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Restless leg syndrome  is now egaining recognition as a diagnosable problem, with a new name(!) (Ekbom Syndrome), and there are a number of treatment options which are being explored. A review article several of these, and the one acupuncture review this in turn cites two to three studies which are interesting but generally concludes that the majority of studies are too small and not methodologically sound enough to draw firm conclusions.From a Chinese medicine perspective, however, there are entirely different ways of looking at the balance of energies within the body which can sometimes make sense of problems such as these within a theoretical structure which is quite different from western medicine. Problems like restless legs syndrome, where the leg feels as though it is 'over-energised' can sometimes make sense in a system of thought which looks at the free flow of energy within the system, and tries to understand the pathologies which arise in terms of excesses and deficiencies, and especially blockages. A skilled practitioner should very quickly be able to make sense of the energy flows within the system, and be able to offer you some sense of whether there is something which is treatable.Even where this is not the case it is important to mention that the older theories of Chinese medicine were primarily aimed at balancing the whole system, seeing symptoms only as alarm bells, not the problem itself. Working in this kind of way our members very often have an effect on problems without necessarily being able to give a highly specific audit trail of what is causing something to go wrong.We have not come across much in the way of new research, although another small study published early this year (2015) the general pattern of significant effects but small study sizes which means that we cannot give a more unqualified recommendation.We have looked at all the available research and there is nothing new to report. However, from a Chinese medicine perspective it would be unusual to treat a named symptom by itself. The whole essence of Chinese medicine is that we treat the person, not the problem, and even where a dozen people suffer from restless leg syndrome in the same way, each might be treated entirely differently depending on how the symptom was perceived to be arising from the overall patterns of imbalance. The best advice that we can give is that you visit a local BAcC member to see what might be possible for you. Seeing the overall pattern as well as hearing your individual account of how it affects you will probably help them to see what causal pathways are involved and advise you on how effective acupuncture treatment may be.

We were asked a similar question a number of years ago, and our answer then contained the following paragraphs:

Chinese medicine is based on an entirely different theoretical basis from conventional medicine, what is often called a different paradigm. The essence of Chinese medicine is a belief that the body, mind, emotions and spirit are all manifestations of an energy called 'qi' whose proper flow and balance means that everything functions the way it is supposed to. If this flow becomes blocked or disturbed in any way, then functional disturbances appear, often affecting all 'levels' of the system and for which needles are used by the practitioner to restore flow.

When someone reports blockages it makes one question immediately whether the energy of that area is flowing as well as it might, and a skilled and experienced practitioner could determine quite quickly whether, from the Chinese medicine perspective, there was something which might be done. Even if there were no immediately obvious signs in the area itself, the principles of Chinese medicine are founded on a notion of overall balance which means that symptoms are less critical, being indicators of a wider imbalance in the system rather than the necessary focus of attention. It would be worth your while to visit a BAcC practitioner local to you for an informal assessment of whether they believe that acupuncture treatment may be of benefit to you.

That said, we have to say that the research evidence for the treatment of both conditions with acupuncture is a little bit thin. There are a few studies, but one of the key factors in undertaking research from a conventional perspective is trying to reduce the variables, and this means being able to define clearly what the problem is. Blocked tear ducts  have several possible causes, and this means that comparing like with like becomes more difficult, and the results less reliable. What research we have identified is of relatively poor quality, and if we were making recommendations based solely on that we would have to say that it would not be worth pursuing. However, our clinical experience is that where there are clear energetic blockages treatment can sometimes have a very direct effect, and it would certainly be worth seeking advice from a BAcC member local to you.  

There are, in fact, some quite useful studies of related problems like dry eye syndrome, and although it is rather technical this paper

is both realistic and encouraging.

This expert has to admit that it has not been the most successful area of his practice. While few patients have come specifically for this as a problem several have had it as a secondary problem, and even where the main problems have responded well this hasn't. That said, in the minority of cases where there has been a positive change the result has been welcomed with great joy.

Acupuncture treatment is always worth a try. There is very little chance of an adverse effect, and there are enough reports of treatment working for this problem to suggest that it is worth a go. The only issue for cases where there is less evidence is to make sure that a patient doesn't get tied into a long and potentially expensive course of treatment without any tangible benefit. In another context, Dr Johnson once described something as 'the triumph of hope over experience', and we always ask our members not to succumb to joining patients in a desperate hope for good outcomes. If there is nothing happening after four or five sessions it may well mean that nothing will happen.

If you do decide to go for treatment, we hope that your case is one of the ones which does respond.

We are sorry to hear of your experience with your practitioner. Making a good rapport with a patient is seen as central to what we do, and our training standards for students make this an important feature of our work. We depend on people feeling comfortable with sharing information with us, and since in traditional acupuncture we treat the whole person anything and everything which may help us is important. We can sometimes make predictive statements based on what the diagnostic signs tell us, but not at the expense of giving the patient plenty of time first to tell us what is going on. 'Rushed' does seem to be the key word.

