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Ask an expert - body - head - ear

23 questions

Q:  My husband has been told that his eustachian tube in his ear remains open when it should be closed would he benefit from acupuncture?

A:  We have spent some time researching your question about Patulous Eustachian Tube (PET) because we have to be honest and say that it is not a frequently presented problem. We have found no studies of its treatment with acupuncture, although we have no doubt that they exist in China. The problem is that only a very small percentage of studies are translated, and these are usually for the 'headline' named conditions, back pain, headaches, and so on.

From a Chinese medicine perspective, any failure of function should theoretically be amenable to treatment unless there has been a physical change in the structure of the body which it would be unrealistic to see reversed. As we understand it PET can range from a birth defect often found in people with Downs through to a shorter term problem generated by excessive weight loss and consequent loss of fat in the tissues of the Eustachian tubes. Depending on the putative cause treatment aimed at establishing the overall balance of the body may have a chance of restoring function to a degree. A practitioner might also be interested to see whether there are any local blockages in the flow of energy set against a general backdrop of energetic weakness which might have caused the condition to appear or worsen.

Generally, however, with conditions such as this there are fewer guarantees than usual, and we always recommend that treatment undertaken in a 'let's see' mode is carefully monitored. It is always worth trying acupuncture treatment because we have seen unexpectedly good results on occasion for conditions like this, but we have also seen situations where someone has had a course of twenty sessions with no change, and this can often lead to dissatisfaction. Regular review periods are essential.

The one small ray of hope is that there was some excitement about the use of a Chinese herb Jia-Wei-Gui-Pi-Tang following a Japanese study found here

http://web1.incl.ne.jp/ishikawa/PET/art1.html

which achieved some remarkable results in some patients, although the study itself was terminated because of adverse effects on other patients. We are not Chinese herbalists, but a small proportion of our membership are jointly members of the Register of Chinese Herbal Medicine (RCHM) and it may well be that if you can find a dual-registered practitioner near you, they might be able to offer you a very good assessment of what is possible by using a combination of acupuncture and herbs. There is also an association of mainly Chinese practitioners, the Association of Traditional Chinese Medicine, whose members all use acupuncture and herbs. Most members of all these associations are usually happy to give up a small amount of time to see someone briefly in order to assess whether treatment may be beneficial. This will enable a slightly more in-depth view than we are able to offer at this level of generality.

 

A:  We find it quite difficult to answer questions about very specific problems like this. There is little or no research into problems like this, and where this is it tends to be in the form of case studies. These are interesting but offer far too many confounding factors to be able to draw any conclusions or recommendations. In modern times the advertising rules are now far too prescriptive to make claim without proper evidence (although we often argue with the ASA about what counts as 'proper'!)

However, symptoms are the same the world over, and in its 2500 year history there is a rich vein of addressing the pains and discomfort which people feel from problems like this by looking at their structure and appearance from within the framework of traditional Chinese medicine. This is an entirely different paradigm of medicine with patterns and syndromes which sound utterly alien to the untutored ear,  but it has stood the test of time. If we drop disease labels out of the picture and focus on what someone experiences as a change in the balance and flow of energy, called 'qi', on which the system is based we often find local blockages and systemic weaknesses, the correction of which can make a significant difference.

Essentially Chinese medicine treats the person, not the condition, and the practitioner will want to understand why this particular symptom developed in this person. In this sense traditional acupuncture can help in the treatment of most named conditions, but we have to be careful because 'treat' implies 'cure', and this is often not the case. All that we can do is to maximise the balance of the individual and then let nature take its course. Sometimes the results are very good, on other occasions there are many hereditary and lifestyle issues which limit what is possible.

The best advice that we can give is that you visit a BAcC member local to you for an informal chat about the possible benefits of acupuncture. You will be able to let them know a great deal more about what exactly is happening, and this will offer the chance of a much better and more precise view than we can offer here. Most do not charge to have a quick look at a problem, and of course you get to meet them and see where they work before committing yourself to treatment.


Q:  Do you know of doctors in Las Vegas, Nevada, USA, who use acupuncture to treat severe tinnitus? Also has seizure-like events been known to accompany tinnitus or has been caused by it? My daughter, born with a profound hearing loss in 1969, has lived with chronic pain since 1999 and tinnitus since 2012 with little relief. Any information you can provide will be helpful and appreciated. We are at a loss as to how to help her.

A:  We are sorry to say that we are not really aware of who works in Las Vegas, our reach being somewhat limited, and we certainly have not heard of any dramatic breakthroughs in the treatment of tinnitus. We are absolutely sure that had there been a serious development in the treatment of this chronic debilitating condition news would have travelled very quickly. When some acupuncture practitioners claimed to have a treatment for macular degeneration it sparked a whole host of questions across the globe.

We tend to be very conservative in the advice we give about tinnitus. One recent response said:

We used to be a great deal more downbeat about the treatment of tinnitus than we are now because our experience in practice was that it could prove intractable to treatment. However, as our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tinnitus.html

and as some recent personal experience in clinic has shown too, there may be some hope. 

