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Q:  I have been having  acupuncture treatment for ankle swelling and pain mostly on the outside of the foot but after three treatments I have been noticing pain on the inside of the foot more than out. Is this possible?

A:  This is always possible, although without knowing a great deal more about what caused the ankle swelling and pain we are not able to be too precise.

It is not uncommon, when treating patients with a problem on one limb, or even one side of the body, to find that as the body restores normal function and with it normal structure, the side which has not been troubled now starts to play up, This can often happen when a limb or foot is rotated and the muscles are slightly less stretched than they should be. When they are stretched into normal shape this can hurt. Osteopaths and chiropractors routinely warn their patients that they may get some unusual reactions in the body as normal structure is re-asserted, and our work, which encourages better structure through regaining best function, is no different.

However, sight unseen it is really difficult to say, and we think that your own practitioner is the best resource you have at your disposal. He or she will know exactly what they have on the basis of exactly what they found, and this will enable them to make better sense of what you describe than we are able to at a distance.

Q:  My 92 year old mother has been suffering with what she has been told by a GP with tension headaches. These headaches start as soon as she is upright but not when she is laying down. She has them everyday. She has severe osteoporosis in her spine and arthritis in her neck.  My question is "is it safe for her to have acupuncture"

A:  There is nothing in what you have told us to give any hint that acupuncture would be at all unsafe. The only problems might be associated with mobility and visiting a clinic, but we are sure that you have had to address these already in getting your mother to various appointments, so your systems are probably well geared to this.

There is a growing body of evidence to suggest that acupuncture can have a very positive effect on tension headaches, as our factsheet shows:

With the elderly patient we usually start with relatively gentle treatment and needle rather more conservatively, using less needles and less needle manipulation, until we have assessed how well they can handle treatment. Most are probably more hardy than us younger ones, but there is no reason not to start slowly. Older people can also be slightly more prone to bruising and slight bleeding after needle insertion, so we always near this in mind when treating.

Overall, though, it is always a pleasure to treat the elderly. They often respond very well, and they have usually reached the stage where they tell people exactly what is happening, which can make feedback very direct on occasion. We wish you luck finding a good practitioner for her.

Q:  I had solilcsis curvature of the spine and was corrected with surgery 21years ago.  I get spouts of bad back pain which become unbearable and it's hard to continue with work and life even with medication ....would acupuncture help.  I've  had all other physio which is not of great help.

A:  A huge amount depends on the kind of surgery you had when you were younger. This often involves some kind of spinal fusion, although if the surgery is performed in pre-teenage years it may not be quite so drastic.

Without a much greater amount of detail about the surgery and the potential this has created to interfere with other physical structures like spinal nerves it would be difficult to say precisely how much benefit you might expect. This expert, for example, has a patient with a serious ankle deformity which has meant operations leaving the right leg longer than the left leg. The effect of this on the lower back is going to be permanent as her body strives to maintain the head over the centre of gravity while the pelvic and sacro-iliac joint are rotated. However, treatment does seem to contain the occasionally more severe bouts of pain, although in one bout the pain simply did not respond at all.

This was a surprise because acupuncture for pain relief is a fairly well established option. After the US President Nixon's visit to China in the 1970s where we saw operations where acupuncture was used instead of anaesthetic there was a huge amount of research into acupuncture for pain relief, and the main question is not so much whether it works but how much it works and how sustainable the results are. If a treatment can buy a week or two's reduction in pain it might be a viable long term option, even if the cause remains and will continue to cause bouts of pain. It may come down to a matter of how deep someone's pockets are, but there is certainly provision within NHS Pain Clinics if you are lucky enough to get a referral to one.

Other than that the best that we can recommend is that you visit a BAcC member local to you for an informal chat about what acupuncture treatment may be able to offer. Most members are happy to give up a small amount of time without charge if they or the prospective patient are not entirely sure whether acupuncture would be a good option. This also gives you a chance to meet them and see where they work, factors which can make a difference in people's choices.

