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Q I have no upward movement in my big toe joint following an operation to remove a lump in the base of my foot. Can acupuncture help with muscles and nerves?
A: A great deal depends on the extent of the damage caused by the operation.
We do not intend any criticism of your surgeon or podiatrist, but any operations to remove lumps or growths carry a small but real risk of interfering with both the nerves which supply the foot 'downstream' and also the muscles which sometimes have to be cut slightly, or may even have become fused to the lump and become collateral damage when the lump was taken out. It would only be fair to say that if the damage is permanent then acupuncture treatment will not make a difference.
However, traditional Chinese acupuncture operates on an entirely different theoretical basis from western or conventional medicine. The basic premise is that the body, mind and emotions are all one interconnected flow of energy, which the Chinese call 'qi' and which does not translate well into English. Health, vitality and proper function all depend on a good flow, rhythm and balance of energy. When someone has an operation involving cutting through tissue there is always likely to be some break in the flow. In severe cases, especially when someone has a great deal of keloid scar tissue, the blockage this creates can cause significant trouble. In more confined areas it can result in symptoms such as you describe, loss of sensation or loss of movement.
Of course, if everything in life were that simple it would be an easy thing to fix; just pop into an acupuncturist's clinic, have a few needles and all should be well. In reality, some cases respond well and others don't respond at all. There are all sorts of factors which influence this, not least of which the overall balance of energies in the person in whom the problem occurs. This will mean that some people will heal faster anyway, and others will struggles. A skilled practitioner would take this into account when making an assessment.
In any event, where the outcome is rather uncertain it is vital to set a limit to the number of treatments which someone has before drawing a conclusion about whether it is working. Having a measurable outcome makes life much easier because progress will be visible, not just based on how someone feels on the day. We tend to suggest that four or five sessions at most are a good chance to tell whether treatment will work. If there has been no change at this point it may be good to look at other options.
The best advice, which we invariably give, is that someone visits a local BAcC member for an informal assessment of what may be possible. Actually seeing a problem is a far better basis for offering advice, and most members are happy to spare a short time without charge to see if it is something they think they could help with.
Q: Can acupuncture for lower back pain cause imbalance and dizziness . The next day I spent in bed because when I moved I felt I might fall over and and everything was moving especially when I bent down or moved quickly.
A: We are sorry to hear of your problems.
The first thing we have to be clear about is that acupuncture, whether performed as traditional acupuncture or one of the versions of medical/symptomatic acupuncture, treats the person as much as the condition. To that extent even a symptom elsewhere in the body may have been triggered by treatment aimed at something entirely different. The same applies even if the person thinks they are 'only treating a bad back', and we have registered our concerns over the years about people using formula treatment having unexpected effects on the patient.
That said, the reaction which you have had is a great deal more severe than we would normally see. We warn patients that they may feel a little odd for 24 to 48 hours, but the 'normal' reactions of this type are relatively minor - a slight headache, additional tiredness for a while, and occasionally a slight return of an earlier symptom as the body reverses the process of disease. To have to spend a day in bed feeling dizzy after a treatment would be highly unusual; we gather statistics on what we call adverse events, and this is not one we come across before. That does not mean that it hasn't happened, only that it hasn't been reported to us. However, we find that patients are usually very keen to tell us when something has happened.
We think the most likely reason is that you have had the misfortune to have a viral infection which has by chance coincided with your treatment. With over 4 million treatments a year in the UK there are going to be a few cases where something happens after a treatment which has nothing to do with it, and this may well be one. It does sound rather unpleasant, however, and if it has persisted into a second or third day we think you might do well to consult your GP. There are other possibilities, none of which you should worry about but which treatment may be able to help. There are a number of problems associated with the inner ear, for example, which can generate these symptoms, and your GP may well be able to help you deal with this.
We shall definitely keep a record of what you have reported, though. The fact that we have had very few reports like this in the past does not mean that there isn't a theoretical risk that it could happen, and if we find over time a cluster of cases we would always update our information to the public to make them aware of the potential risk.
In any event, we do hope that the problem has already resolved, and that it hasn't put you off having further treatment for your back. As you may be aware from our literature back pain is a problem which really does seem to respond well to acupuncture treatment to the extent that it forms one of the recommended treatments in the NICE guidelines for NHS patients.
Q: I would like to know what I have to do to become a registered NHS Acupuncturist. I am a qualified acupuncturist. I studied with the CNM college.
We are not sure that there is such a thing as a registered NHS acupuncturist. Our members have sought for years to achieve some form of recognition, either by way of statutory regulation or by way of recommendation from statutory bodies, and the best that we have managed to achieve at a national level is the use by NHS Choices of the BAcC's register as the 'go to' place to find a traditional acupuncturist. This was very much premised on the fact that the BAcC has been accredited by the Professional Standards Authority under its Assured Voluntary Register scheme.
