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Ask an expert - general
Q: We are very attracted by the Channel Islands, and would like to move there. My husband has been practicing acupuncture in the USA for 30 years. In USA and in China, he learned TCM. He is an American citizen and I am German citizen. How would it be possible for him to practise his profession and help the people on the Channel Islands?
As far as we are aware, the level of qualification which your husband has achieved in order to be able to practise in the USA should be more than adequate to meet the eligibility requirements for practice. We are familiar with the requirements in Jersey, having had extensive correspondence with the government of Jersey when the new Code of Practice
was introduced, and we are sure that the current US standard more than meets the criterion set down in page 22 of the document.
Guernsey and Alderney have a very similar statement in their byelaws
We believe that Sark submits to, or complies with, the laws of Guernsey in most matters, but with a population of 600 we think it is highly unlikely that you will be choosing this as your primary practice site.
In all matters to do with registration for acupuncture practice we always advise people to initiate a dialogue with the authorities under whose jurisdiction they fall. In the end they will always have the final word on who and what is acceptable, and practitioners will always become visible sooner or later, so hoping to go unnoticed or uninspected is not a good option.
There are a number of aspects of the legislation in Jersey to which we took exception, mainly around requirements for second sinks in treatment rooms for washing equipment to be re-used. The laws apply to all skin piercing activities, and although none of the equipment we use is re-useable, our members were required to comply. This illustrates what we have always told our members, that whatever standards we set, the local authority rules, if higher, are the ones they have to follow.
The only factor on which we cannot comment is the more general one about residency on the islands. Jersey, for example,. has fairly stringent rules for who can and cannot live and work on the island, and you would need to take advice from the relevant authorities on eligibility to work there. The summary here
is quite useful and the formal portal
gives further detail and paperwork.
We wish you every success in your endeavour.
We suppose the short and truthful answer to your question is 'no' if by it you mean 'can acupuncture accelerate a natural process?'. The rate at which young people enter adolescence can vary dramatically, and 'late starters' often accelerate very rapidly to catch up with their peers and sometimes overtake them. One of the basic premises of traditional acupuncture is that it encourages best function in the body, mind and spirit, and to this extent works within the potential which each person has by making everything function as well as it can. If the body has its own game plan for an adolescent, acupuncture treatment cannot change that by speeding things up.
That said, there can come a point where someone's growth may start to attract clinical attention, and where clinicians in orthodox medicine will start to commission hormone tests to see what is happening. Once this is the case, and a pathological pattern has been identified, there may be some scope for using acupuncture to help to normalise matters. The research evidence for the treatment of hormonal problems is a little sketchy, but slow growth and development in later adolescence has been examined by Chinese physicians for over 2000 years, and there are a number of ways of understanding and making sense of this within the terminology and conceptual framework of Chinese medicine.
However, our advice to any twelve year old who presented at our clinic would be to have patience and wait for changes which in the vast majority of cases will occur within the 'normal' band for teenage development. Only when someone reaches the end of this range at about 15 or 16 would most medical practitioners start to consider that things may not be as they should.
However, we wouldn't want to deter someone from trying acupuncture before that! In ancient times, acupuncture treatment was primarily aimed at keeping people well, not getting them better after they had become ill. This, said the ancient Chinese, was like digging a well when you were already thirsty or forging a spear after the battle had started. In a world dominated by disease labels and getting rid of problems treatment for healthy living and encouraging better function often get set aside from the way we present what we do, and we believe that we could perhaps be doing more to get this message across.
Q: This question is not strictly related to acupuncture, but i couldn't find answers anywhere else so I'm hoping an expert here could help me. Last week I accidentally punctured the palm of my hand with a large thumb tack by putting my weight on the desk when standing, not realising the was an upturned pin under where I put my hand. It was a shock to say the least but the pain subsided quickly after I pulled the pin out. There was very little blood but my ring finger did twitch and my forearm felt tingly. Now a week on I am still feeling uncomfortable sensations in my ring finger, like a tightness and slight pain. The pin went in about two inches below the base of my ring finger. I should mention also that about a year ago I accidentally sliced open my hand about 1 inch below my ring finger and pinky. At the time I had it glued with butterfly stitches. There was no remaining pain once the slight swelling etc had gone down.
A: We're sorry to hear what has happened to you.
As you say, it isn't an acupuncture-related injury, but if we did have a patient report of similar response to an acupuncture needle, we would probably say that the reason for the continuing pain is most likely to be from deep bruising which has caused a clot to form and which is pressing on the nerve, replicating the pains you felt when the accident first happened. If this is the case, then it will clear within a fortnight or so with a gradual reduction in the unpleasant sensations.
