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.Q:  Is it possible to have acupuncture for the help of getting my taste and smell back?

A:  This question comes up from time to time, and one of the answers we gave was:

Most of what people regard as 'taste' is in fact 'smell', and if someone has lost their sense of smell entirely the range of tastes which they can experience is very limited. There is a frequently cited case study from nearly a decade ago
which reports the successful treatment of one case, but in all honesty there are very few others, and no substantial evidence suggesting that this has been replicated by other practitioners. Most members have had patients for whom the loss of the sense of small. anosmia, has been a secondary complaint, but we have heard very few reports of great success.
It may be worth you while to visit a BAcC member local to you to ask their advice face to face. If you were to decide to have acupuncture treatment, or indeed any treatment from a complementary medicine practitioner, we would advise you to be very clear about outcomes and reviews of progress. Our experience is that people can rapidly run up considerable costs chasing solutions when there is nothing substantive to suggest the treatment is having any effect, and the responsible practitioner will always draw a clear line in the sand if they are not achieving changes which the patient can experience and which underpin continued treatment. 

Essentially we would not want to give you an unrealistic expectation about the outcome. We have not heard many reports of this condition being treated successfully, and there are very few case reports on the web which report success.

We have edited out some bits of the answer because the questioner had also problems with excessive mucus production, and we could not say without a face to face examination whether there may be some aspect of this which was the principal reason why the sense of smell had gone. It may well be that if you visit a BAcC member for advice they can see something in the energetic presentation and balance which similarly encourages them to believe that there may be a solution. There may also be something in the way in which your sense of smell and taste went which encourages then.

The bottom line, though, is that if you are fortunate enough to find that it works, you may be the exception rather than the rule.

Q: I had acupuncture today, the lady used re-usable needles instead of disposable ones. She assured me they were sterilised using the appropriate machine. Is this ok?  Shouldn't all acupuncture needles be disposable?

A:  The BAcC's Code of Safe Practice could not be more explicit on this:

You must only use single-use pre-sterilised disposable solid needles which, if in multipacks of five, ten or more needles, must not be used or stored for use after the session in which the seal on the package is broken. Any needle with damaged packaging seal must not be used.

The only exceptions which we ever allowed were when the transition to guide tube needles was introduced in the late 1990s and some of the longer needles were not available at that stage. We allowed members who purchased these to use them only after they had been sterilised before use and then only used a single time as if they were single-use needles. In modern times all sizes are available as single use needles and there is no excuse for re-using needles.

The ban on the use of re-useable needles was introduced for safety reasons. It transpired that prions, the proteins involved in the transmission of Variant CJD, the 'mad cow' disease human equivalent, were not killed by autoclaving, and there was always a theoretical risk that someone could unwittingly spread the disease by needle re-use. Subsequent investigation revealed that it required more than simply exposure to the prion to create the condition in another subject, but by this stage the change to single use needles had become firmly established and patients and practitioners alike were reassured by the safety that this provided. The growing market also meant that needle prices dropped and quality improved, where the earlier disposables had been shockingly poor. Nowadays a needle can cost as little as 2p, and there really is no justifiable reason not to use single use needles.

If the practitioner is a BAcC member, you would be well advised to report them to the Professional Conduct Officer or Safe Practice Officer immediately. The chances that you have been put at risk are minimal, but that does not change the fact that this is a breach of one of the more strict rules under which we operate. If the practitioner is not a BAcC member, you should take the matter up with their professional body, or should that not be something you want to do, then you could contact the local authority Environmental Health Department. The law relating to skin piercing does embrace the possibility of re-using needles, but this is because the new byelaws were extended to covering all skin piercing and many tattooists and body piercers do use re-useable equipment. Had it been an acupuncture-only law, we would have insisted on single use disposable equipment being the legal norm. If someone is re-using needles, then their autoclaving equipment has to be maintained in an exemplary fashion to guarantee that it delivers what it is supposed to.

Aside from anything else, inserting a needle can do considerable damage to the point, as this recently published paper shows

and creating small fish-hook ends which go in easily but tear tissue on the way out is not a great option for patients. Needle breakage is almost unknown in modern times, but where this used to happen in the old days, it was usually related to the over-use of needles with autoclaving which made the steel become more brittle. Single use needles have all but eradicated this problem.


Q:  Could acupuncture prevent further deterioration of joints affected by osteoarthritis, specifically joints between base of thumb and wrist, where an osteophyte is forming. Might the area even restore itself with treatment?

A:  We are always a little cautious about appearing to offer over-positive outcomes in giving advice here. The frequently used line in modern sales advertising, that 'once it's gone it's gone', seems to us appropriate when talking about actual physical change in the body. We have come across cases where there appears to have been some reversal in the growth of osteophytes, but when this has happened there have often been two or three treatments in use at the same time, making it rather difficult to assess whether one of them worked or whether there was some kind of synergistic response to using all three. We take the safer view that once osteophytes have become established the best that one can hope for is that the rate of growth slows down or stops altogether, the 'getting worse slower' option.

There is considerable evidence accumulating that acupuncture can be effective in treating osteoarthritis, as our factsheet

shows. The majority of this evidence, which is not yet quite enough to give a blanket assertion of efficacy, is centred on treatment of the larger joints (hips, knees, etc) but the general principles employed are the same.

