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Q: My partner has two slipped discs in her back. She been refused surgery due to her age and has now been refused injections.
Will acupuncture help her?

A: We have been asked surprisingly few times about slipped discs, and our answers to the questions have been relatively circumspect, as you can see from this example:

Slipped discs can take a long time to recover, even when using therapies which are known to help. Where the standard treatment in conventional medicine used to involve a great deal of bed rest, continual movement is now the order of the day to help the accumulated tissue to disperse. Our fact sheet on sciatica

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

mentions a number of studies which show some encouraging results for the kinds of secondary problems which can arise from a slipped disc.

Sight unseen it is very difficult to offer a detailed opinion, but speaking in very general terms, there is often an accident or underlying pattern of weakness which predisposes someone to have a slipped disc, and there are often ways of understanding the disease process from a Chinese medicine point of view which offer treatment possibilities. This can often be the case when someone has reached a plateau in the conventional treatment they are having.

However, it is not uncommon for people to seem to plateau and then for the condition to resolve after 3-6 months, and you may well find that you suddenly begin to make progress again. Acupuncture treatment certainly won't do you any harm, and given that the area where you have been affected will have been quite immobile and 'stagnant' for a few months it is possible that from a Chinese medicine perspective there are significant blockages whose clearance may help to speed up your recovery.

At least a part of the reason for this circumspection is the fact that herniation usually resolves after about three to six months, and it can be difficult to assess in the circumstances whether the acupuncture treatment has added to the speed of recovery. The range of problems covered by the generic term 'slipped disc' is also quite extensive, and assembling a control and test group with identical problems may present problems in the current climate of minimal funding for acupuncture research in the West. We are confident that trials will have been conducted in China but most are never translated. Where there have been good results, though, they do tend to surface quickly, and the absence of research which meets western standards probably speaks volumes.

The fact that surgery has been considered probably points to some quite serious herniation, and we would probably surmise that the best we could achieve would be to lessen some of the pain and reduce some of the symptoms. The extent to which this worked, and how sustainable the change would be, is something only treatment itself would establish.

We always believe that the best option for cases like these is to visit a local BAcC member for an informal assessment of what may be possible. Most offer a small amount of time without charge to prospective patients to get a better idea of what benefit there may be in cases where it is not clear from the 'headlines', and if someone does commit to treatment there is usually a very clear agreement to assess progress after three or four sessions to see whether the progress warrants further time and expense.

Q: I have trapped nerves in my lower back. My pain radiates down my left leg into my foot. I have now had three sessions of acupuncture. Both of my legs feel a lot worse. They ache tingle and throb. Walking is more difficult for me and I walk a lot slower. I should be having another three sessions but I am reluctant to go back.

A: We are sorry to hear that you seem to have developed slightly worse or different symptoms after your treatment.

We would be very surprised to find that the acupuncture has actually made things worse in a directly causal way. Short of sticking a needle into a nerve there isn't a great deal a practitioner can do in the lower back which would generate the symptoms of which you speak. The only time we have come across this is when someone has a trapped nerves because of changes in physical structure, and the muscles have been guarding to hold the vertebrae apart. If treatment caused these to relax, then it is just possible that this has let bony structures change position and increase the level of impingement. We do know that physios offer this as a caution when treating lower back pains and nerve impingement, but they do tend to use more vigorous techniques than we do, and this can magnify the effects.

Another, and more likely possibility, is that the treatment has started to encourage the structure of the spine into a better shape. We do sometimes find that after long periods of operating out of shape the body's musculature can start to adapt, so when improved function starts to bring the structure back into alignment some muscles relax and others tighten to accommodate the new position, both of which can generate mildly unpleasant symptoms.

Of course, the third and less palatable possibility is that something has changed or deteriorated in the back alongside rather than because of treatment, and this has created new and unpleasant symptoms such as those you now have. This can sometimes happen, and we encourage our members not to get into pointless arguments about what caused the problem but to get the person seen by their GP as quickly as possible to establish exactly is going on. This almost invariably points to causation, but crucially it makes sure that someone gets the correct attention first.

We think your best first step is to discuss the matter with your practitioner. It may simply be a matter of adapting the treatment to suit you better, perhaps by working away from the problem area or reducing the strength of treatment. If they cannot see any reason why what they have done could have caused these problems, then they will probably refer you to your GP for further examination.

We would say 'don't panic', though - we have known of very few cases where acupuncture treatment has caused serious long term adverse effects, and the majority of these have been to do with actual physical damage caused by the needles, not reactions to treatment itself. We hope you feel confident enough to talk to your practitioner about what has happened, and remind you that you are in charge in the treatment room, so if you are not happy with proceeding, then you can just draw a line straight away and stop.

Q: My mom just had acupuncture yesterday at noon as the practitioner said that she had blood deficiency (her pulse on her left wrist was too weak). Now my mom is experiencing extreme dizziness, cold sweat, fatigue, and nauseousness. Is this normal and what should we do?

A: We are sorry to hear of your mother's post-treatment episodes. However, we are confident that by the time you receive this reply everything will have settled down.

It is very rare for people to suffer serious side effects or adverse events after treatment, and the ones that do happen are invariably to do with actual physical damage caused by a needle. In the hands of a properly trained and qualified professional acupuncturist this is extremely unlikely to happen; it is only the poorly trained or inept that cause these sorts of problems.