Other than that we have many individual members who have managed over the years who have managed to gain contracts for services with specific NHS departments or consultants in their area, but the recession has seen a significant fall in the number of these. Where NICE guidelines have made room for the use of acupuncture, as in the currently hotly challenged NICE Guideline for Back Pain, what little take up there has been has been through work being offered to practitioners like physiotherapists who are already employed within the system.
And more than that, we are afraid, we cannot say.
A: We have produced a factsheet on hypertension
which we have to confess we found a little lukewarm. However, we were delighted to find that there have been a number of new studies published since the factsheet was written, two of which
https://www.ncbi.nlm.nih.gov/pubmed/23724695 make much more encouraging noises. However, the most recent systematic review https://www.ncbi.nlm.nih.gov/pubmed/26207806 concludes that acupuncture treatment is probably more useful as an adjunct to the use of conventional medication, and that, surprise surprise, more research needs to be done with larger studies. Easier said than done in the West where very little research is funded by mainstream bodies. However, one day....
From a Chinese medicine perspective there are a number of clearly defined patterns which generate hypertension and where there are well-established protocols for lowering blood pressure, usually described from the external signs - the ancient Chinese did not have sphygmomanometers. When we come across new patients with these kinds of symptoms patterns we are usually confident of being able to offer some help. However, we always work as closely as we can with their doctors, whether directly or indirectly, to ensure that any reduction in medication is managed carefully. We have seen enthusiastic patients stop taking their meds in their desire to use a more natural method of B control and watched their BPs go through the roof. This is not what we want to see; the risk is too great.
As far as snoring is concerned, there is very little research about snoring per se. There is quite a bit about obstructive sleep apnea, and we suspect that if your GP is aware of your BP problems and the snoring that investigations have been done to assess whether the snoring is part of the sleep apnea and contributing in part to the higher BP. Otherwise we have to be honest and say that when we take on patients with a problem like snoring, we tend to do so with the caveat that we will use our skills to balance things as well as we can from a Chinese medicine perspective and see what effect this has. However, we tend to set a tight limit on how many sessions we will do as an experiment, and we always look for a decent measurable outcome so that it is clear whether the treatment is working or not. This can be a problem; the sufferer is usually blissfully ignorant of the effect they are having.
Q: I've had three weekly sessions of acupuncture having had a miscarriage 5 weeks ago. After the first I felt strong benefits. After the second I experienced unpleasant stomach cramps and diarrhoea and after the third although it was a gentler session, diarrhoea and vomiting 12 hours after. Just for a couple of hours and then I was fine again. obviously I am concerned as to whether I should continue as my body is clearly reacting quite dramatically. She is unable to advise me as she hasn't had any other patients react in this way in ten years! I'm happy to continue if this is seen in TCM as a positive thing but concerned that I may be causing harm to my body.
A: It is always a problem when someone throws a large reaction to treatment on more than one occasion. We do tend to advise patients of the range of possible reactions, what we usually called transient adverse events, and that if these do happen they will last for no more than 24-48 hours. We also tend to say that they are more common when someone has a first session, and we are often quite reassured by a strong reaction that the treatment has cleared something, and that the reaction has been a good one.
However, if the same thing happens twice or three times, then we start to look at a number of factors. First is the case history. Is there sufficient evidence of prolonged energetic disturbance over a long period of time to warrant the kind of disturbance which is happening? We have come across cases where the 'clearing' of past blockages has taken a number of sessions, but when you look at the case history it was not a surprise. Then we might ask whether the treatment itself was too much for the person to take. There are a number of individuals for whom acupuncture treatment will always be a problem. This 'expert; had a patient for whom any more than three needles with minimal manipulation sent her spiralling out of control for a week or more. It took a long while to establish what the safe limits were.
However, it looks as though your practitioner has taken this into account by making the treatment more gentle, and vomiting and diarrhoea is a very extreme reaction, even as a positive one. The first thing that we would do is to advise you to see your GP just to rule out that there isn't some sort of background infection which having treatment brings to the surface. It is highly unlikely, but there may be a contingent bug in your system which is causing problems because of the added influence of the treatment, for whatever reason, and you need to eliminate this.
What we can say with some certainty is that you are highly unlikely to suffer any damage to your body with symptoms such as you report, other than perhaps a pulled muscle or two from heaving and slight soreness from the diarrhoea. There is almost no evidence that acupuncture can cause harm other than by the physical nature of the needling itself puncturing organs or causing bruising. Reactions such as yours are probably a sign that the body is dealing with a pathogen of the kind which we describe, and this should mean that the reactions will diminish and cease soon.
Without knowing a great deal more about your case history there isn't much more that we can say, but we are impressed by the candour of your practitioner and believe that you are in safe hands. We strongly suspect that she will be as puzzled as you and will be talking to experienced colleagues to see what suggestions they may have.
In any event we hope that these reactions cease and that the treatment can really benefit you without first having caused this rather extreme ripple on the pond.
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