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It is always rather difficult to provide the kinds of answer people might like for questions like this. From a Chinese medicine perspective metacarpal bursitis is the kind of problem which we all tend to feel confident that we can do something about, even if we cannot make the problem go away. With its central themes of removing blockage and stagnation moving stuck energy in the form of fluid filled sacs should be highly responsive to treatment.

However, just as there can be any one of a dozen reasons from a western medical viewpoint which someone might have as the underlying cause of the problem, so in Chinese medicine the symptoms might well arise from many different causes. It will depend a great deal on whether this is a purely local problem, brought on by accident or over-use, or whether it is the tip of a much larger iceberg. In this latter case clearing the symptom will only be effective to the extent that the conditions which created it are gone.

Although there is a fair bit of research into osteoarthritis as one of the predominant causes of bursitis there isn't a great deal specifically about the hands, and osteoarthritis is only one possible cause of the problem. The best and only advice we can give is that you visit a BAcC member local to you for an informal assessment of what may be possible. There is no substitute for a face to face look at a problem, one which also allows you a chance to explain in more detail how the problem has arisen, the precise nature of the pain it gives you and the what you have discovered for yourself makes it easier or worse. Most members are happy to give up a small amount of time without charge to prospective patients to make sure that everyone is very clear before committing to treatment what the propects for change are.  


Generally speaking most of us feel fairly confident that we can do something. The only question really is how much that something is and how sustainable the outcomes are.


We would advise you not to worry too much about short term adverse effects after a first treatment. The vast majority of these are short-lived, and we would not be at all surprised to hear that by the time you receive this reply they will have gone. Our experience is that this usually only happens after the first treatment, and you should have no reason to feel any trepidation about the next treatment.

There are a number of possible explanations for this. When someone has had Western medical acupuncture, which we suspect is the case, there may well be some sinus involvement in the pain and the treatment may well have provoked some clearing of the sinus which, in this particular expert's personal experience, can be a very painful business. In Chinese medicine terms we often describe this as the energy of the area being reinstated, but because we treat the person, not simply the condition or pain which they have, there can often be secondary consequences as the system as a whole rebalances. Pathogens are often seen by the Chinese are 'going into' the system, so the process of health can lead to a reverse of this which can cause ripples in the energy as they leave. This can leave the patient feeling a little unwell for a day or two.

It is very important to let the practitioner know exactly what has happened. There may be aspects of the treatment which he or she can adjust. Some people are highly sensitive to treatment, and using fewer needles with less manipulation can make a big difference to the experience of the treatment without lessening the effect.

At any rate we hope that you feel comfortable with continuing, and hope that the treatment deals with your pain

We are very sorry to hear of your problem.

Long-lasting side effects from acupuncture treatment are very rare. Where these happen they are generally to do with the 'wound' of the needle, i.e. puncturing or touching a part of the body. Surface responses are usually transient, lasting no more than 48-72 hours. Where these occur it can result from one or two special cases. First is a possible allergy to the stainless steel of the needle. Needles are usually composite material, and one or two types contain a small amount of nickel to which some people are very allergic. This can trigger a response which can last for some time. The other possibility is that the needles has a silicon coating. This has been a modern development to make the needle insertion smoother, but again there are some patients who find silicon can generate nasty side effects.

Leaving aside the technical causes, there is a small chance that this is a reaction to the treatment in terms of the stirring up of energies which have raised but not removed an internal pathogen. It depends to some extent on the kind of acupuncture you were having - traditional or medical - but in our experience a medical acupuncturist can generate what we call an energetic reaction without having any idea that this is what they are doing. If this does happen, though, it does tend to dissipate relatively quickly, so it would be unlikely to be causing longstanding pain.

Another possibility is that there has been a failure of hygienic practice, and there has been some form of transfer of surface material to areas of the skin where it is not checked. We advise members to take extra care where someone has just had surgery, and to treat them as though they were immuno-compromised because the chance of infection is a little higher.

Finally, there is also a possibility that this has got nothing to do with the acupuncture and may simply be a coincidence. With over four million treatments a year there are going to be a number of cases where something just happens to start at the same time and a spurious causality is assumed. This always sounds overly defensive - 'it wasn't me' - but we have seen a number of cases where the problem simply could not have arisen from the treatment, however it may have appeared to be the cause.

The most important thing, though, is to find out what is happening, and for this you will need to get a referral to a dermatologist via your GP. It would be helpful if you can provide information from your acupuncture practitioner about where needles have been inserted because this will help to establish potential causal factors.

More than this we are sorry to say we cannot say. Sight unseen it is very difficult to give a definitive view when an adverse effect arises, but we hope that we have given you enough information to consider what might have been the case and to find an effective way to get rid of the irritation and pain.

We think that the first thing you might want to do is to see your GP to rule out any other underlying conditions for which this might be a presenting symptom. The fact that you are unable to lie or sit comfortably suggests something quite a deal more problematic than a simple muscle strain, and there are a number of health issues, like niggling gall bladder problems, which can generate referred pain in the shoulder area. On the surface these feel like muscular pains but actually aren't, so you need someone with an expert medical eye to have a good look first to exclude anything which needs conventional treatment. This is unlikely, but it is probably what we would recommend if you came to treatment.

