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As you might imagine we have been asked this question on several occasions and our answers have tended to be rather upbeat, as for example:

The evidence for the use of acupuncture to treat migraines and tension type headaches is encouraging enough that NICE, the National Institute for Health and Clinical Excellence has recommended it as a treatment for many types of headache. Our factsheet

provides details of a great deal of the research which has been undertaken. 

However, we have to be a little cautious. The great strength of Chinese medicine is that it understands the symptom within its overall context, and that does mean that while the majority of people will experience some benefit there will always be those whose overall balance means that short term success is less likely. On the other hand, the majority of research trials tend to be undertaken with formula acupuncture in order to meet the criteria espouse in the West, where the outcome is the only variable, and we have long argued that this is not the best way to test a system which is geared to the individual and where treatment evolves as the patient progresses. In many cases this refinement of treatment generates much better results than the orthodox trials suggest are likely, but until we come up with ways of preserving the integrity of what we do in a research setting we are where we are.

The best advice we can give you is to visit a BAcC member local to you for a short face to face assessment. Most of us are happy to give up a few minutes without charge to assess whether acupuncture is the best treatment for what troubles you, and this will also give you a better idea of what we do, who you might see and the surroundings in which they work. We find that this means prospective patients feel more empowered in making their choices rather than simply being booked in sight unseen.

We think that it is important to add riders like this. Research very often uses formula treatments, and this goes against our ethos of treating the person, not the condition, of seeing symptoms in their overall context. Just as there are occasions when an individualised treatment will exceed formula treatment in effect, there are equally occasions when formula treatment will not be appropriate, nor will individualised treatment be much better. Talking to a practitioner before committing to treatment is a wise move.

The reply should probably point out that the evidence for cluster headaches per se is not quite as compelling, although the one study cited in the factsheet

comes from the GERAC trials in Germany in 2006 which are particularly interesting because the figures were gleaned from German medical doctors and were statistically significant by virtue of the sheer size of the trial.

Our advice from the earlier answers remains very apposite on one main point, though, and that is the fact that each person is unique and individual in their balance of energies, and for problems like cluster headaches which can arise from a number of systemic problems it is essential that someone has sight of a patient before blithely making any prognostications about what may be possible. Most members are happy to give up a little time without charge to prospective patients to enable them to make properly informed decisions about having treatment.

From a western/conventional medicine perspective this might well be a trapped nerve, and given the location of the sensation which you have had and are now experiencing the trapping might be anywhere from the neck down. The fact that the sensation has not been too powerful until recently suggests that the level of impingement has not been too great, and this might mean that the clinical signs are not that obvious to examination. GPs tend to be pragmatic, and since the cost of trying to establish what it is might be disproportionate to the amount of disruption the problem is causing it might be difficult to pursue much further. The one option you might want to consider from this perspective is osteopathy, since a small adjustment of the bone structure might be enough to deal with the problem.

That said, from a Chinese medicine perspective we see a great many of these undefined or ill-defined problems. We see them as disruptions in the flow of energy, and whenever these occur there will always be pain or discomfort. This can arise from a blockage in what we call 'qi', the energy of the body, or equally often from excesses or deficiencies in the flow. The skill of the practitioner lies in determining whether this is a local problem or whether it is a systemic problem and the tip of a much larger iceberg which needs addressing. We then use needles to reinstate the correct balance.It is always impossible to predict at a distance whether treatment might work. It is in the nature of the system of medicine to see each person as unique and different, and for this reason twenty people with an identical named condition might have twenty different treatments. This is not a method solely confined to complementary medicine; the great Canadian physician William Osler often said 'the good physician treats the disease, the great physician treats the patient who has the disease.' This is why we always advise prospective patients to contact a local BAcC member for an informal chat about what may be possible. Most are happy to give up a little time without charge to offer a more informed view face to face of what may be possible
We have usually taken a rather downbeat view of how successful treatment can be, as this 'nested' response last October shows. Our personal experience is that by the time people come to acupuncture treatment there is often not enough evidence to underpin a commitment to a long course of treatment which may be necessary. Hence we wrote back then:

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 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 powerfulThis 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.  There is an interesting case study about the use of therapeutic massage is useful for the background information, but nothing new involving acupuncture treatment.However, we have since heard anecdotal accounts of people committing to lengthy spells of treatment which have seen significant changes, and when you consider that surgery is probably one of the few other options available, this may not be a bad thing to try.As always in cases where the evidence base is a little thin and where the stories of success are not that frequent we advise prospective patients to set or find measurable targets for change, and also to insist on regular review periods if they do go ahead. The measurable target is essential; problems like Morton's neuroma can lead to good days and bad days, and asking how things are on either won't really help to decide whether to carry on. Walking further and with less pain is something which is more difficult to argue about, and this really helps where changes can sometimes be too small to recognise day by day.Reviews are equally essential. Where there may be a long haul it is very easy to rack up a very large bill for treatment without realising it, and it always pays to know where you are, both in terms of progress and expense. As above, an initial informal chat with a local BAcC member is a great place to start. 
As you can imagine we have been asked about sciatica on many occasions and a typical recent answer was:

