say 'doctor' we're not sure whether you mean a conventional medical doctor, a Chinese practitioner who uses the title (as many do) or a traditional acupuncturist amongst our members (who do not use the title doctor unless they are also conventional doctors).

The reason we say this is that there are different styles of acupuncture. Conventional medics use a much more direct style of needling with thicker gauge needles, deeper insertions and often aim for what are called trigger points. When these are needled the sensation can be quite powerful. Many practitioners trained in China use a much more vigorous needle technique than European trained practitioners. The needle is often manipulated quite powerfully to generate a dull aching sensation called 'deqi' which for many Chinese practitioners is an absolute requirement for good treatment. Many western trained practitioners also do the same, but there is a wide range, with many using a relatively light technique. On occasion, however, the needle can cause a channel to become very 'live', and this can produce a sensation which may be painful.

What we can't judge from your account is how long the sensation lasted. If it was short-lived it is much more likely to have been an energetic reaction. This can last for a few hours, but after the initial burst of activity it tends to subside over time. If there is a very sudden and painful reaction which goes away quite quickly, then you cannot rule out the possibility that the practitioner has actually hit a nerve, of which there are many in that area.

The bottom line, though, is that it hurt, and most practitioner can adjust what they do to reduce the chances of it happening again. This can be achieved by needling less depeply, less vigorously, or even somewhere else altogether - the interconnections make this possible. There is no need to worry about talking to the practitioner about it. If they are reputable, they will listen. If they do not respond well to your questions, there are hundreds of practitioners out there!


Q:  Can acupuncture help with kidney disease (Microscopic Polyangiitis)? One of the effects of my kidney disease, or my medication, is high blood pressure - generally about 155/90, target is 130/85 - can acupuncture help with this even if it cannot address the underlying kidney disease?

A:  The condition from which you are suffering is quite rare, as you probably know already, and with the development of of drugs like rituximab used alongside corticosteroids there is now a reasonably good chance of inducing remission and with that normal life expectancy.

From what we know about the condition itself hypertension does not seem to be a common aspect of the presenting problems, so it may well be the drugs which you are receiving which are the primary cause. a BP of 155/90 is not catastrophic, depending on your age, and most doctors will only just be starting to consider medication for the problem. There is a growing body of evidence, as our factsheet shows

for the successful use of acupuncture to bring high blood pressure under control, but a great deal depends on the precipitating cause. If there is a specific reason, like a medication routine, then to some extent one needs to be careful not to try to reverse the effects in an attempt to reverse the side effects.

However, when we are looking at the use of acupuncture for named conditions like yours it is a bit 'apples and oranges', i.e. we are working from an entirely different paradigm which understands the body as a system of energy. From a Chinese medicine perspective, the overall picture, from symptoms and signs through to the effects of medication, are factors which we would take into account for treating a patient. If the hypertension has arisen through malfunctioning elsewhere in the system or from the use of medication impacting on the Organs which process them, then we would expect to be able to make some difference. The main question would be how much difference and how sustainable any change was; there are many conditions which respond for a while and then revert, so we are always careful to assess long term benefits in this context.

When the words 'auto-immune' disease appear in a presentation most practitioners find their attention drawn to the problem. The sense of a system turning against itself can sometimes be addressed within the protocols and understanding of Chinese medicine, and as practitioners of the last resort we often have successes where conventional treatment has failed.

However, each case is unique and different, and the best advice we can give is to visit a practitioner near where you live for a brief face to face assessment of what might be possible. With more direct and indirect information at their disposal they will probably be able to give you a better assessment of what may be possible than we can at a distance.

Q:  I am 84 years old and have had no sense of taste or smell for about 20 years. I have seen an ear, nose and throat specialist and they have found nothing wrong. Can acupuncture help this condition?

A: We have been asked questions of a similar kind several times, and we have a very comprehensive answer quite recently which said:

As the NHS website on anosmia (loss of sense of smell) says

around 80% of the taste of food depends on the sense of smell, but this does leave a residual 20% which does mean that food does have a taste. As we understand it, the sense of taste is largely confined to much more basic distinctions between sweet, salty, etc, but there are cases where people with no sense of smell appear to be able to make finer distinctions. The NHS website mentions a number of potential causes for loss of the sense of smell, but in most cases there really is no clear reason.

As far as the use of acupuncture to treat anosmia is concerned, we have been asked this question a number of times, and our answer has always been:

Google is a massively powerful search facility, and if you google 'acupuncture anosmia' it looks as though there are a number of studies which give cause for hope. If you look carefully, however, you will see that there is but one study

which is frequently quoted, generating a number of secondary references. This study, what we call an n=1 case study because it is the report of a single case, is important because it suggests that there may be something worth looking at in the use of acupuncture treatment. The weakness of n=1 studies, of course, is that they are not designed to test acupuncture, and the positive outcome could have arisen for any number of reasons, especially since the case study can provide no evidence for the sudden onset of the problem.

