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Q: I have had acupuncture for a specific problem (achilles tendon pain) which has responded very well. Now it has been suggested that regular visits for acupuncture are beneficial to overall health and balance. Is this a generally recognised approach and if so is there a frequency of visits that is recommended e.g. is once a month too much, too little etc.

We are very pleased to hear that your ankle responded well to acupuncture treatment. Although it would be fair to say that the majority of patients in modern times consult us with a specific health problem, in ancient times the idea of staying well rather than getting better was central to the use of acupuncture and herbal medicine. Going to a doctor and seeking help when ill was said to be 'like forging a spear after the battle has started or digging a well when you are already thirsty.' The ancient practice was to have treatment to stay well, and it is believed that in some cases the doctor was paid to do this on pain of having to keep the patient in the style to which
they were accustomed if they got sick!

The key aspect of maintenance treatment is that each of us has a constitutional balance which predisposes us to certain problems at specific times of year or when we are faced with more mundane challenges of life like stressful times ahead or chronic problems. In China the seasons are very much more distinct than here, but the change of season was seen as critical as the temperature dropped rapidly or the winds picked up. The Chinese saw these as having a major impact on health (as a primarily outdoor agrarian race), and the doctor treated the person just before the season to ensure that the person was well-prepared for the change. With five seasons in the year,
this would have meant treatment every ten weeks, and there are many patients who take this seriously enough to do just that.

We find, though, that the majority of patients find a good balance by trial and error somewhere between four weeks and thirteen weeks, and in fact become very sensitive the idea of 'time for a treatment.' Of course, proving the long term benefits of this approach is very difficult; how do you demonstrate that someone is better than they might have been? However, enough patients have shown an increased resilience and overall health with regular treatment to convince us that the ancients had got it right.

The odd thing is that some people think that five treatments a year at around £200 is a mite excessive but have not the slightest hesitation in putting a perfectly well-functioning car through a full dealer service at £900. We think that the values of modern life have become a little off-centre at times! It is up to us to convince, though, to convince them that good health is more than just absence of illness but an enhanced ability to live well at all levels.

 

A:  A great deal depends on where you are and what you are trying to deal with. In most cases practitioners in the UK see people weekly because the majority of treatments are constitutional in nature, i.e. aimed at balancing the system as a whole, and the received wisdom is that it takes a week to get a clear picture of what has changed since the last treatment. There are as many analogies as there are practitioners, but many talk about re-arranging things in a pond and waiting until the ripples have ceased to see what has changed.

In some cases, a practitioner might see someone twice or even three times in a week if there are acute problems to address. It is not unusual with acute back sprains to see someone more than once weekly. This is more a matter of reinforcing the treatment regularly to make sure that it 'holds'.

If you were to visit a practitioner in China, however, it would be quite normal to see someone daily for ten days. This constitutes a 'course of treatment', and many Chinese people with a chronic or acute on chronic condition will trot along to the local out-patients department at the hospital to have treatment every day. With an increasing number of Chinese practitioners in the UK it is possible that this may begin to happen more frequently here, although the crucial difference is that in China the treatment is free at point of delivery within the national health system. In this country ten sessions, one a day, would probably be beyond most people's pockets unless the practitioner had come to an arrangement over the overall fee.

Many of us believe that there can be a tendency to over-treat unless one is careful, and again the often-used analogy is that of watering a plant. There is only so much watering that one can do before leaving the plant to make its own progress, and that is why we are very insistent that BAcC members maintain a rolling review of progress to assess how much treatment is needed and how frequently. This is a matter of professional judgement, because each patient is unique and different, and even though two patients may apparently have the same problem, the underlying cause could mean one gets sorted in two sessions where the other one needs ten sessions.

Covering all bases in our reply, we have to say that you can never be harmed by over-treatment, so if someone were treating too often there is no damage that can be done. The worst that can happen is that nothing happens or the system may feel a little unsettled, but the inbuilt safety margins of the system usually ensure that the body re-sets to a good working balance very quickly. That is why any adverse effects, like tiredness to a mild headache, tend to go very quickly.

A:  Proximal myopathy can result from a number of causes, and to a large extent how treatable it may be can depend a great deal of what is thought to have caused it. There are a number of underlying causes which involve pathological and irreversible changes in the body, and it would be unwise to start giving people unrealistic hope or expectation in cases like this. The first thing a practitioner would want to do in great detail would be to go through the medical history and see what had happened as the condition developed.

As is not surprising, there is very little research into the use of acupuncture treatment for proximal myopathy. The immense variety of presentations and the huge range of possible causes would make it rather difficult to assemble a meaningful trial. There will undoubtedly be studies in Chinese, but the majority of these are not translated into English and there are not many searchable databases along the lines of Pubmed and other western ones.

That said, the great strength of Chinese medicine is that it takes the symptoms which someone experiences, which are the same in any language and medical system, and makes sense of them through an entirely different conceptual grid. Chinese medicine is based on theories of energy, called 'qi', and its flow, rhythm and balance in the body. When symptoms arise these are seen as changes or disruptions in the flow, and there is a 2500 year history of making sense of these through an entirely different understanding of the human body. Someone may have had the same symptoms 2000 years ago before there was any understanding of the nervous system, and there would have been, and still are, strategies for addressing the problem.

