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Ask an expert - neuro and psycho logical - stroke

2 questions

Q:  5 years ago a colleague suffered brain damage after a serious car smash. He was in a coma for three days and has been left with stroke like disability in his left arm and leg. He has feeling down to his wrist but little in his hand. would accupuncture help in any way to restore nerve function?

 

possible after the stroke in ten day courses to try to restore the function in the affected limbs. The research is not conclusive, and we cannot give an unequivocal recommendation, but as our fact sheet on stroke shows

please click here
 and a much more detailed review paper please click here
 there is a growing body of evidence suggesting that acupuncture treatment may be of benefit.
 
This is not quite the same as restoring nerve function, and we would not make any claims of this kind. From a western medical point of view, when most nerve function has been lost or compromised there are serious difficulties in recovering what has been lost. Chinese medicine is based on a theory that the body mind and emotions are all manifestations of the flow of energy, called 'qi', in the body. When this flow is blocked or impaired, as is the case with a stroke, then the aim is to restore the flow and try to recover the functions which have been lost.
 
However, your friend hasn't had a stroke but instead a serious car smash, and to some extent it would be unfair to use information based on a naturally occurring phenomenon as a basis for comment on what may or may not be possible in his case. If there has been substantial damage to the tissue of the brain, then there may not be any possibility of recovery, and it would be wrong of us to create hope or expectation. However, you could do a lot worse than see if a BAcC member local to you can give him a short face to face assessment of what acupuncture may be able to achieve, based on what the practitioner can actually observe. We are sure that he will get an honest and realistic view.
 
It may also be worth mentioning cranial osteopathy as a modality which may have something to offer. This is based on a number of theories in which the structural integrity of the skill is crucial, and while it more often addresses subtle changes which can have a profound effect on function, there is no reason in principle why it should have an effect here. It is highly likely that your local BAcC member may be able to give you a good referral; many work closely with other local practitioners and have a network of trusted colleagues with whom they cross-refer patients. 
 
 

Q. My father has post stroke pain ,  please can you tell us if there is any scientific evidence that acupuncture is helpful for patients suffering from post stroke pain.  our reason for asking this is that we are in the process of challenging our local hospital that is refusing him treatment. Many thanks.

 

A. The short answer is 'no'. Scientific evidence of a kind which satisfies the current gold standard of western research, the randomised double  blind control trial, is in short supply. This, however, is mainly a methodological problem; the practice of traditional acupuncture does not lend itself to standardisation and reducing variables. A review paper on the current evidence for the use of acupuncture after stroke can be found on our website here
 
Although the evidence for the use of acupuncture is not accepted in the West acupuncture is very widely used in China and the Far East for assisting in recovery after stroke. It is not unusual for someone who has had a stroke to receive a course of treatment almost immediately after the initial stage of recovery has passed, and the accepted wisdom is that the earlier treatment starts, the more effective it will be. This does not always work so well in the West, where many patients turn to acupuncture only after conventional methods of treatment are not working as well as they had hoped, and the delay in starting acupuncture treatment may make it less effective.
 
You say that your father's hospital is refusing him treatment, but it is not clear whether this is because they doubt the effectiveness of acupuncture and will not fund it or whether this is because they have concerns about the treatment itself. If it is the former you may well have a struggle to convince them. Evidence based on clinical trials is very much the determining factor. If it because of uncertainty about the safety of treatment the Council has on many occasions been happy to provide evidence that acupuncture in the hands of a properly trained practitioner is extremely safe.