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Ask an expert - muscles and bones - feet

19 questions

Q:  I have numbness in my feet (not 100%)which prevents me from falling asleep and is generally most uncomfortable. It is apparently not related to diabetes - according to medical tests - nor to a neurological condition. Can acupuncture help?

A: The short answer is that it is difficult to say! Had you gone to one of our members before seeking any other treatment they would have referred you back to your GP for tests for diabetes and for further neurological assessment. Given that both of these have been done and nothing has been found, the next question would be whether the condition developed slowly or whether it had a sudden onset. This might point to an injury or set of circumstances which might explain its occurrence.
 
In broad terms Chinese medicine is based on a theory of energy, called 'qi', the flow, balance and rhythms of which maintain the body, mind and spirit in healthy function. There are a number of internal and external causes which can disturb the flow, and also a number of constitutional factors which predispose people to certain types of symptom. The practitioner will cover a great deal of ground trying to understand the unique balance of each patient to find the most effective means to try to address the problems.
 
In the case of symptoms such as numbness, there are functional reasons why this can occur, and it is a recognised part of several syndromes. If this were the case the practitioner would expect to find other parts of the same pattern in someone's health, not necessarily as symptoms, but just as features of daily living which they have come to accept as 'normal', like bruising easily. There may be more localised reasons for the symptoms, although the fact that both feet are involved tends to suggest otherwise - an identical bilateral local blockage would be unusual.
 
There is such a wide range of possible interpretations based on diagnostic evidence which we do not have that realistically the only way you are likely to get an informed answer to whether acupuncture treatment will help would be to see a BAcC member local to you for face to face advice. It is the kind of condition which we often find ourselves treating when conventional explanations have yielded no answers, but not every condition is necessarily treatable by acupuncture, and a responsible practitioner will want to see how the problem manifests before committing you to treatment. 
 

 

Q:  I have suffered from numbness and pain in the balls of my feet for 2 years. After many tests and MRI scans, I have been informed that the condition is neurological and defined as a 'painful sensory neuropathy' possibly originating from prolapsed discs in my lumbar region. I have been advised that it's not curable without surgery. Do you think that the condition could be improved by acupuncture?

 

A:  If the condition has been clearly defined as arising from prolapsed discs in the lumbar region, then we would be very cautious about making claims for what acupuncture could or could not achieve. If the condition arose from the prolapse itself, i.e. the protrusion of the disc material causing pressure on one of the nerves descending to the foot, we would expect the prognosis to have been a little more positive than this. Prolapsed material eventually tends to be cleared by the system itself, and patients are often told to expect to have a three to six month period during which things return to normal. If you've been told to have surgery as the only way to correct the problem it suggests that the compression of the vertebrae is causing the problem, in which case an operation may make a difference.
 
However, we have to remind ourselves sometimes that the system of medicine we practise has been around for 2500 years and well before the advent of X-rays, so a Chinese practitioner in ancient times, faced with the same symptom, would try to make sense of it within a system of understanding the body which has remained largely unchanged for the whole of that time. When there are areas of numbness the immediate conclusion is that there is weakness and blockage, and at a very simplistic level all we do with needles is to increase, decrease or unblock flows of energy, called 'qi', in the body. The practitioner will want to establish whether this is a local disturbance, or whether there is a blockage 'higher upstream' which is causing the problem, or whether there are systemic reasons for the problem, or even a mixture of all three.
 
This is really a matter for someone to take a look at face to face, though, to be able to give you the advice you need. It should take an experienced practitioner only a short while to determine whether they think they can help. It occurs to us that there might also be some mileage in considering cranial osteopathy as another possible modality, and if the practitioner you see thinks it may be beyond their capacity to help this is something that they may also recommend with the advantage of being able to make a personal referral. 
 

