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You will not be surprised to hear that we have been asked this question before, although not for some time. Our last answer over a year ago said:

We have to be honest and say that there is not a great deal of evidence for the effective treatment of Morton's neuroma with acupuncture. We published an answer through this same section three years ago to a question from a patient who was convinced, and with some justification, that treatment with one of our colleagues has been wholly responsible for a complete improvement in his condition. 

We have to say, though, that our clinical experience runs counter to this, which is why the very upbeat tone of webpages like that of this American practitioner

(informative as it is) raises a wry smile. If only... Having said that, what he describes in the formation of the tissues which cause the condition is something with which we deal elsewhere on the body, and in theory there is no reason why treatment should not be able to reduce some of the discomfort. However, we would be very surprised if this could be done without the aid of orthotics which reduce some of the pressure on the affected areas while any treatment beds in.

Each case is unique and different, however, and the only real solution is to seek face to face advice from a BAcC member who can look at exactly how the problem manifests in you, and more importantly, can see the overall context in which it is occurring. One of the great strengths of Chinese medicine is that it looks at the whole system, not simply at a symptom which is regarded as merely a warning sign. Thousands of people with identical foot structures to you will walk thousands of miles without getting neuromas, and there may be systemic problems which have predisposed this to happen.

The other recommendation we would make, and we are sure that you have done this already, is to find a good chiropodist or podiatrist who can work alongside any other treatments you try to help to maintain improvements. Working in partnership with other health professionals for problems like yours can often be extremely powerful

This still represents the best that we can say. We have looked at the research databases to see whether any further case studies have appeared, but the cupboard is remarkably bare. Our earlier advice, to visit a local BAcC member for an informal assessment of what may be possible, is still likely to be your best option. We are confident that you will get an honest opinion before committing to treatment.





We are often asked whether adverse reactions are normal, and our usual response is 'not normal, but not unknown'. It is not unusual early in a  course of treatment for someone to experience a slight worsening of their original symptoms (we aren't sure what you presenting problem is/was) or even the expulsion of pathogens which can cause the body to feel a little sore. Pathogens in the Chinese medicine sense can cover a  wide range of what the Chinese called 'invasions' like colds and viral conditions which can lurk around until they are expelled. Occasionally people do feel flu-like symptoms out of nowhere. It is unusual to find this happening on the third session rather than the first or second time, but there are no rules. The aches should subside within 49-72 hours.

Of course, the possibility which we have to factor in is that this is a new condition which has nothing to do with the treatment. With over 4 million sessions a year there are bond to be odd times when something comes up just after a session which has nothing to do with the treatment. it is always best to bear this in mind if the problem continues for more than a few days. Acupuncture very rarely causes long term adverse effects except on the rare occasions when a needle pierces something it shouldn't, so if a potential side-effect doesn't subside after about four days then it is worth seeking medical advice.

Hopefully by the time you receive this the aches and soreness will have subsided. 


We are really sorry to hear of your wife's problems. It must be extremely hard for all of you.

First, let us say that acupuncture and herbal medicine are two distinct and separate disciplines, although in China they are usually learned together. For historical reasons in the UK there were already existing traditions of acupuncture and western herbal medicine, and the two eastern modalities developed separately. So, if you go to an acupuncturist the chances are that they will not be using Chinese herbs as well. If they are you can be assured that they are very well trained, and are particularly careful when someone is already taking medications which have a serious impact on their functioning. Herbalists will know what the potential interactions of the medications are, and will make sure that nothing they do will interfere with your wife's treatment.

Acupuncture itself is extremely unlikely to cause any problems for your wife. The main source of adverse effects from treatment, other than minor transient ones, is from insertion of the needles themselves, not from the energetics of what is going on. There are no case reports of which we are aware which suggest that acupuncture treatment can do anything other than good when treating people with serious mental health issues.

 As far as the treatment itself is concerned, we were asked a question about schizophrenia a while ago, and although this is a very different problem the response we gave captures some of what we would like to say. We responded:

We have to say that although the World Health Organisation's list of treatable conditions does include schizophrenia as a condition for which some evidence of efficacy exists, the overall position is that there is nowhere enough evidence to suggest that acupuncture would be able to deliver a solution to this problem.