It is possible that there has been some damage to the nerve itself, or any one of several nerves which traverse the area, and the outcome here may be a little more difficult to predict. We have certainly come across one case where a direct hit on a nerve generated unpleasant sensations for a number of months. However, this would be very rare, and if the symptoms continue with the same level of intensity thrughout the next fortnight, or even become a bit worse, then you will need to see your GP to get a referral to a neurologist. There may be no harm in seeing your GP early anyway; waiting list medicine sometimes demands that people try to get themselves on the treadmill sooner rather than later. If your GP has on inspection any reason to suspect nerve damage, then an early referral is a good idea.
On the balance of probabilities, though, the symptoms should begin to subside during this week.
As an aside, there are a number of powerful acupuncture points on the palm of the hand, and you may have given yourself an unwitting treatment. Two of the major channels travel where you report symptoms, but the chances that they would resonate for this long are very small. Not the nicest way to have acupuncture treatment either!
There is absolutely no doubt that this has become a very popular and recent extension to traditional acupuncture practice; many BAcC members undertake postgraduate training in the techniques, some of which are not a part of mainstream acupuncture training, and openly advertise this as an extension of their work. 'Rejuvenation' is not an acceptable term any longer; you would need much more rigorous evidence to meet the current ASA standards for advertisers. Most people describe their work as 'cosmetic acupuncture' or simply 'facial acupuncture.'
Q: Popularity brings challenges, and this field has also become something of a lucrative sideline within the beauty business. This has meant the entry into the business of people who have trained only in this aspect of the work, and we have two major reservations about this. First is that no-one can be properly and effectively trained in the safe and hygienic practice of acupuncture in the course of a weekend training programme. From our perspective it matters not whether the practitioner uses ten needles a year or ten thousand needles a year, the standards remain the same. Our concern, as always, is that an amateur in what is a professional field does something wrong, and we can guarantee that the headline will say 'acupuncturist does.....'. No point in us quibbling about levels of training, the damage will have been done. When you think that this technique may be used by people in the public eye, the possibilities for a PR disaster are considerable.
More importantly, though, there is ino separate field of 'facial acupuncture'. There are simply the techniques of traditional acupuncture applied to a specific area, and these techniques will only be effective to the extent that the practitioner takes into account the systemic problems against which the facial problems occur. The most irritating thing from our perspective is that acupuncture used without an understanding of the wider system will most often not work very well, and we believe that a porr experience, where acupuncture treatment seems not to work, will turn someone away from a system which properly applied could do a great deal not just for the face but for the rest of the person too.
Our advice is that if you are looking for someone to provide this form of treatment, be sure to go to someone who also uses traditional acupuncture as a main profession. That is your best chance, in our view, of optimising your investment in time and money. We would also advise you to shop around. In the view of this expert, this has become something of a 'cash cow' for some practitioners who price themselves according to the beauty market in which the treatment is offered. Whilst we would recognise the value of postgraduate training and experience, it is after only only traditional acupuncture applied in a specific area, and the gap between someone's ordinary charges and this form of treatment should not be too great.
Q: My uncle has just completed treatment for bowel cancer and he's suffering really badly with burning hot feet. I asked a family friend, who is an acupuncturist, if she thought treatment would help. She seemed to know the symptoms I'd described and called it 'something' syndrome (I can't remember what the name of it was and now I'm not able to get back in touch with her to clarify). Is this something that you are familiar with and could you offer any advice - including if there are any specialists in this area in the north west of England?
A: While we admire our colleague's diagnostic prowess (!), we'd have to say that the symptom has to be seen in the wider context of the patient's overall patterns of energy. While there may be one or two syndromes where this symptom is central to the diagnosis, it is always possible that it is a secondary reaction to a deeper underlying pattern which could only really be identified by looking very carefully at all aspects of someone's functioning.
We don't know exactly what treatment your uncle has had, although very often it involves surgery and chemotherapy, and occasionally radiotherapy, but we do know that it usually has significant effects on the whole system, and that includes body, mind and emotions. It is really important to be able to assess first hand what effects it has had. This is why in Chinese medicine the same symptom can be treated in dozens of different ways. Even in conventional medicine the great Canadian physician William Osler famously said 'it is more important to find out what patient has the disease than what disease the patient has.'
The best course of action for your uncle is to visit a BAcC member local to him to see if they can give him a brief face to face assessment of whether in their view he would benefit from treatment. The great majority are willing to do this without charge in order to give the patient as much information as possible before they commit to treatment. There are no specialists in this field, but this is not because of the field but because of the nature of Chinese medicine which treats the person, not the named condition. In reality, though, so common is cancer and its treatment in modern times it would be unusual to find a practitioner who has not had experience of treating someone who is recovering after cancer treatment.