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Although there is an increasing amount of research into the use of acupuncture treatment after radiotherapy the majority of studies are aimed at specific symptoms which often accompany treatment - nausea, dry mouth, fatigue etc. Unfortunately nerve pain or generalised pain in the pelvic region is not amongst them, and we suspect that this is because the generality of the symptoms makes it difficult to assemble meaningful trial groups. The results of the research show some quite positive outcomes for dry mouth and nausea, but as always is the case with acupuncture research the conclusion is that larger and better designed trials are needed. Even if someone had researched nerve pain specifically, the chances are that this is what the conclusion would be. The bar is set very high, and not always appropriately, for the work we do.

That said, there is a substantial and growing body of evidence for the treatment of neuralgia with acupuncture, even in the strange limiting cases like phantom limb pain, so it would not be a bad idea to see if treatment could alleviate some of the discomfort. The effects of radiotherapy in terms of the heat and scarring of tissue are outcomes which can clearly be translated into the diagnostic systems of Chinese medicine, and a practitioner can hope to address some of these within the overall constitutional setting within which they have had an effect.

The idea of context is central to Chinese medicine. Every is a unique blend of energies, so even when two people have the same symptoms they might arise from different internal disturbances. The skill of the practitioner of traditional acupuncture lies in treating not the symptom but the person as a whole. This means that the kinds of damage which radiotherapy can do will differ from person to person, both in terms of severity and in terms of potential for recovery.

The best advice that we can give is that you visit a local BAcC member for an informal chat about what may be possible. Most of our colleagues are happy to give up a little time without charge to establish whether acupuncture treatment might be worthwhile, and this gives you a chance to meet them and see where they work before committing to treatment. There is nothing to lose from trying treatment. Not only is acupuncture a very safe therapy but it does not have any major side effects. Even if the treatment managed to help you to deal with the discomfort it may be worthwhile.

The key thing is to set measurable outcomes from the beginning so that you can judge how well the treatment is working. Amounts of painkillers, sleep disturbance and general energy levels are the usual markers, and using them sidesteps the problem that people can feel good on some days, bad on others, and are not always able to say on any given day whether they are feeling better overall. 

If we took your question as face value as one about peripheral neuropathy then we might be tempted to use an answer we gave quite recently:

There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html
shows but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achievement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.

This is quite a useful start because it sets out some basic principles and also emphasises that for conditions like diabetic neuropathy in the language of modern sales talk, 'once it's gone, it's gone.'

However, without any further elaboration of the health condition which may be the root cause of your symptoms we would be looking at them as they were in  themselves and trying to make sense of them within the framework of Chinese medicine. As our factsheet on vertigo shows

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

there is a growing body of evidence which suggests that acupuncture might be of benefit, but even here we would say that vertigo is simply a label for someone's experience, and that once it is put in the context of someone's overall balance it can be the result of any number of possible imbalances from a Chinese medicine perspective. That is why we invariably recommend that someone sees a BAcC member for an informal chat. Most are happy to give up a little time without charge to discuss based on a first hand view whether acupuncture treatment might the best option for you. We have confidence that if it isn't they will say so. There are alternatives if this seemed to be the case.

It does illustrate very well for us, though, how working backwards from symptoms to a disease label can make a huge difference to how one perceives a problem. The great strength of Chinese medicine is that it see symptoms in their wider context as manifestations of the disease, not necessarily the disease itself.

We're not quite sure whether you are asking about having sessions of acupuncture with your GP or whether you are considering asking your GP whether it is OK to have acupuncture.

If it is the former, then we suspect you may not get very far. There are quite a few doctors who now incorporate acupuncture within their day to day practice, but generally speaking they are normally only allowed to do so when there is an evidence base for the condition which they are trying to treat. For a variety of complex reasons most of the research into acupuncture doesn't pass muster with the UK regulatory agencies, and chronic lower back pain is one of the few that does. Unfortunately NICE, which used to recommend ten sessions of acupuncture for chronic lower back pain, has recently reversed its ruling, so it is now unlikely that your GP will take advantage of this to refer you on or to treat you themselves.

