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We are sorry to hear of your continuing problems.

As far as direct physical damage is concerned we would be very surprised if the acupuncture treatment could have generated adverse effects like these which continue for a couple of years. The key factor here is that the temple pains are bilateral. A practitioner might get unlucky and cause irritation of a nerve on rare occasions  but to do so with a range of points over all parts of the head would require someone to be using excessively powerful needle insertions on all occasions. In our experience if someone was doing this the pains would be immediate and unmistakable.

However, one can never rule anything out completely, and the one rare possibility is that the needles have been manipulated vigorously and caused bruising which has formed local scar tissue which in turn is impinging some of the local nerves. This is something which you could discuss with your GP, and possibly also have some bloods taken to see of there is anything in your clotting factors which predisposes you to bleeding with small wounds or cuts.

The other two possibilities are straightforward. One is that the reaction is energetic, and that the treatment has in some way uncovered or created blockages which haven't yet been cleared. This again would be rare. Where treatment generates these kinds of transient adverse effects they tend to last or about 48 hours and then the system returns to the status quo. Two years would be a remarkable length of time, and again the fact that the effect is bilateral tends to make this less likely.

The second possibility is that the discomfort and pain has nothing to do with the treatment but just happened to turn up at the same time in roughly the same place. With over 4 million treatments a year being offered in the UK there are bound to be coincidences, and our main concern when this happens is to ensure that arguments kick off about whether the acupuncture did or did not cause the problem. Our advice is always to see the GP and have the problems checked. This tends to identify the cause and in turn this usually reveals whether the acupuncture treatment has caused the issue.

So, in summary, this is not a normal side effect from treatment, and certainly not this length of time after the treatment. We would recommend that you visit your GP to get inside the system again in order to find out what is going on. Sometimes we recommend that people go back to the practitioner to discuss what they did and for them to assess whether from their perspective there is something they can see which could alleviate the problem, but we have to accept that patients who have suffered adverse effects are reluctant to go back and even more reluctant to have further treatment. However, it remains an option.

 

We usually filter all our responses via our London Office, but in this case, with the office closed until Monday, it is essential that you get a response immediately. If you're father is a Type 1 diabetic stopping his insulin is putting his life at risk, and he must start taking it again immediately. 

If he feels that the acupuncture treatment he has been receiving has changed his balance in such a way that he can address his diabetes with a lower dose of insulin then that is something he can discuss with his doctor. If the doctor agrees then he can start to reduce his dose. Otherwise he is putting himself in danger.

Our members  are trained never to recommend that someone stops taking an essential medication unless it is with the agreement, and under the direct supervision, of their doctor. We would most probably take action against a member who put a patient at risk for suggesting that they stop taking an essential medication.

We are sorry if this seems a little alarmist but we have seen cases where not taking insulin on time has had serious consequences, and we cannot stand by and do nothing if your father has been advised to do something which has put himself at risk.

In our experience it would be most unlikely for acupuncture treatment to reverse the causes of Type 1 diabetes. For this reason we need to reiterate that your father seeks medical advice as soon as possible.

 

 

It is rather difficult for us to comment on the clinical strategies of individual practitioners. Without reference to the notes or the patients themselves we are reluctant to make observations which may be then used to criticise or take issue with a practitioner.

in general, we can say that there has been some research into the use of acupuncture for fibromyalgia, as our factsheet shows

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

but it is far from conclusive. Our clinical experience is that it can take a very long time for the problem to resolve, and it is almost always a complex presentation involving both physical and emotional issues. When we take on patients with fibromyalgia we are always very clear that it will probably be a long haul, and that progress will be slow.

From this perspective we are a little puzzled about the frequency of your treatment. We would normally only treat someone this often in an acute situation, like a locked back, and this mirrors what happens in China where quite often a course of treatment will involve daily treatment for ten days. Without knowing exactly what your presenting symptoms were we are a little surprised that your practitioner has worked in this way. However, eighteen years of experience means that she may well have hit upon a way that works for her and for her patients, and if so and if her professional judgement is that this is an effective way to treat you, then it is worth sticking with it.

