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163 questions

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.

Q: I have hypothyroidism and am taking a 100 dose of thyroxine daily.
Since being diagnosed 10 years ago my weight went from 10stone to 12 stone over the first 3 years and has been steady at 12stone ever since. I do not eat sweets etc and have a pretty good diet. I know I am overweight and need help do you think acupuncture could be the answer. I have faith in it as I had a course to relieve severe hip pain some years ago and it worked wonders. I am a 65 year old female.

A:  We are always a mite cautious in answering questions about the management and effects of thyroid problems. Our clinical experience is that it can often take patients a considerable time to achieve a good balance of thyroxine, and one of the consequences of using acupuncture is that it can boost residual functions across the whole system. When people have limited function in the thyroid, and also in the pancreas and other endocrine glands, we are always concerned that we might just prompt the whole system to work better and cause fresh problems.

The first thing we would want to check is whether your thyroxine dose is precisely matched to your needs. Fluid retention and subsequent weight gain would be a sign of hypothyroidism, and it may just be that the dose you are taking is not quite meeting your current needs. On the assumption, though, that we can rule this out, the advice we give to people about acupuncture and weight loss is consistently the same - unless there is clear evidence that there are functional disturbances from a Chinese medicine point of view which might be causing some of the weight gain, we would never recommend acupuncture as a general treatment for weight loss. While our underlying belief is that a system in balance will perform better in all respects, and might in theory bring weight under control, the evidence from research and from our clinical practice is not that favourable.

One of the problems, of course, is that when we treat people for weight loss, it is rarely the only thing they are doing, and as people who go to Weightwatchers and similar organisations know from their initial briefing, after a short period of rapid loss every pound takes time, with targets set very low at a pound every two weeks or so. It is very difficult with this kind of time frame in mind to be able to determine whether acupuncture works or not, and whether it is having a direct effect or simply helping to maintain someone's determination to carry on.

That said, there are a number of syndromes recognised in Chinese medicine where we can and do give advice, and sometimes treatment, which can have an effect. Chinese dietary advice is always to eat more at the beginning of the day than later, and to avoid certain types of food. There was a saying used in this country 'breakfast like a king, lunch like a lord and dine like a pauper' which expresses well the best pattern of eating to fit in with the body's natural rhythms. Our digestive functions are far better in the earlier part of the day, and meals taken in the evening are never digested as well.

The main Organs of digestion, the Stomach and Spleen (we capitalise them to denote the Chinese medicine understanding), also work better when the food is fit for purpose. The Spleen is said to like warm dry food, and if it is over-loaded with cold and damp food, it under-performs and can lead to a condition the Chinese call Dampness which can mean an accumulation of fluids, especially in the middle third of the body and lower limbs) and a general feeling of sluggishness. When you think that the usual reaction to weight problems is to eat lots of salad, raw fruit and raw vegetables, it is not hard to see how things can easily get worse rather than better. This doesn't mean not eating all of these foods; they are still a healthy diet. It means rather to balance the coldness with something either physically hot or spicy hot. You rarely see cold food in a Chinese restaurant; even fresh vegetables are stir-fried to retain the crispness but lose the coldness.

What we sometimes advise prospective patients to do is to begin with a number of small dietary changes, and perhaps have a number of acupuncture treatments to see what happens. If the system is waterlogged this can sometimes mean that there is an immediate response to treatment and better dietary patterns. We have to be realistic insofar as people can't always change their eating patterns in one go, and we also need to be able to distinguish between what we do and what the dietary change is doing. However, if there seems to be some progress, then we usually discuss regular but spaced out treatment to keep the system working towards a better overall balance.

As always, it is best to visit a BAcC member local to you for a brief chat about what may be possible. Whatever we say here it will never be as accurate as what someone can tell you even from a brief look at diagnostic signs.

A:  It came as a surprise to us that there have been a number of studies of teeth grinding/bruxism. One example of this is

http://www.ncbi.nlm.nih.gov/pubmed/15108607

and another

http://www.researchgate.net/publication/235768598_Acupuncture_as_therapeutic_resourcein_patient_with_bruxism

although it has to be said that this is an unusual approach, not drawing on traditional acupuncture but on auricular acupuncture which is a much more modern development.

The problem of bruxism is usually described as multifactorial, arising from a combination of causes and very often having a mental and emotional causes as well as arising as a consequence of conditions like sleep apnoea and from some forms of medication. Some of these causes are very commonly treated by acupuncture, as our factsheet on anxiety, for example, shows

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

The only way to get a clear answer, though, would be to visit a BAcC member local to you for a brief informal assessment of what treatment may be able to offer. The main purpose of seeing you face to face would be to check whether this was a stand-alone symptom, or whether there were other factors involved. In Chinese medicine diagnosis it is rare to find a single free-standing symptom. Most symptoms are evidence of a functional disorder within the system as a whole, and the Organs of the body (capitalised to distinguish what this means from the western concept of an organ) have a range of functions which means that a single one out of kilter might generate several symptoms manifesting on different levels. The skill of the practitioner lies in getting information from patients about their overall functioning and making sense of the various ways in which these depart from their normal range.

If the practitioner can see immediate connections which point to straightforward treatments, they will be able to give you a good idea of how successful treatment may be. Even if there are no obvious connections it does not mean that treatment may not work; the most ancient systems were asymptomatic, driven by the simple belief that a symptom in balance did not generate symptoms and that these would lessen and go. Versions of this style of treatment are still very popular and successful today.

You can find a list of practitioners close to where you live by using the postcode search function on our home page.  

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