There is nothing to stop you asking your GP if he or she is happy to give you acupuncture treatment, and most GP practices have at least one partner who uses acupuncture regularly. In terms of getting treatment free at point of delivery, this is perhaps your one and only option.

In terms of safety with the problems which you have, there is nothing in the literature to suggest that any of your health issues might make acupuncture a bad idea. We have experience of treating people with all of these problems. We are always careful with epileptic patients, but that is mainly because many want to get off their medications and we would never make that recommendation, however successful treatment may appear to be. When a condition is well controlled even GPs are reluctant to interfere with the treatment plan. As far as mental health issues are concerned we advise members to be aware of their limitations. Although we take detailed case histories and explore many problems with patients there are some areas where a practitioner needs specific skills in addition to acupuncture training to be able to understand the kinds of problems with which they are dealing. We regard mental health issues as one such area, and we are in the process of exploring standards for expert practice which would define what additional training a practitioner should have.

As far as the back problems are concerned, we feel confident that acupuncture treatment may well be able to help, but you may find it worthwhile to discuss your complex health background with a local practitioner before committing to treatment. Most acupuncturists are happy to give up a little time without charge to discuss with prospective patients whether acupuncture is the best option for them.

There is no doubt that the treatment which you have already been prescribed, oestrogen in pessary form, has been consistently shown to help prevent recurrent UTIs in post-menopausal women. As such, we would be unlikely to recommend acupuncture treatment as an immediate alternative, but there may be some scope in discussing with your GP what happens if the oestrogen brings the UTIs under control. Using acupuncture alongside the other treatment may improve the overall results and may facilitate a safe withdrawal from long term medication use.

Whenever we receive an enquiry we look through all the research databases to see what, if any, research exists. Most acupuncture research is undertaken in China and not translated, so restricted funding and the problems of assembling suitable cohorts of patients can mean not a great deal exists. However, there are two studies from Bergen in Norway


https://www.ncbi.nlm.nih.gov/pubmed/9612877

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447293/


which showed some very promising results. Both of these are cited on reviews of the treatment of recurrent UTIs, and the following two

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931387/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/

are worth a look because they spell out all of the options and are generally very positive about the treatment which you have been recommended to have.

There are obviously ways of treating UTIs from a Chinese medicine perspective; they are not a recent invention! The theoretical basis of Chinese medicine is entirely different, and the manner in which the condition presents will point to specific patterns of imbalance which may be reflected in other systemic problems. It is not often that a symptom stands in isolation, and our basic premise of treating the person, not simply the condition, tries to make sense of a symptom within its overall context. This can sometimes mean treating the overall patterns without specific reference to the individual problems, which can be quite confusing to a patient. However, if it works...!

Our one concern in cases like this is that people often get caught up with treatment regimes which it is quite difficult to unravel. The Trospium and Lansoprazole may not be entirely necessary if the oestrogen takes effect, but a practitioner would not be able to make that call, only the GP who prescribed them. This can make the clinical picture a little more confusing, but a properly trained practitioner will be able to assess the impact of medications on the system and allow for them.

Trospium is often prescribed for an over-active bladder, and if that is one of the manifestations of the UTIs you have been experiencing, there is some good evidence that acupuncture may have be of benefit. These three studies 

https://www.ncbi.nlm.nih.gov/pubmed/15994629

https://www.ncbi.nlm.nih.gov/pubmed/25399241

https://www.ncbi.nlm.nih.gov/pubmed/25033919

all make interesting reading.

However, the best advice that we can give is that you drop in to see a local BAcC member to discuss what may be best for you. Complex presentations are always best advised on face to face, and most of our members are very happy to give up some time without charge to prospective patients to ensure that acupuncture is the best option for their problems. This also gives you a good chance to meet them and see where they work before committing to treatment.

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

http://acuroots.com/mortons-neuroma-treatment-plan-with-acupuncture-and-tui-na/

(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 gettinneuromas, 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.  There is an interesting case study about the use of therapeutic massage

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390214/

which is useful for the background information, but nothing new involving acupuncture treatment.

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.

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