That is not to say that acupuncture treatment is not worth trying. The use of Traditional Chinese medicine involves a great deal of questioning and examination to determine the state and flow of the energies of the body, called 'qi', and the state of the organs which are responsible for all of the functional aspects of the body. Even where there is no obvious cause from a conventional medical point of view, it is rare for a symptom to stand alone in Chinese medicine other than where it derives from a blockage. In this case, if the blockage is removed, the function is restored. We strongly suspect that this is what happened in the case study, and blockages of this kind can sometimes occur for no obvious reason.

Generally speaking, though, a pattern of disharmony will generate a number of symptoms or changes in function, not all of which are clinically significant from a conventional perspective, and these may point t specific imbalances affecting Organic function. Note that we capitalise the word 'Organ' - what we understand by this in Chinese medicine is a great deal more than a physical unit in the body. The Chinese understanding of an Organ embraced functions on all levels, body mind and spirit, and whenpractised properly Chinese medicine can legitimately claim to be holistic.

The best advice we can give is that you visit a BAcC member local to you for advice on whether they think that acupuncture treatment may be of benefit, and to discuss briefly with you the other aspects of your health which may indicate wider patterns which in turn may link to your problem. That is not to say that there may not be as simple a treatment as the one described in the paper, and one of the points used has the Chinese name 'Welcome Fragrance' suggesting that it may have a direct bearing on the sense of smell. You would certainly not do any harm. However, we would be more likely to look at this as a functional disturbance and be looking at other factors in the system which might point to a treatable pattern.

There is not much more that we can say than this. From a Chinese medicine perspective, however, the functions of taste and smell are assigned to specific, and different, parts of the system, and if there has been a functional disturbance in one it may not necessarily mean a loss of function in the other. It may be interesting to see what a practitioner can find, because if either function has been disturbed there will be other confirming evidence.

We think that this still represents the best advice we can give. The fact that you have had tests which suggest that there is nothing wrong is, from our perspective, rather strangely a cause for some hope. If there had been a physical or neurological change that might have made matters a little more difficult, Unexplained problems, which we see very often as you can imagine, are sometimes amenable to our style of working.

However, we are not in the business of encouraging people to chase rainbows, so if you did decide to give acupuncture treatment a try it would be worth drawing a sharp line after three or four sessions if there has been no overall progress. Otherwise it is quite easy to fall into a costly treatment habit when there is no sign of any progress.

Q:  I was diagnosed from an adrenal stress test with stage 4 adrenal then all I could do was lie in bed all day.I took prescribed supplements and after 3 months my energy was much better,as I also have sore kidneys I was advised to try acupuncture.the acupuncturist diagnosed my liver as being the source of my exhaustion.  I agree with this. She has 20 years experience but after 7 treatments,when I was gradually gaining strength a treatment devastated my adrenals and I was thrown back 3 months with my symptoms.It is 3 weeks and I haven't recovered.I feel she was too heavy handed I pointed out how sensitive I am before treatment but this has not been taken into account.  Can you recommend an acupuncturist who has a light touch,who can treat my liver/kidneys? 

A:  We are very sorry to hear of your experience. We have come across a small number of cases like yours where a treatment may well have been a little too powerful for the patient. To be absolutely fair, though, we also have to say that our experience of patients recovering from all sorts of long term chronic problems like adrenal exhaustion or the various ME-related conditions is that they can often have a good run with treatment and then for no discernible reason have setbacks which feel like they are back to square one.

The overall strategy with these sorts of conditions appears to be to treat as gently as possible, and to the extent that this is something that any practitioner can do it is simply a matter of negotiating with the practitioner about what they do. This expert, for example, has a patient who insists on no more than three needles per session at a very superficial level, and our experience of doing more than that has been very educational - she gets blown away by treatment and ends up being disorientated for a week.

The question really is whether you have lost confidence in the practitioner. If so, then the best thing to do is to use our postcode search facility to find a number of BAcC members near to you, and then to visit each of them in turn for a brief face to face chat to explain your predicament. The fact that you have had treatment with someone else is something which they will be duty bound not to discuss with the previous practitioner if you ask them not to, and you should assess whether you have confidence in any of them to keep the treatment as simple as possible. It may well be that you feel that the existing practitioner still has your confidence, and this would obviously be the best route to follow. She will know your energies well, and if it is simply a matter of turning the volume down, then she should be well capable of doing that.

We hope you manage to make some good progress. We are aware that adrenal exhaustion is not always accepted by the orthodox professionals, and this can make for a very uncomfortable situation when someone's genuine inability to work is not backed up by doctors who cannot fit the symptoms into their diagnostic models.

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