As you can read from our factsheet has been a significant amount of research into the treatment of sciatica with acupuncture, and the results have been increasingly positive. The threshold for being able to make a definite claim is based on a research process for which very little acupuncture treatment except non-traditional formula work will work, but there have been dozens of Chinese studies aimed at finding what works better which seem to show that sciatica responds well to treatment. Certainly this 'expert's' experience is that sciatica seems to respond well to treatment in most cases.There is no doubt that formula treatment will work to an extent, and there are many medical acupuncturists and 'cookbook' practitioners who will use the same 'sciatica' patients on every patient. The real strength of traditional acupuncture, though, is that it addresses the problem of why sciatica occurs in this particular patient, or more properly why the system does not put right and recover from the injuries which normally cause it. Twenty different people may have the same named condition but be treated in twenty entirely different ways. What this does is not just put the problem right but try to make sure that it does not recur.There are no special treatments for sciatica, and no specialists, so any well-trained traditional acupuncturist should be able to help you. The best advice, though, since there are one or two cases which would not make us feel so optimistic, is to pop in to see a BAcC member local to you for a chat and to get a short face to face assessment of what is going on. This will not only give you more precise information but also give you a chance to meet a practitioner and see where they work before committing to treatment.This seems to us to remain the best advice we can give without actually being able to see the patient first hand. What we would say, though, is that we often work closely with osteopaths in treating problems like this. Although we work 'functionally' so to speak, encouraging the muscles and tendons to re-assert the body's correct shape and posture, there are times when a visit or two to an osteopath to make structural amendments can often speed up progress. Where acupuncture really helps structural work is that it appears to consolidate structural changes and maintain the gains which have been achieved. We are assuming, of course, that your wife has had the usual battery of tests, X-rays at least, to see if there is a change in the lower spine which may be contributing. There are cases, especially where discs have worn badly, where the possibilities for change and improvement become more long-term and gradual. Given the extent to which your wife is suffering further information from an X-ray or scan sounds like it might be a very good idea. Most sciatica can be alleviated by a change of position, and if the pain is acute and continuous it suggests more is going on than meets the eye.
There is no reason not to have acupuncture every week if it achieves the objective you want, in your case pain relief. We are often asked about treatment for pain, and we usually say that it becomes, somewhat sadly, a matter of how deep someone's pockets are.

From a traditional acupuncture perspective it is not entirely satisfactory to be treating someone every week. Our understanding of the nature of pain is that it arises because of blockages in the energy of the body, or excess and deficient energy in specific area or channels. We always hope that our work will reinstate correct flow, and that the pain will begin to subside such that we can increase the intervals between treatments. However, there are occasions when changes to the physical structure of the body, like arthritic change, are not reversible and will keep on generating inflammation in the same places. In these circumstances we might well consider treating weekly for as long as it takes.When this happens most practitioners tend to come to some sort of arrangement with patients to ensure that the treatment doesn't become a financial burden, but this is a matter for individual negotiation. People have different ideas of financial deprivation, and it call for honest and sensitive discussion. Many practitioners are now involved in the establishment of multi-bed clinics which provide treatment in a group setting at a reduced cost, and there may well be something in your area which offers treatment at significantly lower rates than in private practice.NHS provision, though, is seriously limited, and we have found that a six-session course is about the maximum that anyone is likely to be offered. It might be possible to make a financial case for acupuncture treatment if the alternative is expensive medication and greater costs to the health system as a whole, but there is a principle of equity at play and most Pain Clinics have long waiting lists of patients desperate to get a crack at pain relief through acupuncture, and we suspect that most take the view that if it works then people know that there is an alternative to medication that they can pursue themselves.This is not ideal, and we would be the first to argue for acupuncture to be free at point of delivery and on demand within the NHS, but that day is a long way off while basic services remain under-funded. We do our best to demonstrate that acupuncture treatment is cost effective, and some of our colleagues in York have undertaken research studies which clearly show that acupuncture treatment saves money in the long run, but this hasn't really impacted on policy makers yet.In the meantime we suspect that the best we can advise is that you contact local practitioners and see if anyone is prepared to come to an arrangement which offers the same level of relief at a cost which is not too burdensome.

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