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Ask an expert - body - head - ear
Q: I am a muscian and DJ, looking for safe and effective treatment for tinnitus and long term hearing damage from working in loud venues. I do a little acupressure, and would like to learn acupuncture too as a self treatment. How much training do I need in order to perform self treatment safely and effectively?
A: There are two issues here. The first is whether acupuncture is really an effective treatment for tinnitus. As you might imagine, we have been asked several times about tinnitus, and most recently we replied:
The fact sheet which we have on the website
is quite upbeat about a number of small studies, but our clinical experience is not as good, with tinnitus among the more intractable conditions with which patients present. In a recent answer, to which we can probably not add a great deal more, we said:
A. Tinnitus is one of the more intractable conditions which people seek acupuncture treatment for. Our Tinnitus fact sheet, found at lists a small amount of research which suggests that acupuncture may help, but there have been no significant trials which provide solid evidence. It is also fair to say that many practitioners are very cautious about taking on patients for whom tinnitus is the primary problem. It is quite easy to spend considerable time and money and be no better off than when you started, and the individual case reports in the tinnitus sufferers' magazines often have the same shape.
However, what many practitioners do find when treating people with tinnitus is that while the noise remains largely unchanged their ability to cope with it seems to improve. Evidence for this is largely anecdotal, though, and it would be wise to discuss carefully with any future practitioner whether they think that they might be able to help. In all events we would recommend that frequent and regular reviews of outcomes and progress are essential.
We don't think you can say more than this. There are two or three clearly identifable patterns in Chinese medicine, described as syndromes, where tinnitus is a specific named symptom which frequently appears, and it is possible, if your tinnitus has arisen as a part of the syndrome, that there may be some help which acupuncture treatment may offer. An experienced practitioner should be able to make a very straightforward determination on whether this is the case. Overall, however, there is not a great deal of cause for optimism about getting rid of the unwanted noise.
As far as self treatment is concerned, opinion in the profession is divided. There was a paper published some years ago
which summarised the arguments for and against self treatment, although the last few years have seen an increase in the use of self-treatment for people who need regular top-ups after chemotherapy and the like. We believe that while the risk of an adverse event is very low, as indeed it is for any treatment with acupuncture, it is asking quite a lot of a patient to observe the rigorous conditions which we ourselves have to follow when we are needling. Disposal of the needles and any clinical waste is just one major headache among several. The fact that someone has agreed to accept the risk is all very well, but our experience is that this perception changes very quickly if something does go wrong. We have seen this when people treat friends; hell hath no fury like a friend with a bruise.
It is also fair to day that we do not necessarily think that formula treatments for named conditions are the best way to perform acupuncture. Our work is evolutionary and dynamic, the very thing which makes it so difficult to fit with the so-called 'gold standard' research model. Formula treatments tend not to work for everyone, and lack that very thing which makes acupuncture such a powerful intervention, the fact that the treatment plan and treatment is unique to the individual patient.
That said, we hate to discourage someone from using acupuncture because although the likelihood of making a big difference with acupuncture for tinnitus is low, it can and does happen. Your best bet is to try to find a practitioner local to you who uses ear acupuncture and uses stud needles or ear seeds which can be left in place and manipulated regularly to achieve the necessary effect. They can also review your treatment on a fairly regular basis to ensure that everything is going to plan. This is probably better, in our view, than self-needling.
Q: I have been diagnosed with an inner ear problem that is causing pressure and discomfort. Can acupuncture help?
A: A great deal depends on what is causing the pressure. Although we work with a system of medicine which rests on an entirely different basis from conventional medicine, we have the advantage of an understanding of the inner workings of the body which the ancient Chinese would have loved to have. If there are gross physical reasons for the pressure being in your ear, like narrowing or stenosis of some of the fluid conduits, then acupuncture treatment isn't going to be any use at all. If, however, the flow of fluids in the area is in any way compromised because they are becoming more viscous, then this is the sort of territory where Chinese medicine may make a difference. There are, for instance, a number of protocols for dealing with local blockages and with the systemic thickening of fluids which may offer some hope.
As far as research is concerned, there is nothing which we have identified which relates directly to this kind of problem. You will find a number of studies on Meniere's disease and vertigo where there may be an overlap, but nothing which relates to 'pressure' in an of itself.
We suspect that the only way you are going to get an informed answer to your question is to visit a BAcC member local to you and explain to them the exact nature of the problem. This will enable them to give you a much more informed view than we can here. Most members are happy to give up a small amount of time without charge to enable prospective patients to check whether this is the therapy, and sometimes the therapist, for them.
We are also aware that people also use cranial osteopathy to good effect with problems like this, especially where someone has a history of major dental treatment. This can sometimes cause subtle displacements of some of the joints in the area, and while acupuncture treatment can encourage a reinstatement of proper energy flow which might help the body to reassert its proper shape, a more direct method may work more quickly. Your local BAcC member will undoubtedly be able to give you a trustworthy referral for this option.