However, when we talk about evidence in this context, we are talking about the kind of randomised control trials beloved of drug testing regimes, which are not the most suitable way of testing a complex multivariate process like traditional acupuncture. Is there a history of acupuncture and herbal medicine for serious mental disorder? Well, the answer would be a qualified yes. There are a number of presentations for groups of symptoms which could well be characterised as psychosis which are recognised syndromes in Chinese medicine with clear treatment protocols. This is even more the case with Tibetan medicine which uniquely in Far Eastern medicine has a very complex and enduring tradition of using herbal medicines to treat a number of what we regard as sectionable mental disorders. However, this tradition has barely travelled to the West, and few practitioners have the necessary skills to offer solutions.

The major issue would be to locate someone with the requisite skills and experience. Although we have few recognised specialisms in traditional acupuncture we have been developing areas like paediatrics, obstetrics and mental health issues where we believe the special nature of the client group may require additional skills which we would recognise as expert practice. Although in theory, as generalists we should all be able to help any patient we take the view that serious mental disease needs some familiarity with the field and some experience of how to work with people in extremely distressed states. Not everyone has this experience or skill, and it would not help your wife is someone is out of their depth. With that caveat it may be possible to locate someone through our searchable database who is skilled in this area and willing to have a try. The chances are that anyone working in an area will know which of their colleagues is most likely to be able to help,

We think that there is still some wisdom in these words, and our advice is pretty much always to visit a local BAcC member for a brief informal assessment of what might be possible. These situations are so very complex that it is nigh on impossible to give a definitive view at arm's length. We always feel confident that we can help everyone to a degree, but when a situation is quite fraught it is always best to make sure that a patient gets the help they need, even if that means referring them to other forms of treatment.



We have to be honest and say that it is almost impossible to predict how many sessions someone will need. We can make educated guesses with some problems, but I suspect all of us have had the experience of saying 'two or three sessions should do it' and then found ourselves ten sessions down the line with a better but unnecessarily disappointed patient. All that we can do is to make sure that we review progress on a regular basis (every four or five sessions) to assess what progress there has been and whether it is worth continuing.

Anxiety can be particularly difficult to treat, although the research does point in favour of acupuncture, as our factsheet shows

However, the causes of anxiety and the different types are so many that it is very difficult to make predictions. If someone has been anxious for thirty years, though, it might be reasonable to expect that it will take a while to unlearn some of the behaviour patterns that have developed.

That said, we do often see people change after the first session, sometimes in terms of feeling that they are now oriented in the right direction and able to start a journey towards better inner states. This change can be subtle but anxiety sufferers who are often very tuned in to their inner states can often perceive the difference. Progress can sometimes be unpredictable, though, and life cna often generate challenges which cause setbacks.

On balance, though, we see many people for the treatment of anxiety, and we get many of our referrals by word of mouth, so as smart lawyers say, res ipsa loquitur!



We are not quite sure from your question whether you are not paying for your treatment because it is being paid for by a health insurance company or whether it is being provided free at point of delivery within an NHS Pain Management Unit or perhaps delivered by an NHS physiotherapist. However, we are pretty sure that you would know if you were covered by private insurance so you must be one of the fortunate ones who has managed to find treatment inside the NHS. This is not as common as it was, say, a decade ago, although more prevalent in Pain Management facilities.

Generally speaking, we have always heard that people referred to Pain Clinics are offered a fixed number of sessions in order to ensure that everyone can have access to the service. The NHS Choices website says that up to ten sessions of acupuncture may be available in a course of treatment, but this can vary greatly with supply and demand. Your doctor, through whom you presumably were referred, can both let you know and make a case for you if you feel that the sessions are of benefit and need to be carried on.

While NHS provision is the only treatment free at point of delivery you will find that many acupuncture practitioners are prepared to discount treatment fees if someone is in need of help but not able to pay the standard fee. There has to be an element of professional judgement in this; not everyone shares the same sense of poverty. This 'expert' was asked for reduced fees through poverty by a patient who revealed during the session that his brand new BMW had broken down but it was under warranty so he was happy.

There are also a growing number of community acupuncture clinics which offer treatment in a group setting for a lower fee, partly to ensure that all income groups can have access to treatment. A national listing of clinics in this scheme can be found here This might provide another option if your NHS funding ceases.

We hope that you manage to get your MRI within the limit of treatments you've been offered, but if that doesn't work we hope that we've given you other useful options.



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