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Q: My mom just had acupuncture yesterday at noon as the practitioner said that she had blood deficiency (her pulse on her left wrist was too weak). Now my mom is experiencing extreme dizziness, cold sweat, fatigue, and nauseousness. Is this normal and what should we do?

A: We are sorry to hear of your mother's post-treatment episodes. However, we are confident that by the time you receive this reply everything will have settled down.

It is very rare for people to suffer serious side effects or adverse events after treatment, and the ones that do happen are invariably to do with actual physical damage caused by a needle. In the hands of a properly trained and qualified professional acupuncturist this is extremely unlikely to happen; it is only the poorly trained or inept that cause these sorts of problems.

However, it can be the case that people can 'wobble' a bit after a first session, and some of the things you mention - dizziness,  fatigue, nausea and so on  - can happen. There are a number of possible explanations for this. Sometimes it is the body starting the process of cleansing itself of energetic blockages. The Chinese believed that pathogens travelled inwards and reversing this process could often lead to a disturbance as they cleared. Some people are also energetically very sensitive, especially if they are somewhat weakened. This can be a reaction to treatment which is too powerful for them, and the practitioner will take this into account when they get feedback, and adjust the strength of treatment accordingly. This might mean fewer needles, less manipulation and so on, but all of these adjustments can make a tremendous difference if someone is a strong reactor.

Of course, there are two other more prosaic reasons. The first is that your mother may not have been warned of some of the basic housekeeping rules before treatment, as for instance making sure that you have eaten something within the last few hours rather than being treated on an empty stomach, and this can sometimes exaggerate the effects of treatment. We have seen a patient faint because she hadn't eaten for twelve hours before treatment, and then only a small bowl of cereal. The second possibility is that the symptoms are of a virus, but by coincidence have happened after treatment. With over four million treatments being given every year there are bound to be a few occasions when someone gets ill at the same time as treatment, but without any causal connection. If this is the case, then the usual steps need to be taken; bed rest, etc etc.

We strongly suspect that these are transient reactions to treatment, though, and we think they may well have subsided before you get this response. It is important to let the practitioner know, and it may well be worthwhile calling the practitioner today for advice and guidance. They will know better than we could what they have done and what your mother may need to do to help. If the symptoms have persisted for 48 hours and show no signs of relenting then it may well be worth having a word with her GP, or calling the 111 advice line, the NHS non-urgent service. We have found this to be very successful at directing people to the best help for their needs.

Q: Is there a possibility that acupuncture will help me with a bad problem of balance?

A: A great deal depends on what is actually causing the balance problems. We have, for example, a considerable body of evidence for the treatment of vertigo, as our factsheet

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

shows but there are literally dozens of conditions which are differentiated in western medicine - Meniere's disease, vestibular disorders, labyrinthitis, ineer ear infections and so on - which can generate balance problems. There are also cases of accidental damage, as for instance this study we found about people being researched for balance problems resulting from whiplash injuries

https://www.ncbi.nlm.nih.gov/pubmed/9051168

Essentially, there is evidence for the use of acupuncture in treating all of these problems, but the quality is variable, and we would be hard pushed without more to go on to make a positive recommendation in case the problems arise from something which cannot change.

However, as we sometimes have to remind ourselves as well as our patients, we practise traditional acupuncture which is premised on treating the person, not simply the problem they have. The theory is based on a complex flow of energy whose rhythms and balance determine good function, and whose loss of balance can generate symptoms. The skill and art of the practitioner lies not in going to the clearly defined areas which are involved in balance from this perspective but in looking at what is going on to make this symptom appear. Many symptoms are not the root of the problem but just signs that the whole system is out of balance, and without taking care of the root causes any treatment of the symptom alone may have short-lived effects.

Balance problems have been around since people stood upright so the Chinese will have addressed these issues for thousands of years. To know whether this accumulated wisdom can help you, though, the best advice that we can give is that you visit a local BAcC member for an informal chat. Most are very happy to give up a small amount of time without charge to give prospective patients a better idea of what may be possible, and it enables you to check them out before committing to treatment. We strongly suspect that they will feel confident about being able to help you but we trust them to say so if they think this is not the case.

Q: My father is a paraplegic and has been since he was 28. He is now 61 and is suffering with severe hip pain. His hip joint is completely worn. Is acupuncture a suitable treatment for him?

A: This is, we think, really two questions: is it OK for your father as a paraplegic to have treatment, and if so, what are the possible benefits for the problems that he has.

