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Q: I have athritis in my hand and thumb. Will acupuncture help me?

A: As you can read from our factsheet on arthritis there is a fair bit of evidence that arthritis can be helped by acupuncture treatment, and the usual response we give says that it is more a matter of how much help and how sustainable the results are. Clearly if treatment only gives a couple of hours of reduction in pain and stiffness then acupuncture may not be the best option, but if the improvement lasts a few days there might be better prospects. The question really is whether the improvement always drops away back to the original baseline or whether there is a gradual overall improvement. There is nothing wrong with knowing that something will only work for a week if the week in question is one where additional mobility is necessary, and of course the joker in the pack is how much treatment may be doing to reduce further deterioration, or 'getting worse slower' as one waggish patient remarked.

However, with arthritis in particular it is really good to get a handle on the possible causes. Although the symptoms are universal, the causes, even in western medicine, can be very varied - repetitive use, diet, heredity, and so on. In Chinese medicine this difference can be crucial because each person will be a unique combination of factors, and treatment can address this unique quality better, we believe, in many cases than western medicine which has clearly defined clinical pathways for all named conditions.

The best advice we can give is that you visit a local BAcC member for advice, and for them to have a look at the exact nature of your symptom in the context of your overall health. There may well be other factors in play which would enable them to determine whether this is simply a local problem or the tip of a systemic iceberg. Most of our colleagues are more than happy to give up a little time without charge to prospective patients to enable them to assess the potential benefits of treatment. We are confident that they will give you honest impartial advice.

Q: I am 78 and had my third session of acupuncture yesterday to relieve soft tissue problems in my upper leg and hip. I had six needles. Today I feel exhausted, light headed as if I had vertigo and my eyes are jumpy and feel as though they are trying to cross. I feel very unsafe walking about. Would you advise me to discontinue the acupuncture?

A: We are sorry to hear of your problems. In our experience it is possible to have short term adverse effects from treatment, but these generally last for a maximum of 48 hours, if that, and then vanish.

There are a number of reasons why this can happen. As you are aware, treatment is aimed at restoring the flow of energy in the body, and this can quite often produce some odd reactions as the body adjusts. Occasionally the treatment can be a little too energetic for someone, and the practitioner needs to be made aware of this so that they can reduce the number of needles and use less manipulation. Some people are very sensitive to treatment, and can react over-strongly, although the fact that this has happened after your third treatment would suggest that this is not the reason. Sometimes it can be as simple as the fact that the treatment took place on an empty stomach, and the body is a little ungrounded and over-reactive.

In any event, there is no reason to discontinue treatment, and every reason to discuss what has happened with the practitioner. All of us are more than happy to talk to patients who experience odd reactions to treatment, and in this case the person will know exactly what they did and why, and perhaps be able to make sense of the reactions. This should give you the reassurance you need.

However, we do have to add one word of caution. Just because something happens after treatment does not mean that it has happened because of it, and we have seen cases where people have experienced some odd problems after treatment which were entirely coincidental. If the feelings persist for more than 48 hours you might want to contact your GP just to make sure that this is not something entirely separate.

The most likely explanation is that it is a period of adjustment after an effective treatment, and we hope that by the time you are reading this everything has reverted to normal, hopefully with an improvement in the problems which took you to treatment initially. If this isn't the case, though, then a call to your GP would be advisable.

Q: I am considering a career change to acupuncture but am suffering with mild osteoarthritis in both my hands. I wonder if this will affect my ability to practise, or is most of the work of a fairly gentle nature? I know this is hard to answer, but I am trying to assess whether this is a sensible career path for me. I am 48 years old.

A: There is no doubt that acupuncture is a gentle therapy, and it would be most unlikely for you to have to anything which involved great pressure or strength. The majority of needles are inserted with the help of guide tubes, which require only the strength necessary to tap the needle in, and there is not a great deal beyond this which would be a must. Some teaching institutions have training sessions in tui na, a form of Chinese massage, which you may find a little problematic, but this is not something which is a must for successful practice.

The only challenge which you might face is fine manipulation and control of the needle if the condition becomes more serious. This would have to be a very significant deterioration, because we had a colleague with rheumatoid arthritis whose hands were terribly deformed and painful who still comfortably managed a successful and busy practice. However, it is something worth exploring because there is a level of dexterity which you will need.

The best way to get advice would be to contact the nearest teaching institution or, better still, visit ones which have Open Days for people to drop in and discuss the possibility of training. We have a sister body, the British Acupuncture Accreditation Board,. which accredits courses offering automatic eligibility for membership of the BAcC on graduation, and a full list of the accredited courses can be found here: The website also contains a wealth of information about studying acupuncture and the benefits of acupuncture as a career.