There is very little research evidence for the use of acupuncture in treating hairline fractures. What evidence does exist tends to be in the treatment of 'proper' fractures and usually in unfortunate laboratory rats, and there are some studies, particularly of the use of electroacupuncture, which are promising. However, taken as a whole, the results are nowhere near conclusive enough to make a positive recommendation.
 
However, traditional acupuncture operates on the basis of an entirely different conceptual system from conventional medicine, involving as it does an understanding of the body, mind and spirit as a flow of energy, called 'qi', and its flow, balance, or blockage. Broken bones remain broken bones whichever system of medicine one espouses, but the rationale adopted in Chinese medicine would be to encourage the flow of qi in the area of the break, and possibly to use points which the Chinese understood to have a direct relationship to the strength of bone throughout the whole body. Some aspects of Chinese medicine appear very literal and rather naive to the western mind, but the idea that something which is broken has its 'integrity' compromised and needs direct treatment to reinstate local flow is intuitively easily grasped.
 
We obviously hear of some dramatic cases where people have benefited from having acupuncture for fractures, but we are always going to hear about the successes because the failures will usually go unreported. We would advise you to seek the advice of a BAcC member local to you, and see what they think they may be able to do based on a brief assessment of your overall energy.
 
The one point to make is that treatment of toe fractures tends to be very conservative, with only the very worst being given a cast or some form of binding. In most cases the fracture is allowed to heal of its own accord, and the received wisdom is that a simple fracture can take up to six weeks to stop being obtrusive and up to six months before it is fully resolved, depending on age and health. If so, it should be fairly easy to establish whether acupuncture may indeed be having a positive effect, although the contrary view, that fractures heal at different rates anyway, would be impossible to rebut.
 
 

Q: I have an ankle sprain which is now 9 weeks, my doctor says I have to put up with the pain and being unable to walk, I also get a lot of swelling particularly at night, could acapuncture help

A: Ankle sprains are one of a number of conditions where the evidence base is quite limited - sprains tend to heal relatively quickly and manifest in so many ways it is difficult to put together a well-defined trial group, at least in the UK and the West generally - but the principles upon which Chinese medicine is based give good grounds for cautious optimism.
 
As you can see from looking at the materials on our home page traditional acupuncture is based on an understanding of the body mind and spirit as a complex flow of energy, which the Chinese called 'qi', and which moves in precise patterns across and within the body. All of the diagnostic systems of Chinese medicine are geared to understanding how this flow has been affected by illness or injury, and also to understand the natural states of imbalance which we all have by virtue of heredity and upbringing - nobody's perfect! Put very simply, the flow of energy can have areas of excess and areas of deficiency, which the practitioner will try to address, but injury tends to create blockage and stagnation. In these circumstances the practitioner will often do a fairly large amount of local treatment to get things moving again, and usually supplement this with constitutional work to ensure that the overall flow is good enough to keep things moving.

 

 

 

This may all sound a little vague and airy-fairy, but the underlying principle in Chinese medicine is that blockage and stagnation cause pain and weakness, and the use of needles and occasionally moxibustion to get the qi flowing again has been documented for over two thousand years. 

 

 

There is ni doubt that the ankle will recover by itself in time, but acupuncture treatment may well move things forward a little quicker. It would be worthwhile contacting a BAcC member local to you to seek their advice; each presentation is unique and different, and the clearest advice will always come from someone who can assess the problem by seeing how it manifests.
 

 

We have been asked this question before and we responded as follows:
 

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


http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007797/pdf

 

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. 

 
I think the only thing we would add is that the word 'cure' is not one which you will ever see in responsible literature about acupuncture. This has always been the case, long before advertising restrictions were greatly extended. Most acupuncturists take the view that they are simply encouraging natural processes to be reinstated in the belief that this should start to restore normal function. A great many factors are at play in even the most orderly life, however - diet, lifestyle, stress, work - which means that people often have to look carefully at the backdrop against which problems arose to see whether these contributed and whether they may cause the same problems to recur.
 
 
 
 

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