One aspect of your condition which you have not mentioned in the question is any specific form of work or leisure activity which may have contributed to the condition. It may be that this 'just happened' but we very often find that there is a background of injury, perhaps even twenty or more years ago, against which backdrop the current condition developed and which an otherwise innocuous activity has exacerbated. This writer broke his scaphoid bone in the wrist as a 15-year old without realising it until his whole wrist seized up as a 29-year writing his PhD longhand (those were the days!) and the radiologist found the fracture lines. Without the constant pen in hand day after day this may never have developed.Once it had been identified, however, it did mean a more careful management of repetitive activity of this kind, and there may be some practical management which a practitioner may have to consider.

In Chinese medicine each patient is unique and different. Twenty different people may have the same problem, but each will have a different overall setting against which the problem developed and which condition the response in such a way that there would be twenty different treatment approaches. The best advice we can give you for the best assessment of what acupuncture treatment may be able to offer you is to contact a BAcC member local to you and see if they can offer you a few moments without charge to take a look at what is going on and offer a slightly more precise assessment of what might be possible.

Q: I am a practising podiatrist . I have my own practice and have been qualified for 15 years. My question is what is the  most appropriate way to train and qualify to be an acupuncturist?

A:  From our perspective as the leading body for traditional acupuncture in the UK, we believe that training at one of the courses accredited by the British Acupuncture Accreditation Board (BAAB) is the best route into the profession. A full list of the courses which have already been accredited or are in the process of seeking accreditation can be found here:

These are mainly three-year degree equivalent courses, and successful completion leads to automatic eligibility for entry to the BAcC, subject to suitable health and criminal record checks. There are a number of courses which are not BAAB-accredited, one or two of which appear to aim for an equivalent standard, but we believe that the insistence on a full 3600 hour programme involving a great deal of clinical time is the best preparation for full time independent practice.

Roughly one third of the course is dedicated to western medicine, and it may well be that your current training and experience will render you suitable for an exemption from some of the training, which may have both financial implications in choosing which course may be more suitable for you.

This, of course, is the training to become a traditional acupuncturist. The other option is to train in western medical acupuncture. While this is suitable for working within the scope of practice of an existing doctor or physiotherapist, as most medical acupuncturists are, it does not offer the same breadth of application, being limited usually by the regulators to work within scope and for which there is an adequate evidence base. For reasons too technical for a brief response, the evidence bar is set at the randomised double blind control trial, which is not really appropriate for testing a multivariate discipline like traditional acupuncture, and as a consequence the limits of scope are quite severe.

We believe that your best option is to visit one of the regular open days which the colleges hold several times a year, or to initiate contact with the ones most likely to be of interest to you. All are more than happy to discuss their training with prospective students. You might also be able to talk to BAcC members local to you about what being an acupuncturist is like. We cannot guarantee that they will be able to spare you time, but some may. The other option is to have a course of treatment to see from a user's perspective whether it is the sort of thing you want to be doing. The underlying premise of traditional Chinese medicine, that the true aim is keeping people well rather than getting them better after they have become ill, means that you do not have to be unwell to have treatment and may benefit in unexpected ways from  being balanced in accordance with the 2500 year old principles of the Chinese medicine system. This will give you plenty of chance to talk to your practitioner about their practice

Q: I had acupuncture done to my left hip and I'm in a lot of pain is that normal and  what can I do to ease the pain?

A:  We would need to know a great deal more about the exact nature of the pain, and crucially why you first sought treatment, before we could offer precise comments. It would also be helpful to know how long after treatment the problem started.

There are a number of possibilities. On occasion when patients present with structural problems or problems which arise from a structural fault, such as low back pain or sciatica, then there can be a chance that in the process of the body re-discovering its proper shape there can be a number of aches and pains to do with the muscles and tendons having to adjust. In common with osteopaths and chiropractors, we often advise people that the next 24-48 hours might be a little more uncomfortable, after which they should see improvements.

If the initial problems was in the hip itself, then there are a number of points which are used in the area which can be inserted quite deeply and with perfect safety. It is always a possibility that there has been some bruising fairly deeply under the skin, and this may well cause some local nerve impingement which, because the bruising is deep, would show no surface signs.

in both of these cases we would expect the discomfort to pass relatively quickly, although we have come across cases of deep bruising where the effects have lasted longer. 

The best course of action is to raise the matter with your practitioner. He or she will know exactly what they have done and been trying to achieve, and can probably set your mind at rest. There is no obvious reason to start seeking medical advice at this point unless the pain is very severe or there is an accompanying loss of free movement. If it does carry on for longer than either you or the practitioner think reasonable, then a visit to the GP would be a sensible option.

As far as short term measures are concerned, proprietary pain killers are probably the first line of attack. In most cases these will buy time while the underlying problem rights itself. If the pain is too strong to be touched by proprietary over the counter drugs, then the visit to the GP for advice and stronger treatment may be brought forward.

Your practitioner may, of course, uncover energetic reasons why you have pain and be able to address these with needles, although understandably someone who believes a pain has been caused by treatment may be unwilling to have further treatment to deal with it.

Of course, the one possibility that we haven't mentioned is that the pains are unconnected with the treatment. We always have to say this cautiously because some people take it as an attempt to say 'not my fault' but we do come across a small number of cases each year where problems arise after treatment which were not caused by it, they simply were a case of the timing suggesting a causal relationship which wasn't there. We are always concerned when this happens because the focus tends to turn to whether or not the problem was caused by treatment when the problem itself is left untended. If there is a problem, howsoever caused, the main priority is to get it sorted. Arguments about causality and responsibility can usually wait a while.

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