However, we are always very clear with our members that a patient to whom everything has been explained and from whom informed consent is given at every stage is usually a happy patient. We recommend that members review progress with their patients every five to ten sessions so that everyone is in the clear about how things are going. This also gives a patient  a chance to ask questions about what is happening. Good communication is everything!

Perhaps the best thing to do is discuss matters with your practitioner if you are feeling a little uncertain. Our view has always been that a responsible practitioner will always listen to patient concerns. If they don't, then that becomes a factor in deciding whether to continue!

 

If we are talking about straight causation, like an adverse effect from treatment, then the answer is probably not. There are many surveys of adverse events, and colds and flu are not recorded as an adverse effect of treatment. With over 4 million treatments a year in the UK there are bound to be a number of coincidences where a cold or flu virus takes hold at the same time as a treatment but is not directly related to it.

Having said that, there are occasions when treatment can release pathogens which the body has stored but not properly dealt with, and it is just on the margins of possibility that this might have happened. The ancient Chinese saw the symptoms of what we now explain as viruses arising from 'invasions' of pathogenic factors, often expressed as cold, wind or damp. If the body has had such an invasion but the person's constitutional energy has not been strong enough to expel it fully it might take treatment at a later date to 'release' the problem. If this were the case then someone might experience a short and sharp return of symptoms. The effect would be short-lived, though; this is like a ripple on the surface as something leaves rather than a full scale viral attack. Although this can happen, the 'getting worse to get better' effect, it is not that common.

The confounding factor in giving an explanation, however, is that if acupuncture treatment was only a part of what was done in a holistic treatment there may have been other interventions or modalities which could have been responsible for what happened. 

On balance, though, we suspect it was a probably coincidence, and hope that it has not been too troublesome for you.

 

 

File under muscle and bone - arm

As you might imagine, we have been asked questions about tennis elbow on a number of occasions and a typical answer has been:

Tennis elbow is one of the more frequent conditions with which people present at our practices.

 The BAcC has a factsheet which outlines some of the research which has been unertaken

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

 although it would be fair to say that the results are not as clear as for some other conditions for which we prepare factsheets. 

 Our clinical experience is that many people do benefit from having treatment but we are always very careful with conditions like this. If someone has four for five sessions without any apparent benefit we tend to draw a sharp line in the sand and look for alternative options for treatment. If treatment is likely to be successful there is usually some improvement, even if it reverts to being not so good again, and the improvements are incremental, i.e they get a little more pronounced each time. If nothing happens or there is a similar temporary burst of better times each time, then the chances are that acupuncture is not the best option.

 The key thing is to set measurable targets: how far can someone turn the arm without pain or restriction, how much weight can they sensibly bear, and so on. There is often also 'homework' - it is remarkable how many people want to carry on playing golf or windsurfing while they are being treated, and the concept of 'two steps forward, one step back' is difficult to get across sometimes.

 Best advice, as always, is to visit a local BAcC member for an informal assessment of what may be possible. Most BAcC members are happy to spare a few minutes without charge to see what may be possible, and this way you get to meet the practitioner and see where they work before committing to treatment.

This is still the essence of what we would say now. Further evidence keeps on being generated, as for example in this trial published last year

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783565/

but the overall weight of evidence is not enough at present to make firm recommendations.

We are not quite sure what to make of your GP's suggestion. Certainly without sight of your problem we are a little in the dark. If there is strong clinical evidence suggesting that surgery is the best option then it would be wise to follow the advice you are being given. Cutting is usually only done as a last resort, and if that is what the scans and X-rays show then acupuncture may not work. However, it can certainly be said that it won't make things worse, and it might well be worth having three or four sessions to see what can be achieved to head off surgery if this is at all possible.

 

 

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