However, it can be the case that people can 'wobble' a bit after a first session, and some of the things you mention - dizziness,  fatigue, nausea and so on  - can happen. There are a number of possible explanations for this. Sometimes it is the body starting the process of cleansing itself of energetic blockages. The Chinese believed that pathogens travelled inwards and reversing this process could often lead to a disturbance as they cleared. Some people are also energetically very sensitive, especially if they are somewhat weakened. This can be a reaction to treatment which is too powerful for them, and the practitioner will take this into account when they get feedback, and adjust the strength of treatment accordingly. This might mean fewer needles, less manipulation and so on, but all of these adjustments can make a tremendous difference if someone is a strong reactor.

Of course, there are two other more prosaic reasons. The first is that your mother may not have been warned of some of the basic housekeeping rules before treatment, as for instance making sure that you have eaten something within the last few hours rather than being treated on an empty stomach, and this can sometimes exaggerate the effects of treatment. We have seen a patient faint because she hadn't eaten for twelve hours before treatment, and then only a small bowl of cereal. The second possibility is that the symptoms are of a virus, but by coincidence have happened after treatment. With over four million treatments being given every year there are bound to be a few occasions when someone gets ill at the same time as treatment, but without any causal connection. If this is the case, then the usual steps need to be taken; bed rest, etc etc.

We strongly suspect that these are transient reactions to treatment, though, and we think they may well have subsided before you get this response. It is important to let the practitioner know, and it may well be worthwhile calling the practitioner today for advice and guidance. They will know better than we could what they have done and what your mother may need to do to help. If the symptoms have persisted for 48 hours and show no signs of relenting then it may well be worth having a word with her GP, or calling the 111 advice line, the NHS non-urgent service. We have found this to be very successful at directing people to the best help for their needs.

Q: Is there a possibility that acupuncture will help me with a bad problem of balance?

A: A great deal depends on what is actually causing the balance problems. We have, for example, a considerable body of evidence for the treatment of vertigo, as our factsheet

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/2599-vertigo.html

shows but there are literally dozens of conditions which are differentiated in western medicine - Meniere's disease, vestibular disorders, labyrinthitis, ineer ear infections and so on - which can generate balance problems. There are also cases of accidental damage, as for instance this study we found about people being researched for balance problems resulting from whiplash injuries

https://www.ncbi.nlm.nih.gov/pubmed/9051168

Essentially, there is evidence for the use of acupuncture in treating all of these problems, but the quality is variable, and we would be hard pushed without more to go on to make a positive recommendation in case the problems arise from something which cannot change.

However, as we sometimes have to remind ourselves as well as our patients, we practise traditional acupuncture which is premised on treating the person, not simply the problem they have. The theory is based on a complex flow of energy whose rhythms and balance determine good function, and whose loss of balance can generate symptoms. The skill and art of the practitioner lies not in going to the clearly defined areas which are involved in balance from this perspective but in looking at what is going on to make this symptom appear. Many symptoms are not the root of the problem but just signs that the whole system is out of balance, and without taking care of the root causes any treatment of the symptom alone may have short-lived effects.

Balance problems have been around since people stood upright so the Chinese will have addressed these issues for thousands of years. To know whether this accumulated wisdom can help you, though, the best advice that we can give is that you visit a local BAcC member for an informal chat. Most are very happy to give up a small amount of time without charge to give prospective patients a better idea of what may be possible, and it enables you to check them out before committing to treatment. We strongly suspect that they will feel confident about being able to help you but we trust them to say so if they think this is not the case.

Q: My father is a paraplegic and has been since he was 28. He is now 61 and is suffering with severe hip pain. His hip joint is completely worn. Is acupuncture a suitable treatment for him?

A: This is, we think, really two questions: is it OK for your father as a paraplegic to have treatment, and if so, what are the possible benefits for the problems that he has.

As far as the first is concerned there is absolutely no reason for a person with paraplegia or quadriplegia not to have treatment. Although someone may have lost conscious and voluntary nerve control of the limbs which have been affected all of the autonomic functions continue, and from a Chinese medicine perspective this means that there is energy flow which can be enhanced or corrected by suitable treatment. The main caution with problems like your father's is that there can often be a sensory deficit, so practitioners are always very careful in how they treat. If someone can't say 'stop it, that hurts' there is an increased chance of bruising, and in the case of moxibustion, an increased risk of burns. All professional acupuncturists are trained at undergraduate level in what to do with cases like this.

As far as treating hip problems themselves are concerned, a great deal depends on the level of deterioration in the joint. If the wear is great enough to warrant or nearly warrant a replacement, then we would have to be honest and say that short term pain relief would be the most we would expect to be able to offer. The question would be how much relief and how sustainable it was, and again, to be honest, this may become a question of how affordable treatment is. For people with deep pockets three or four days relief from indefinite weekly treatment may be a good deal. Most of us couldn't afford this, though, and we trust that members do their best in these circumstances to direct people to the most effective and cost-effective means of getting relief, be this herbal medicine or reflexology or any one of dozens of possible complementary medicine solutions.

The best advice that we can give is that your father visits a local BAcC member for advice about what may be possible. Nothing beats actually seeing the problems first hand in order to be able to give an accurate assessment of what may be possible, and most of our colleagues are only to happy to see prospective patients without charge to give them a good idea of what can be done.

We suspect, though, that if the wear is very considerable the amount of relief may be limited, and if someone does think treatment is worthwhile it would be advisable if they offered realistic expectations.

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