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Ask an expert - general - Mystery aches and pains
Q: My first visit for acupuncture was nearly 2 weeks ago. I wanted to try it for my hot flushes, itching skin(due to a medication I am on) and arthritis. Unfortunately that evening I realized I had a heavy ache in the whole length of my left arm. I can use the arm as usual but I am aware of the dull ache, at nightime it seems to trouble me so much more and I have to take painkillers or use ibroprufen gel.
On my 2nd visit 3 days ago the acupuncturist was obviously concerned that I was still suffering this ache, I did not have needles on that occasion in the arm, but she tried massage etc all to no avail. She said she had never heard of anybody having this ache for this long before.
I did have a fracture of the wrist on this arm before, but this was about 9 years ago; no pins or anything so she presumed it was nothing to do with this.
I would be glad if you could be of any help as this ache is now causing me sleepness nights, (it wakes me when the medication has worn off).
A: This is a most unusual outcome. There are a number of rare short term adverse effects associated with treatment, but most disappear after 24 to 48 hours. There are also a number of normal treatment effects, and a dull aching sensation where the needle has been inserted is relatively frequent, but this again disappears within minutes of treatment, although occasionally lasting a little longer.
The only thing we can think may have happened is that there has been a slight bruise created by the treatment adjacent to a nerve, and the impingement is causing the sensation you are experiencing. In any event we think that it would be best to visit your GP and ask for a neurological assessment to see whether there is a specific nerve which is being affected.
We also need to emphasise that all of our practitioners are fully insured so that if this problem continues and is a direct result of treatment you would be entitled to make a claim for any disturbance or distress this may have caused.
However, we hope that it proves to be a consequence of minor bruising within the underlying tissue, and in our experience where this kind of problem does occur it does resolve within a week or two, gradually diminishing in intensity and discomfort. We are sorry that you have had this happen, and hope that it does not deter you from having further treatment.
Q: I have persistent pain in my chest just under my left nipple. I have had heart scan, X Ray, endoscopy all to find everything is ok. Would acupuncture be worth a try?
A: When someone has had a battery of conventional medical tests to assess a pain they have, the first thing we say to them is that this should be reassuring - it has ruled out most, if not all, of the serious possibilities. We tend to 'inherit' a great many patients in your situation, and working in a different paradigm of medicine can sometimes offer new treatment possibilities.
Chinese medicine is based on an entirely different understanding of the way in which the body mind and spirit work as an interconnected system of energy called 'qi', a term which is virtually untranslatable. An understanding of the flow, rhythms and balance of this energy is integral to understanding the concept of disease in Chinese medicine, and the practitioner will be looking at excesses, deficiencies or blockages to try to establish what is causing the pain. This might lead to local treatment to clear a blockage, or could involve systemic treatment if the problem is the tip of a larger iceberg. Usually there is an element of both involved, with underlying patterns allowing local patterns to develop. A practitioner would probably ask you the same kinds of question you have already been asked - nature, frequency, onset, duration, etc etc - in order to refine their diagnosis.
The best advice we can give you is to visit a BAcC member local to you and seek a brief face to face assessment. This will enable someone to give you a much better idea of how treatable the problem is. Our experience is that these kinds of pains clear quickly with acupuncture treatment or not at all, and you should, if you decide to have treatment, set measurable outcomes and a set review point to avoid a sequence of treatment extending a long time without discernible improvement.
Q: I have had a 'mystery' pain in my left arm for some time now. I think this was caused when I was out walking with my wife, who was holding my hand or to be more precise by two or three fingers, when she stumbled and pulled down hard on my fingers to steady herself. I have been to the doctor who told me to take some Iboprufen (not my preferred cure!) and the pain is with me still. It hurts most when i lift something or grasp and lift.
A: It would certainly be worth seeking out a BAcC member local to you and asking their advice on what acupuncture treatment might be able to achieve. There are a number of musculo-skeletal problems for which acupuncture has been shown to be successful, notably in the case of chronic back pain, and from a Chinese medicine perspective the problems often involve blockage and stagnation in the energy or 'qi' which flows around the body, caused by strain or injury. The removal of the blockage, usually with needles but sometimes using heat in the form of a burning herb called moxa, enables the body to resume its normal functionm. Without seeing exactly where the problem lies, however, it is difficult to pass on a more informed judgement. Some conditions, like tennis elbow, are relatively amenable to treatment, and there is an increasing number of studies which show that treatment may be beneficial. Other muscle or tendon strains, which is what this sounds like, can be more intractable.
Although it may not please some of our members to read this (because many physios use acupuncture and are often felt to be 'poaching' on our territory) this is a case where we believe an assessment by a physiotherapist or osteopath may also be a very valuable route to pursue. It may not simply a matter of removing pain; there are issues to do with re-building normal function involved, and the advice of an expert in the body's musculature and movement about what to avoid and what to do to build up one's strength again may be very useful. Our members work closely with a great many other health professionals and it is a part of their role and duty of care to ensure that a patient gets the care most appropriate to their needs.
Q: I suffered with guillian barre syndrome, I have foot drop in my left foot and tight calves. Would acupuncture offer any relief?
A: Many of the symptoms which persist after an episode of Guillain Barre syndrome spontaneously remit within a year, so it is unusual and unfortunate to be troubled by residual effects.
There is not a great deal of research evidence of the treatment of Guillain Barre syndrome, although a group of Chinese researchers have posted a protocol for a review about to take place
which might produce a better picture once they have searched the databases for information.
To answer your question really means to look at what traditional Chinese acupuncture attempts to do, and that is to reinstate and maintain the flow of energy, 'qi' as it is called, in the body to ensure that everything functions as it should. Conditions like Guillain Barre which interfere with the normal flow in the muscles and tendons are seen in Chinese medical thought to be causes of blockage and deficiency, and at a very simplistic level the treatment is aimed at reinstating a blocked or missing flow. Of course, in practice things are a little more sophisticated than that, because the practitioner will want to know what happened to the system as a whole to let these particular symptoms appear where they did, and to decide whether it is really a local problem or one which requires a more subtle and systemic approach. Any condition involving a change in muscle tone or function may be benefited by acupuncture, though, and even the western medical acupuncture tradition sees this as a worthwhile intervention.
However, one important factor to bear in mind is that in a small percentage of cases residual symptoms not only persist for a great deal longer, but are sometimes intractable to treatment. If you did decide to give treatment a go and contacted a BAcC member local to you, it would be very important to establish very clear outcomes in order to assess whether the treatment is having an impact and a very clear sense of how many sessions to have before reviewing whether there has been progress and whether it is sustainable. It is in everyone's interests to ensure that, in Dr Johnson's famous words, continued treatment is not the triumph of hope over experience.
Q. I have persistent tingling and numbness in my right hand not painfull but very irritating.. Had scans, tests to no avail would acupuncture help?
A. Practitioners in the BAcC often have patients come to them after all the western tests have been done and nothing has been found, because they've heard or read that the symptoms which they describe are a part of the disease patterns understood within Chinese medicine. It is certainly the case that some patterns describe numbness and tingling in the hands as a symptom, but equally true that many people experience symptoms like these where none of the usual accompanying signs occur and for which treatment would not be as straightforward or as likely to be of benefit.
Chinese medicine has developed over thousands of years, and offers many different ways of intervening to put someone's system back in order. Symptoms such as yours may be evidence of local disturbance which might benefit from local treatment, or they may result from major functional imbalances and require more work. The best way to establish whether acupuncture would be appropriate would be to visit a BAcC member who can offer you a better assessment based in their own observations about whether your particular case has some clearcut features which suggest that acupuncture might work well.