As far as treatment of vertigo is concerned, acupuncture has a fairly good research base, as you can see from our factsheet

and various balance problems like vertigo, Meniere's disease, labyrinthitis and the like have always formed a good percentage of our regular referrals. However, we are aware that treating problems like this can take several sessions, and more to the point where blockage is involved, it can cause a few ripples on the surface when treatment starts. This 'expert' along with many of his colleagues is usually unwilling to start a course of treatment for many chronic conditions immediately before someone goes away because the chances of an immediate positive outcome are slim, but the chances of a short term disruption are often quite high. The last thing any of us wants is a patient with a reaction to treatment over a thousand miles away with no access to treatment.

We don't want to over-dramatise the situation, and in the vast majority of cases nothing would happen. However, simply in terms of being able to work incrementally with a patient building on the results of the previous treatment it doesn't make sense to do a single session and then wait a few weeks to follow up. If there has been some momentum then we want to be able to capitalise on this. Only in very acute situations of chronic pain or immobility do we feel that a one-off session is usually worthwhile.

However, if you use the postcode database search function on our home page,uk you will find a number of BAcC member within easy reach, and it may well be worth your while contacting one or two with a view to finding someone better attuned to your needs ready for when you get back. It may be that they find something which is a kind of 'holding' treatment to take the edge off what you are experiencing without too much risk, and that could well make the different between a good journey and a great one.

It is often difficult to answer questions like yours because there are so many variations on this particular theme. This happens not least because the term IBS has become so elastic that it covers nearly every digestive problem from one end of the digestive tract to the other.

The first thing to say is that if you are experiencing or have experienced any episodes of diarrhoea then we are assuming, and hoping, that your GP is fully aware of this. The management of chronic diarrhoea involves ensuring that a person remains adequately hydrated and also does not develop deficiencies in some of the vital trace elements which are re-absorbed in the lower gut. We are not suggesting that you should be taking preparations like diarolyte, but we think that your doctor should be making suggestions about what it is best to do, along with organising investigations like stool tests and endoscopy to ensure that there is nothing more serious going on.

The second thing we would do, if you were a patient, would be to have one of those discussions which we enjoy (!) about what you are actually describing. Chinese medicine works from an entirely different theoretical basis from conventional medicine, with a complex understanding of the energies of the body. The term 'diarrhoea' is used to cover a wide range of presentations, and the treatment for all in conventional medicine is often the same. From a Chinese medicine perspective there are some crucial variations, which is why we need to establish exactly what is happening. There is a considerable difference between, say, the kind of explosive and often unpleasant bowel movement which often feels like heat leaving the body and the less well-formed stool that needs to be passed urgently and quickly. These point to entirely different pathologies in the system, and that would mean very different kinds of treatment.

The research evidence for the treatment of IBS is not great, as our factsheet shows

but this has a great deal to do with the difficulty of assembling test and control groups with identical presentations and causes of problem. Our clinical practice involves treating many people with IBS, often as a part of a wider pattern of problems, and we usually feel confident about being able to make some progress. The question for us is often how much and how sustainable, rather than does it work, and oddly for a therapy about encouraging movement and flow we are often more able to bring loose movements under control than to deal with constipation which often forms part of a wider pattern of 'stuckness.'

IBS often sits as a part of a wider pattern of imbalance, and the strength of Chinese medicine is that in treating the person, not simply the named condition, it aims to remove underlying causes as much as addressing the symptoms alone.

The best advice that we can give is that you visit a local BAcC member for an informal chat about whether acupuncture may be appropriate for you. Most of our colleagues are willing to do this without charge so that they can give an informed view before a patient commits to treatment.

You may well find that acupuncture treatment is effective for you not simply because of the treatment for eczema itself but also for the treatment of the stress which seems to make it worse. As our two factsheets show

there is research on both which is mildly encouraging, and even more research into anxiety

'Stress is such a wide catch-all that unless you really start to unravel what stress means to someone it is very difficult to line up their definition with the kind of data you have to hand.

If we deal in conventional medical disease labels for skin problems we often find that the research to hand is not as good as we might hope. In our clinical practice, however, we usually find that it is rare for someone simply to have a skin condition without there being some other accompanying clinical features, and because we treat the person, not the disease, we almost always find that the wider context enables us to work with the root cause of the problem, not simply its manifestation. This may sound a bit pompous, but it really is the most effective way to work in our view, by understanding what the patient experiences within the context of their overall health picture.

The one factor which we invariably mention with treating skin conditions is that the received wisdom inside the profession is that Chinese herbal medicine treatment used in conjunction with acupuncture is often seen as the most potent combination for addressing chronic skin complaints. Most members of the Register of Chinese Herbal Medicine are also on the BAcC register, and it might well be worth your while to see if someone near to you is able to offer this combination of treatments. If not we are are sure that acupuncture alone may be able to offer some real progress, especially with the management of stress.

In all skin conditions, though, the real challenge is measuring progress, and we would always urge someone to try to establish a measurable outcome to assess whether treatment is really working. It can take a while for skin conditions to relent, and it is very valuable to have some sort of marker for improvement to judge whether treatment is starting to take root.  

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