Q:  I am interested in having acupuncture as I am suffering from a dissociative condition called Depersonalisation Disorder at the moment, and - in order to aid my recovery - am trying to reduce my anxiety levels. I am taking some anti-anxiety medication (Venlafaxine) and am on the waiting list to be seen by a specialist at The Maudsley but, in the meantime, thought it worth pursuing some other avenues. I just read the following on your website which prompted me to get in touch:

Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety by:
Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the 'analytical' brain, which is responsible for anxiety and worry (Hui 2010).
Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain's mood chemistry to help to combat negative affective states (Lee 2009; Samuels 2008; Zhou 2008; Yuan 2007). Would you suggest I pursue acupuncture?

A:  The information which you quote is probably the least representative material on our website of what we actually do. There has been a considerable amount of research into acupuncture looking at the effect of treatment on specific chemical and hormone balances in the body, and unsurprisingly sticking needles in people does tend to change these. However, the acupuncture used in the studies is often very much formula/cookbook style of treatment (it has to be to meet the criteria for the gold standard of medical research, the randomised double blind control trial), and our usual take on this is to ask how much better the results would be if the treatment was tailored to the individual needs of the specific patient, as our work always is.

We do treat many patients with anxiety, as you know from looking at the factsheets where the information you quote comes from. However, we always take great care to understand what someone's experience of anxiety is, what it actually means to them to be anxious. Some people find this kind of talk odd, but disease labels like anxiety and depression can mean vastly different things to different people, and the pathological changes in someone physical, mental and spiritual functions can be very different and point in an almost limitless direction of potential treatments.

DPD is an odd condition, but it will not surprise you to know that that ancient Chinese had ways of understanding the feelings with which you may be familiar, such as the dissociation and feeling of being outside oneself. That does not necessarily mean that this offers treatment solutions in the modern world, but the way in which you experience some of the episodes may greatly enhance a practitioner's understanding of what is going on.

We think that there would be no harm in trying acupuncture, but we would very much recommend that before committing to treatment you arrange to meet a practitioner or number of practitioners in your area. You may find that some will be reluctant to take your case on; some may feel that it is not within their scope of practice or limits of competence. However, most will, and it would give you a chance to meet them and see where they work before committing.

A:  This is quite a difficult question to answer without knowing a little more about the swelling. There are all sorts of reasons why a thyroid gland can swell, from a benign cyst which can be drained through to the goitres one would associate with Hashimoto's Disease or Graves Disease. If we are talking about the latter, where the swelling is a part of a larger pattern of pathological changes in the body, then acupuncture may be more relevant but the advice less specific.

If this is a pattern of thyroid enlargement causing hyperthyroidism (over-active thyroid) then the evidence from research for the use of acupuncture is not that encouraging or plentiful. Our factsheet

cites three studies which address some of the more common manifestations of hyperthyroidism, but while the results are quite positive the samples are too small to generalise.  there are some Chinese studies of the treatment of benign thyroid nodules, and these again, while encouraging, are quite small.

However, one of the great dangers in trading in symptoms from a conventional medical perspective is that it does not do justice to Chinese medicine theory which has developed over 2500 years. Thyroid problems are not new, and although the ancient Chinese would not have understood hormone levels and thyroid function as we know it, they would certainly have made sense of all of the symptoms associated with thyroid hyperactivity, and would have been able to address them within the system of medicine. That does not mean that they would always be able to treat them successfully, and we have to be very careful not to let our maxim of 'treating the person, not the disease' lead people to believe that anything is possible. However, it does mean that there is a chance of bringing the symptoms under control.

However, without more specific information we would struggle to say more. It may simply be a benign swelling, in which case there may be more cause for optimism about what treatment can achieve. What we always say, though, is that if you are on medication for thyroid malfunction we always tread with great care. It can take a long time to achieve a good working balance from a diseased thyroid, and treatment can affect a good balance which has taken months of establish. We tend to work as closely as we can with a patient's medical team to ensure that everything is managed to maintain a good and stable pattern.

The best advice we can give is that you pop along to see one of our members local to you. This will give you the best chance to describe in greater detail what is going on and to be able to get from them a better idea of what may be possible. 

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BAcC Factsheets

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