A good analogy is the treatment of strokes. In China, acupuncture treatment is started on the day of the stroke because the paralysis and spasticity which happens is seen as a break in the flow of qi, and every effort is made to reinstate proper flow as soon as possible. There would be no equivalent western treatment because the model used does not give any grounds for immediate intervention at the level of mobilising the limbs, the event being largely thought to be contained within the brain itself. So, in proximal myopathy, there may be ways of treating the presentation through a look at the local conditions where the problem lies or through looking at the wider
functional disturbances which in Chinese medicine could affect the functioning of the limbs through a systemic imbalance.

The long and short of it is that we think you would be well advised to meet one of our members local to you for a brief face to face assessment of what treatment may be able to offer. An experienced practitioner should be able within a few minutes to have a good view of what may be achieved and offer you a realistic assessment. The caveat remains, however, that if there has been a major change in the body which has precipitated the problem, this may limit the extent to which you might improve.

Q:I have had an ongoing feeling being 'spaced out' for about 6 weeks now.  It seems to take two forms, the first -and worst- a tense, queazy, feeling in my stomach which is accompanied by the feeling almost like flu, without the flu, if that makes sense, This is generally in the mornings and it then seems to revert to a more generalised feeling of being 'spaced out' in the day. It seems to lessen in the evening. I have had blood test, all clear and an MRI scan, again all clear. I was told it could be related to a migraine issue and I have also cut out certain dietary triggers ie caffeine/ dairy. I would prefer not to take medication to try to resolve this. Do you think acupuncture could help?

This is the kind of presenting problem which many of us love to address. One of the great strengths of Chinese medicine is that it can take symptoms such as these and offer several different possible explanations within a conceptual framework which is entirely different from that used in Western medicine. As you probably already know, Chinese medicine is based on the understanding of the body mind and emotions as a flow of energy, called 'qi', the various patterns, flows and rhythms of which contribute to good functioning in the body as a whole. Where this flow is disturbed, for whatever reason, symptoms will begin to appear, although not necessarily where the imbalance
manifests.

If someone were to look at your case history there would be in all probability other aspects of your functioning which, from a Chinese medicine perspective, would probably indicate a wider pattern of which this symptom was a part. There are also some very complex diagnostic signs which would also help the practitioner to refine their view of what is happening.

If the cause is similar, from a western point of view, to vertigo or migraines, there is considerable evidence for the treatment of both of these problems, as our factsheets 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/vertigo.html

to suggest that you would not be wasting your time on giving acupuncture treatment a go. However, these are usually precisely defined in western medicine, whereas the feeling which you have is a more indefinite presentation, although none the less disturbing even though it doesn't have a distinct label.

To give you an example of how different the diagnostic process can be, this expert treated a patient once who was experiencing a similar problem, and it turned out that she was eating as much as half a pound of cheese every evening. Given the energetic balance of her body, which was already out of kilter, this contributed to the formation of what the Chinese call 'phlegm' which embraces what we give the same name but can also extend to solid lumps in the body as well as something which the Chinese call 'mist'. This is said to rise and cause all manner of symptoms of which feeling spaced out is one. Other patients can often manifest the same symptom is their work or
personal circumstances are very stressful. This can lead to a condition called the Rising of Internal Wind, again causing the same problem.

Poetic as these descriptions can sound, they are based on over 2000 years of successful clinical observation and experience, and also 2000 years of successful treatment. On that basis, we think it would be potentially very beneficial to give acupuncture treatment a go, but to make sure that you review progress very carefully so that you don't run beyond the first four or five sessions without assessing what progress there has been. This may involve you in trying to get as objective a measure as you can of how
frequent or severe the symptoms are to be able to assess as accurately as possible whether there has been a change.

Your best bet is to visit a BAcC member local to you to seek an informal face to face assessment of what may be possible. Even a ten minute chat will probably give significant clues about what is going on and whether treatment would be of benefit.

 

Q:  I have read that acupuncture can be helpful in the treatment of abdominal adhesions  (colon to bladder) is this correct and what would be involved?

A:  We have looked back over our previous answers on topics similar to this, and we find that we continue to be unable to find any research, even case studies, which suggests that acupuncture treatment may be able to deal with adhesions. We have on a number of occasions discussed the merits of having treatment to deal with the pain which is thought to be coming from adhesions, but on each occasion we have had to say that we have never been able to say with confidence that the pain was coming from the adhesions. There are many occasions when the adhesions can in turn cause IBS because of the disruption in normal function, and it is not at all clear where the pain is
coming from.

As far as dispersing or reducing the physical manifestation of adhesions is concerned, we believe that this is highly unlikely, and the only route that we are aware of, which is surgery, remains the best option if the disruption it causes is very great. However, clearly there is some form of disturbance in the energy of the body in that region to encourage the formation of adhesions, and we would be probably more confident in saying that acupuncture would be worth a try to stop things getting worse or to try to
maintain things at a reasonably clear level after surgery. Chinese medicine in its oldest form was almost entirely asymptomatic and rested on the simple
premise that if everything was in balance symptoms would not appear.

We think, though, that this is problem best discussed face to face, and we would recommend that you visit a BAcC member local to you to discuss your own unique case. There may well be factors in your medical history which would shed light on why you have started to get adhesions, and understood from a Chinese medicine perspective these may well inform an educated assessment of what may be possible through treatment.

This is probably the best we can say. We have treated many people with unpleasant adhesions, sometimes with great success but equally often with no change, and we have to be realistic about what may be done, even though we really would wish to rid women patients of the problem.

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