The only caveat to bear in mind is that teaching bodies are often obliged to take on students without necessarily having to take into account their ability to practise or to register as professionals afterwards, i.e. someone can insist on being trained and a college can't turn them away. So, being pronounced fit for study may not be the same as being fit to practise. We are as sure as we can be that no-one would be unscrupulous enough to take you on if they felt that you really would struggle to carry on in the career, but we are aware that this is the legal extent of their responsibility.

Anyway, we hope that you get good news about this and decide to take the plunge. This particular expert is thirty years in and still enjoying every moment of it, and still learning!

Q: I am having an IVF embryo transplant this afternoon followed by another acupuncture session. If I have one more session tomorrow is that safe or is it too much?

A:There is nothing to worry about, as far as we can see. Many of the protocols which have been devised for assisting in IVF are focused on the point of implantation, and the most well known of these, the Paulus Protocol, involves using acupuncture within twenty minutes of the implantation. It would not be at all surprising if someone had developed a protocol which extended this to a slightly longer time frame and to involve multiple sessions. The evidence base for the success of these protocols, especially the Paulus, is good, and even though the treatment is a formula and not the traditional acupuncture which we practise it is a good baseline from which to move forward. You can read the about Paulus here

As far as frequency of treatment is concerned it is not uncommon in China for someone to receive treatment daily for ten days, and because the treatment is offered in the outpatient departments of hospitals within the national health scheme it is accepted as a viable process for short term acute problems. There is no suggestion that over-treatment can be a problem. Acupuncture is a very safe treatment, and if the body has had enough it simply fails to respond any further. Excessive treatment might make someone very tired or a little whoozy, possibly even a little nauseous, but these effects would be very short lived.

In short it sounds as though you are in safe hands with someone who knows what they are doing, and we very much hope that it has the desired result.

Q: For over a year now I've been suffering with a frozen shoulder. I went to see a specialist who said I had a nerve problem because the pain moves around my neck, arm and shoulder. The pain was really bad and I couldn't move my arm. I was given Morphine for the pain and a steroid injection into a different part of my shoulder. I also have Type 1 diabetes and thyroid problems. After the injections the pain went but after a few months it's back but not as bad as the first time. The doctor has now told me that because I have Type 1 diabetes I cannot have any more steroid injections, so has prescribed me ibuprofen and advised me to go back and see a physio. But the physio said he can't treat me if I'm in pain and the ibuprofen doesn't work, so I was wondering if I could have acupuncture?

A: The very simple answer is that there is no reason why you cannot have acupuncture as a Type 1 diabetic. The only caution which a practitioner will have is that with Type 1 diabetes there can sometimes be reduced sensitivity to the extremities. In our Guide, which we publish for our members, we say:

Diabetes mellitus It is recommended to ask diabetic patients about neuropathies they may have developed. In severe neuropathies the patient may experience loss of sensation. Due to impaired blood circulation to the affected area the patient may also be at a greater risk of developing a localised infection.  

Needling into the affected area should be done with particular care and strong manipulation of the needle avoided. Patients with poorly controlled diabetes, especially if insulin-dependent, may experience greater than normal fluctuations in blood sugar levels.

As strong acupuncture treatment can lower the blood sugar levels and occasionally induce some drowsiness, it is recommended that you treat such patients with particular care, especially on their first acupuncture treatment, and ensure that they have had something to eat before the treatment.

This just about says it all, really. We have come across the very occasional patient in whom the treatment triggers a release of additional insulin and can steer them towards a hypo, but most long term diabetes patients are usually very much on top of maintaining their sugar balance.

The reason for stopping steroid injections may also be that there is an upper limit beyond which most doctors will not go anyway. Three or perhaps four usually represents the safe number, after which there is an increasing risk of local damage to tissue in the area.

As far as frozen shoulder itself is concerned, as our factsheet shows there is some fairly good evidence that acupuncture can be helpful. This is far from conclusive, so we can't make specific claims, but the evidence does suggest some benefit as well as some reduction in pain. The only problem is that it is difficult to stop someone using the shoulder while it improves, so progress can often be hampered by unintended setbacks when people reach out automatically and trigger pain and discomfort.

The best advice that we can give is for you to visit a local BAcC member for an informal chat. Most are more than happy to give prospective patients some time without charge to take a look at what is going on and will be able to give a better informed answer than we can about what prospects there are for benefit from treatment.

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