If it is a simple muscle spasm then it is quite possible that acupuncture might well be able to relieve the pain and also reduce or remove the cause. All versions of acupuncture, both traditional and medical, have ways of understanding this kind of symptom and clearly defined protocols for dealing with the problem. Obviously we believe that traditional acupuncture offers slightly more, because in our experience a symptom is usually the outward manifestation of a more deep rooted imbalance. While in many cases treating the symptom will clear it for good there are often times where not looking at the overall picture will just offer temporary relief, and when the symptom returns the patient will conclude that the acupuncture hasn't worked, which is a shame.

Generally speaking, though, traditional acupuncture is premised on the good flow of energy, called 'qi' by the Chinese' and treatment is aimed at adjusting the flow and balance of energy to ensure good function. There are some occasions, though, where other interventions, like chiropractic and osteopathy, can deal with structural problems very directly, if these are the cause of the problem, and we often work alongside colleagues in both traditions to ensure that structure and function are treated together.

Without more detail, though, there isn't much more that we can say. The best advice we can give is that you visit a local BAcC member so that they can actually see the problem and talk in a little more depth about how it started and what works in relieving your discomfort. This will give you a far better idea of what may be possible. Most members are only too happy to give up a little time without charge to prospective patients so that they can offer a more balanced view of whether acupuncture treatment might help.

We are sorry to hear of your problems. It must be disheartening to have a symptom for which no adequate explanation can be given.

We have been asked about reflux many times, and a typical answer has been:

There is surprisingly little research on the use of acupuncture for the treatment of acid reflux even though it is a very common presenting condition in our clinics. There are one or two studies like this

http://www.ncbi.nlm.nih.gov/pubmed/20697939

http://www.ncbi.nlm.nih.gov/pubmed/17875198

and occasional articles like this one

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080874/

which suggest other possibilities for the appearance of heartburn symptoms, but not the solid body of evidence one might expect based on the usually quite effective treatment of this problem.

Obviously there are physical problems such as hiatus hernia where there has been a physical change in structure of the oesophageal tract which can cause heartburn. If this is the case, then it will seriously limit the possibilities for treatment in any system of medicine. If investigations show that this is not the case, however, then there may be some value in using acupuncture treatment.

From a Chinese medicine perspective the classic presentation of reflux or heartburn is described as Stomach Fire or Rebellious Stomach Qi where the energy of the Stomach does not follow its normal pattern of causing food to descend but lets it stay in the Stomach or reverse its flow to create the classic symptoms with which people suffer. Knowing the immediate precipitating cause, however, does not mean that one goes straight to this for treatment. The flow of energy in the body, called 'qi' in Chinese, is a complex interweaving of channels connecting Organs whose functions are also inter-related. The art and skill of the practitioner lies in determining what the primary underlying imbalances are, in the belief that treating here will cause the symptom to go and stay gone rather than be treated simply as a symptom.

This is one of the primary differences between Chinese and conventional medicine. From the Chinese medicine perspective the symptom is an alarm bell telling the practitioner that the system is out of balance. Thus twenty patients with the same symptom could have twenty different underlying causes and therefore twenty different treatments, in contrast to the standard western procedures which have two or three main strategies for a problem. In Chinese medicine the balance of the system is unique in every patient, and this means that each treatment plan is also unique.

It follows that this does limit what we can say about individual cases and why we invariably advise people to visit a local BAcC member for an informal assessment of what is going on and whether treatment would be of benefit. Most practitioners can get an idea in a very short time of what is going on and as a consequence give a good informed view of what might be possible. This would invariably take into account other changes in the way that everything functions which are perhaps not significant enough to concern anyone but from our perspective enrich the picture which we have. Reflux and heatburn are often accompanied by changes in bowel habit, and secondary information can refine the diagnosis a great deal. A practitioner can take all sorts of other factors into account, including mental and emotional ones, to offer you a much more precise assessment of what may be possible.

This remains pretty good advice, even if we say so ourselves! Your description does tend to the fact that this is a physiological problem of the 'containment' structures not working, and that, as we have said, may limit what the possibilities are. However, traditional acupuncture is based on restoring functional integrity to the system, and that may have some impact on the way that the body controls the contents of the stomach. There are other imbalances besides Stomach imbalances which interfere with the steady downward progress of digested food, and a skilled practitioner might well recognise something like this straight away and be able to assess how treatment might well help.

There are also some new treatments which offer possibilities if the existing remedies fail to work. One of our patients has just had this device fitted:

http://www.toraxmedical.com/linx/

and his experience after fitting has been extremely positive after many years of suffering. There comes a point where long term reflux starts to cause serious damage to the oesophagus, and investment in these kinds of treatment are much more cost effective than managing the consequences of tissue damage in the longer term.

We hope, though, that you give acupuncture a try to see what it can achieve. This isn't a blank cheque, and it would be well to set a target of, say, five treatments to see what can be done. If there is no change then it may be sensible to explore other alternatives.

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