As far as the first is concerned there is absolutely no reason for a person with paraplegia or quadriplegia not to have treatment. Although someone may have lost conscious and voluntary nerve control of the limbs which have been affected all of the autonomic functions continue, and from a Chinese medicine perspective this means that there is energy flow which can be enhanced or corrected by suitable treatment. The main caution with problems like your father's is that there can often be a sensory deficit, so practitioners are always very careful in how they treat. If someone can't say 'stop it, that hurts' there is an increased chance of bruising, and in the case of moxibustion, an increased risk of burns. All professional acupuncturists are trained at undergraduate level in what to do with cases like this.

As far as treating hip problems themselves are concerned, a great deal depends on the level of deterioration in the joint. If the wear is great enough to warrant or nearly warrant a replacement, then we would have to be honest and say that short term pain relief would be the most we would expect to be able to offer. The question would be how much relief and how sustainable it was, and again, to be honest, this may become a question of how affordable treatment is. For people with deep pockets three or four days relief from indefinite weekly treatment may be a good deal. Most of us couldn't afford this, though, and we trust that members do their best in these circumstances to direct people to the most effective and cost-effective means of getting relief, be this herbal medicine or reflexology or any one of dozens of possible complementary medicine solutions.

The best advice that we can give is that your father visits a local BAcC member for advice about what may be possible. Nothing beats actually seeing the problems first hand in order to be able to give an accurate assessment of what may be possible, and most of our colleagues are only to happy to see prospective patients without charge to give them a good idea of what can be done.

We suspect, though, that if the wear is very considerable the amount of relief may be limited, and if someone does think treatment is worthwhile it would be advisable if they offered realistic expectations.

Q: What was the qualification to study for acupunture, and what is the cutoff  to study for acupunture?

A: Your question is a little unclear, but we think we can cover all the bases!

In order to enrol for a training course in acupuncture, most UK students have an A level standard of education which would be the normal entry standard for a university degree course, which many UK courses now are. There are obviously alternative routes depending on the kind of experience and life skills a person has. With a career on acupuncture it helps considerably to have some life experience behind you before starting to train, and many courses will offer partial exemptions and deals for people who can demonstrate that as a mature entrant, for example, they have skills which would enable them to train, even though these may not be reflected in formal qualifications.

As far as the qualifications gained are concerned these are usually licences to practice or diplomas, although the university qualifications will be degrees, usually a Bachelor of Science (BSc).

As far as cut-off is concerned, there often isn't one. In the UK it would actually be in breach of formal guidelines to refuse to take someone on as a student on the grounds of age. All that a training establishment can do is assess whether someone is fit to take the course, not factor in whether or how they can practise the skills learned or the length of time they could possibly practice.

The website of our sister institution, the British Acupuncture Accreditation Board  https://baab.co.uk/ has a wealth of information on training and a career in acupuncture, and we can think of no better resource to which to direct you.

Q: I have athritis in my hand and thumb. Will acupuncture help me?

A: As you can read from our factsheet on arthritis https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/osteoarthritis.html there is a fair bit of evidence that arthritis can be helped by acupuncture treatment, and the usual response we give says that it is more a matter of how much help and how sustainable the results are. Clearly if treatment only gives a couple of hours of reduction in pain and stiffness then acupuncture may not be the best option, but if the improvement lasts a few days there might be better prospects. The question really is whether the improvement always drops away back to the original baseline or whether there is a gradual overall improvement. There is nothing wrong with knowing that something will only work for a week if the week in question is one where additional mobility is necessary, and of course the joker in the pack is how much treatment may be doing to reduce further deterioration, or 'getting worse slower' as one waggish patient remarked.

However, with arthritis in particular it is really good to get a handle on the possible causes. Although the symptoms are universal, the causes, even in western medicine, can be very varied - repetitive use, diet, heredity, and so on. In Chinese medicine this difference can be crucial because each person will be a unique combination of factors, and treatment can address this unique quality better, we believe, in many cases than western medicine which has clearly defined clinical pathways for all named conditions.

The best advice we can give is that you visit a local BAcC member for advice, and for them to have a look at the exact nature of your symptom in the context of your overall health. There may well be other factors in play which would enable them to determine whether this is simply a local problem or the tip of a systemic iceberg. Most of our colleagues are more than happy to give up a little time without charge to prospective patients to enable them to assess the potential benefits of treatment. We are confident that they will give you honest impartial advice.

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