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Ask an expert - general

165 questions

Q:  Unbearable pains of body, muscles,nerves.bones,sprain,numbness,twisted feeling from head to toe due to acupuncture treatment over  30 days @twice a week,half hour each for diabetes,bph-prostate enlrgd. A tv doctor in Bangalore advised me to continue acupuncture treatment inspite of severe  kinds of pain.

A:  We have to be careful how we express this, but the first thing to do is to seek conventional medical advice about what is happening to you. These would be most unusual adverse effects of acupuncture treatment, the majority of which are transient and rarely have any impact after the first 48 hours. For something to continue for this long and to such effect would be unusual, so it needs investigating soon. We say this because we have come across a number of cases over the last few years where some really extreme symptoms have started at around the same time as a patient has started having acupuncture treatment, and it is a natural and obvious assumption to make that one has caused the other. Rather than spend time arguing about whether there is a causal connection or not, it is vital to get the problems analysed in case there is treatment which would help or even be necessary.

If, however, it is a result of the acupuncture treatment there are only a few reasons which we can think of where something like this can happen. Physical damage I think we can rule out; you do not appear to have had a single treatment after which everything went wrong. The possibilities are that the treatment is done too vigorously for you, the frequency of treatment is too much for your system, or more rarely, you are one of a small percentage of patients for whom acupuncture is not a good treatment.

In the last case we do find on occasion that there are patients who react too strongly to acupuncture treatment, and it stirs up far too much in the way of reactions. In these cases all that we can do is advise other forms of treatment which are less disturbing to the system. Gentler manipulative therapies like cranial osteopathy or regimens like homeopathic treatment may the best option.

If the treatment is too frequent this can sometimes cause problems. Since the system is a self-enclosed whole, anything which stirs things up could cause all sorts of apparently unrelated problems elsewhere. One of our old teachers used to use the analogy of cleaning a muddy pond. When you do this the water becomes cloudy and you really can't see how well things are until the residual mud has settled. If you keep stirring things up the water will be perpetually cloudy. Reducing the frequency of treatment may help matters settle down.

If the treatment is too vigorous this is simply a matter of discussing with the practitioner whether he or she could use fewer needles, less vigorous needle action, or less powerful acupuncture points. Treatment always has to take into account the patient's overall health, and just as you wouldn't give a sports massage to a 90 year old, there are treatments which may be too powerful for a person to deal with. 

This really comes down to communication with the practitioner. If he or she can say with confidence that what you are suffering now is on a pathway to better health, then you could choose to continue. If your own doubts are growing, then simply take a break from treatment and see if the symptoms relent, in which case you have your answer. In any event, we still think that getting a conventional medical perspective is important. These symptoms may be indicative of another as yet undiagnosed problem, and we would be remiss if we did not direct you to your GP for advice and direction. 

A:  As this expert knows only too well from personal experience, persistent hiccups/hiccoughs can be a very distressing experience, not the increasingly funny experience which many observers seem to find it. 

There is a little bit of evidence for the use of acupuncture, mostly in the form of what are called case studies about single instances where treatment has helped, or sometimes where treatment has been offered to a specific target group where hiccups often present and where there is a need to deal with them quickly, as in post myocardial infarctions. Below are a few examples of these kinds of studies

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035062/

http://www.ncbi.nlm.nih.gov/pubmed/15813167

http://www.ncbi.nlm.nih.gov/pubmed/11908864

 Most practitioners during their training learn a number of what we call 'first aid points' which are known to have an effect on specific conditions. There are certainly two or three which are commonly used to stop hiccups, and one additional one which appears to be effective for treating children with persistent hiccups. Overall, though, there isn't a great weight of evidence, and we would be a little remiss to suggest that acupuncture definitely provided a solution.

However, that said, we are practising a system of medicine where hiccups, a symptom like any other, is not always seen as the problem itself but is usually a manifestation of other imbalances and blockages in the system. As you may have read, Chinese medicine is premised on the understanding of the body as a system of energy in flow, and the skill of the practitioner lies in making sense of symptoms within the general background context against which they appear. This is why the same symptom can often be treated in a dozen different ways in a dozen different patients depending on what internal causes are allowing it to develop.

The short answer to your question is that you may have to visit a BAcC member local to you for them to be able to see what is going on and try to make sense in Chinese medicine terms of what is happening. This is the only way that you will get a clear idea of how treatable the problem is.  What we can say, though, is that with conditions like this we tend to take the view that if they are going to respond they will do so quite quickly, and as such we would caution a prospective patient about getting engaged in a long run of treatment with no obvious improvement. We would suggest three or perhaps four treatments would be the maximum we ourselves would offer before reviewing the case in depth and deciding whether there is any point in carrying on.