The problem with measuring the success of treatment for tinnitus is that its appearance and disappearance can be entirely random. If you read the tinnitus association's magazine you will see stories along the lines of 'I tried everything and then x worked' and an equal number of stories which say 'I had tinnitus for five years and then one day it just went.'  Research trials tend to be quite reliable - it would be a remarkable coincidence if half the trial participants experienced a spontaneous improvement - but one-off cases could be a coincidence, with acupuncture just happening to be the therapy of choice when the change happened.

The available evidence, however, suggests that it might be worth a try with the proviso that progress is reviewed at regular intervals, and some kind of objective measure can be found, i.e. how much it interferes with a radio set at a particular level. It might also repay investigation of what makes it worse and what makes it better. A long n-1 case study this expert conducted had very little impact on the condition but did increase the sufferer's ability to deal with it.

The best advice is to visit a BAcC member local to you and your wife for an informal face to face assessment of what may be possible. There are one or two clearly recognisable syndromes within Chinese medicine which might offer considerable confidence that muting the problem may be possible, but even a general balancing of the system may bear fruit.

As for links between epileptic seizures and tinnitus there are a number of scientific studies which speak of a patho-physiological similarity in the two problems, and there is well document evidence of epilepsy affecting the vestibular apparatus which may well have an impact on the auditory ability of the body. We are acupuncturists first and foremost, though, not medical practitioners in the conventional sense, so we would have to say that we are not the best placed to answer your questions on this.

There is no doubt, though, that acupuncture has a long history of being used for pain relief, much of which was provoked by interest after Nixon's visit to China in the 1970s. That acupuncture treatment can have an effect on the release of the body's natural painkillers like endorphins and enkephalins is not in doubt. The main concern is how much pain relief and how sustainable it is. This can often be a delicate balance between outcome and cost, but it is always worth trying.

That's about the best that we can say. Our members tend to offer people brief face to face assessments which enable them to give a slightly better insight into what might be possible, and this seems to us the best way forward. Looking at things through the perspective of Chinese medicine can sometimes open up new lines of treatment which can in some cases provide unexpected relief.

Q:  My wife has a ringing in her ears which is said to be tinnitus, I recently read of a lady who after many years of suffering this affliction was cured by acupuncture. Could this be true ? 

A:  We used to be a great deal more downbeat about the treatment of tinnitus than we are now because our experience in practice was that it could prove intractable to treatment. However, as our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tinnitus.html

and as some recent personal experience in clinic has shown too, there may be some hope. 

The problem with measuring the success of treatment for tinnitus is that its appearance and disappearance can be entirely random. If you read the tinnitus association's magazine you will see stories along the lines of 'I tried everything and then x worked' and an equal number of stories which say 'I had tinnitus for five years and then one day it just went.'  Research trials tend to be quite reliable - it would be a remarkable coincidence if half the trial participants experienced a spontaneous improvement - but one-off cases could be a coincidence, with acupuncture just happening to be the therapy of choice when the change happened.

The available evidence, however, suggests that it might be worth a try with the proviso that progress is reviewed at regular intervals, and some kind of objective measure can be found, i.e. how much it interferes with a radio set at a particular level. It might also repay investigation of what makes it worse and what makes it better. A long n-1 case study this expert conducted had very little impact on the condition but did increase the sufferer's ability to deal with it.

The best advice is to visit a BAcC member local to you and your wife for an informal face to face assessment of what may be possible. There are one or two clearly recognisable syndromes within Chinese medicine which might offer considerable confidence that muting the problem may be possible, but even a general balancing of the system may bear fruit.


Q  Can an earring on the acupuncture point in the ear lobe help symptoms of travel sickness and mild vertigo. As in labrynthitis of the ear. 

Strange to say, but ear acupuncture is not really within our scope of practice. Although some of our colleagues do use it ear acupuncture is really a more modern European invention, drawing on ancient Chinese traditions but using them in a very 20th century way. The idea of using specific points for specific disorders is not normally how we practise acupuncture, where the same named condition can be treated in dozens of ways as the practitioner aims to treat the person, not the disease or symptom. Many practitioners, however, can and do use specific points for detox acupuncture, helping people to stop cigarettes, drink or drugs, or for general calming.

Ear acupuncture is what we call microsystem acupuncture, where the whole body is treated through one part. As well as ear acupuncture you will also find hand acupuncture, su dok, a Korean development, and there are a number of other systems too. For more information, you can contact the organisation which regulates many of these bodies, the CNHC at http://www.cnhc.org.uk/index.cfm?page_ID=103&disciplineID=13&d=microsystems-acupuncture.

We are bound to say that treating any of these disorders - vertigo, labyrinthitis or travel sickness - is in our view better when done within the context of treating the whole person. We have a number of factsheets on conditions like these

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/vertigo.html

although the research, for a number of reasons, is not sufficient for us to lay claim to efficacy. Having said that we all have treated many cases of these and related conditions, and in the main have enjoyed quite a deal of success, whether full remission or a better management of the problem.

In summary, though, if you are looking for a symptomatic relief for specific situations where these conditions are a problem, but where they are not a problem for most of your time, than a microsystems practitioner might well be a good option. If, however, you are looking to deal with the problem on a more permanent basis, then  it may well be worth trying traditional acupuncture. The best thing to do would be to contact a BAcC member local to you for a brief face to face assessment, hopefully without charge, to assess whether traditional acupuncture would be a suitable treatment.


 

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