A: This is not easy for us to answer. Although some of our members use auricular acupuncture, it is not a part of the mainstream traditional acupuncture tradition, having really developed in thelast half century in Europe, although based on Chinese understanding of inter-relationships between parts of the body. This American site:
provides an answer to your specific question, as well as offering a great deal more information about the tradition and the way that it is practised in the US.
There are a number of UK organisations which offer auricular acupuncture, many of which have grouped together to form an umbrella body called the Microsystems Acupuncture Regulatory Working Group. Further details of its work, and the contact numbers for its members can be found on
This may be able to provide you with more information, should you need it.
Q: I developed sudden hearing loss 18 days ago and went to ENT in Grays Inn this week. They tried a steroid injection into the inner ear which did not work. I have heard that electro acupuncture worked for this in China. I am looking for someone who preferably has had experience in this.
A: This is clearly an area which modern Chinese acupuncturists are studying with great gusto, and the there are several trials with electro acupuncture, of which these are a gew examples, which give promising results, and which also assess whether electroacupuncture is as, or more, effective than ordinary manual acupuncture.
There are also studies like this one
which look at the effect of 'ordinary' acupuncture treatment.
While these trials all fall a long way short of what we are required to cite to be able to claim that acupuncture treatment may be of benefit (the bar is set very high, but that's another story!) they certainly seem indicative of something very positive, and woith the range of conventional options being somewhat limited, it could well be worth your while to give acupuncture treatment a go.
Unfortunately electroacupuncture is not a part of our core training, although a great many members do use EA, sometimes having attended courses, others following well-designed protocols and using trhe equipment exactly as instructed. We do not keep records of who does and who does not - that would mean setting standards, which would be difficult to create, or allowing people to self-certify, which as a registering body we would be relucantant to do. If you speak to a BAcC member local to you, however, and in N22 there are many, they will almost certainly be able to direct you to a colleague who uses EA regularly and may be able to help.
The subset of people using EA is also wider than simply BAcC members with an interest in extending their skills. There is a whole EA community which includes many conventional scientists and medics, although no single professional association to which you could go for a referral. Again, our members also 'know a man who does' and we are sure that they would be able to help you track down what you need in your locale.
As a final remark, you may also want to keep in mind as a fallback cranial osteopathy. We have heard interesting reports that this may also help, although we would always advise the use of EA first. Indeed, we would usually point out that EA does no more than conventional acupuncture treatment but has the advantage of persistent stimulation over time which is difficult to replicate manually. That is not to say that a competent practitioner may not be able to achieve the same results using manual acupuncture, and you have the advantage of several highly experienced practitioners in your patch. Using our 'find a practitioner' function
will generate a number of useful hits.
Q: I have been told that I have wear in my 5th and 6th vertebra can acupuncture help this. I have also been told I have positional vertigo could it also help this?
A: Starting with positional vertigo, as our factsheet shows there is some evidence that acupuncture treatment may be helpful, as our factsheet shows:
There are a number of conventional treatments for positional vertigo, however, and some of these are well worth a go. Many involve peculiar sequences of movements to remove or re-position little bits of debris within the canals of the ear which appear to be linked to the problem. Acupuncture can help where there is evidence, from a Chinese medicine perspective, of some blockage in the flow of energy around the ears which, whether a local problem or systemic one, could be moved by using needles and reduce the impairment which causes the spinning feeling on movement.
The presentations of vertigo tend to be unique to the individual, though, and the best advice is to visit a BAcC member local to you for a brief face to face assessment of whether they think treatment may benefit you.
As far as the wear and tear in the 5th and 6th vertebrae is concerned, we're not sure which ones you're referring to, the cervical spine (neck) or the thoracic spine (back). If your cervical vertebrae are worn there is a possibility that you may suffer from some minor impingement which could cause secondary problems in the upper arms and neck. If this is affecting the movement of your neck and head it may be associated with your vertigo, although this would be a long shot. In either case, what's gone has gone, and the best that acupuncture treatment might achieve would be some reduction in the inflammation and discomfort caused by the narrowing of vertebral gaps and attendant pressure on surrounding tissues. The only question would be how much relief from the discomfort, and how sustainable it turned out to be. If the effects can last weeks rather than days, there may be some value to having regular treatment.
The question which always manifests for us is that most people over the age of 50 have significant wear and tear in the spine, and it is not always the case that pains which appear in that area are directly caused by what the X-rays or scans show. If that was the case then it would be inconceivable that someone would improve, but we have encountered many clinical situations where the deterioration has remained but the symptoms have all vanished. The strength of Chinese medicine is that it is based on an entirely different view of how the body functions, and this can sometimes provide explanations for symptoms where conventional medicine is unable to explain adequately what is going on (this cuts the other way, by the way - the modern understanding of brain function, for example, explains problems which to the Chinese must have defied their attempts to understand and resolve).
Again, however, we have to say that you are best served by seeing a BAcC member local to you for a face to face assessment of what might be possible.