This all sounds rather negative, especially when many of us have stuck a needle in with almost immediate effect like a party trick. However, everything works for someone, but something doesn't necessarily work for everyone, so we would advise caution. 

Q: I had my second acupuncture session 4 days ago and just wanted to check if my symptoms were anything to be concerned about. I've suffered from ME for a number of years but have largely recovered and thought that acupuncture may help improve my health to its former level . The practitioner took this into account and gave me a gentle treatment. Although i couldn't get out of bed for 5 days a few of my symptoms seemed a little improved after this time. The second treatment, much gentler again, has had a very similar reaction but it's been accompanied by a deep painful ache down both legs. Is this part of the healing crisis i was warned about?

A:  We tend not to like the words 'healing crisis' because they do tend to be used of more outcomes than is reasonable. We are always confident that the more unusual apparent outcomes of treatment are not usually causally related because we are familiar with the range of possible adverse effects (rare in themselves) and they tend to be transient. Out main concern is that on occasion we have dealt with queries where the adverse effect was clearly nothing to do with the treatment but the belief that it was was delaying positive action to deal with it.

That said, ME and related long term health problems can generate some very odd symptoms when they start to resolve. From a Chinese medicine perspective the flow of energy is usually heavily compromised by these conditions. One consequence is that blockages in the system which would be obvious in someone in good health are hidden because the energetic flow is so weak they do not cause problems. Once the flow is starting to return to its proper levels symptoms of the blockage start to appear. We have also seen patients learn to move in a rather more restricted way when they are troubled by ME, and returning to better health can sometimes cause muscles to stretch properly again.

However, deep painful aches in the legs are always worth investigating sooner rather than later, so the first thing to do would be to contact the practitioner, explain the situation and if time and energy permit to go along to their clinic to see what sense they make of it. There may well be energetic reasons which they can find and which they can correct, or at very least put your mind at rest. If nothing is apparent, then you are best advised to pop along to your GP and ask their advice too. 

We are very heartened that the practitioner used very gentle techniques, so we are fairly sure that this means what you are suffering does not have a mechanical cause. However, the post-ME constitution is very delicate, in our experience,and setbacks are frequent even years after an apparent full recovery. Hopefully you will be on a continuing upward path soon.  

A: We're afraid to say that this is a little outside our field of competence to comment!

There are often fascinating overlaps between the kinds of energetic information which systems like this are supposed to register and the patterns of energy flow which have been described in Chinese medicine for over 2000 years. Unfortunately the overlap is not anywhere clear enough for us to be able to say that these systems are valid.

The problem in healthcare treatment is that there although everything works for some people, there is rarely something which works for everyone. All that we can recommend is that you exercise suitable caution when looking at the claims which are made. Since these systems can be rather expensive it is worth investigating them as much as possible before committing funds to them.


Q: If Botox has been used for long term headache relief and appears to be successful, would you suggest continuing acupuncture treatments to support this or is there any chance of acupuncture being contraindicated? Do you have any information or research on this?

A:  We are sure that acupuncture is not contra-indicated for people who have had botox injections, either for the treatment of problems like migraine or for cosmetic purposes. Our internally published advice is not to needle into areas where botox has been administered, but that is more to do with avoiding any unforeseen adverse effects of the botox treatment being blamed on the acupuncture. The drug itself is rapidly absorbed so there is no danger of pushing it further into the system and causing detriment.

We were surprised when we first heard of botox being used to treat chronic migraines. We had assumed, as did everyone else it appears, that the effect was on the musculature of the head and neck, but this is not the case. It is assumed, although not proven, that it has an effect on the neurotransmitters which transmit pain messages. Anyway, whatever the mechanism, as the trial report shows

http://www.ncbi.nlm.nih.gov/pubmed/20487038

botox seems to have a major effect.

So does acupuncture! As our factsheets on migraine and headache show

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

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

the evidence for the efficacy is increasing as more and better trials are undertaken, and NICE already make a recommendation for the use of acupuncture for cluster headaches. Migraines remain one of the conditions most frequently reported as a reason to consult an acupuncturist when we conduct surveys of people visiting our website looking for a practitioner.

Of course, that does not mean that every person who tries acupuncture will find a massive difference. Although the ancient Chinese uses very sophisticated diagnostic processes to identify over 50 different types of headache, each is not a free-standing symptom but a manifestation among several of various functional imbalances in the body's energies. This is why we talk about treating the person, not treating the condition; from our perspective every patient is unique and different.  A great deal would depend on what else may be happening in your system, and the only way to establish that would be to drop in to see a BAcC member local to you for an informal assessment of whether they believed acupuncture treatment would be of benefit.

We are confident that they will find evidence of patterns which give them cause for optimism. We certainly feel confident when someone comes to us for treatment of migraine, because our experience has been largely positive. We hope that this will apply to you too.

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