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Q:  I had acupuncture for the first time  and felt very energised after it. By the afternoon I was experiencing lower back pain - which I normally do not have. 2 days later and the lower back pain is still there. Could this have anything to do with toxins being released in the session and if so can I expect relief from the pain anytime soon?

A:  We have to say that we have not encountered any instances where someone has reported lower back pain as a direct consequence of acupuncture treatment, and we have searched the databases to check.

 That is not to say that it didn't come out of the session itself. Our colleagues in the physiotherapy profession who also use acupuncture do say that there are occasions when a rigid back is actually guarding and holding in place a problematic disk, so releasing the muscles by relaxing everything can actually cause problems to appear. However, in this instance there is almost always some case history of back problems before which would support this as a causal pattern.

 You don't mention whether or not you have had back pains before, but there are also occasions when a symptom which has cleared earlier in life can reappear for one last time. This is more common with problems like migraine, where someone can end up with a one-off 'special' but we have heard of the same happening with back pains. This will almost definitely be a transient reaction if this is the case. The same would apply if there were a general release of toxins, but in that case we would expect a slightly more extensive range of odd symptoms.

 

Of course, there can sometimes we simple mechanical reasons. We have heard of people who found that the couch on which they were treated was lumpy or unbalanced, and the back pain literally arose from the treatment because of this.

 Finally we have to say that the appearance of the back pain may be coincidental. This does sound horribly like 'it wasn't me' but with over 4 million treatments a year there are bound to be some cases where the problem appears after but not because of the treatment.

 In nearly all cases, though, the pain will be transient and probably have gone by the time you read this. If if hasn't then it is worth talking through in detail with your practitioner what they did and how this might have been implicated in what happened. If it does carry on, though, it may well also be worth talking to your GP in case it is a sign of an underlying problem which needs to be followed up, or worth seeing an osteopath trained to make precise judgements about someone's physical structure. There are a number of internal problems which can manifest as back pain, and your GP is the best placed person to see if there is anything going on. 


Q: I am pretty confused because I would like to study Microsystems Acupuncture to use it in my relaxation therapy sessions.  I've found different short courses open to anyone. I wonder if they are reliable courses and if I will be able to perform ear, hand and face acupuncture safely.   My concern is can I do it  without breaking the laws about the practice. I see a full acupuncturist degree lasts 3 years so I am pretty perplexed by the difference. 

A:  Let's begin with the basics. Since there is no statutory regulation of acupuncture in the UK the only laws relating to the practice of acupuncture are to do with the registration or licensing of premises in which the practice takes place. There are different laws in place depending on where you are based, but they are mainly concerned with the health and safety aspects of practice - clean and suitable premises, proper techniques for the safe use and disposal of acupuncture needles and other clinical waste and maintenance of the premises themselves. An increasing number of authorities are beginning to check someone's training credentials, and this may have an impact on those with very little training, but the majority of bona fide UK courses will pass muster.

 We obviously are committed to the idea of a degree level training as the minimum standard for a traditional acupuncturist in independent practice. However, many of the microsystems in common use, like ear acupuncture, are relatively modern. Auricular acupuncture, for example, was mainly a development by a Frenchman called Paul Nogier in the 1950s, and other systems, while based loosely on classical principles, are often modern innovations, scalp acupuncture being one such.

 When all the acupuncture groups met to discuss the possibility of statutory regulation the microsystems groups worked out pretty quickly that they would be unlikely to meet the standard for statutory regulation, likely to have been agreed at degree equivalent, and formed a working group to seek recognition through the Complementary and Natural Healthcare Council. This they achieved. The CNHC website itself is rather unhelpful, mainly identifying individual practitioners rather than the organisations which generated them and which provided their training. However, you can still find a listing on what had been the site of the Microsystems Acupuncture Regulatory Working Group here http://www.macrwg.org/html/group_members.html, and the names and addresses look pretty current.

 Some of these groups are mainly 5-point detox organisations, and probably not what you have in mind. The others offer different forms of microsystems acupuncture based on holistic principles, and while it is not our place to comment on them individually, the majority are credible bodies which offer specific training within precise limits of competence. As long as someone works within their scope of practice the work they do can be very effective. We would obviously prefer it if everyone learned to practise traditional acupuncture at degree level, but there are likely to be all sorts of constraints which make that impossible for some.

 Of the different varieties of microsystem work the one which does give us the greatest concern is facial or cosmetic acupuncture. We have reservations about the extent to which people are taught how to use needles safely in an area where mistakes could prove very costly for their insurers, and some of the courses we have seen have been very rudimentary. We are also working hard to establish safety standards for regulated healthcare professionals whose short training courses has led to a number of serious accidents, so we would advise that you check this aspect of the training very carefully. We would not wish to see you expose yourself to risk because you don't know what you don't know, if that doesn't sound too cryptic. Acupuncture seems to deceptively simple at times - find point, stick needle in - that people forget what is going on inside the body they are puncturing, even people who should know better. 


Q:  My toes draw and go crooked and the pain is awful.  It's every day, all day and I wondered  if acupuncture would help?

A: We think that the first thing you should do, if you haven't already done it, is to speak to your doctor about this. There are one or two simple causes of foot cramps like dehydration and mineral deficiencies which may need to be checked (most patients are aware that they don't drink enough water but few realise how little they actually take in), and one or two slightly more serious neurological disorders which can generate these symptoms. We think it is highly unlikely that this is the case, but it would be our duty of care as practitioners if you came along with these symptoms to make sure that you had been thoroughly checked in conventional medicine first.

 As far as acupuncture treatment is concerned there are both local and systemic reasons why this might be happening. Tight cramping pains are often caused by blockage or stagnation of energy, or 'qi' as the Chinese called it, and this can be either a local or systemic problem. If it is a local problem it can sometimes be traced back to a particular event or series of events, especially since i Chinese medicine terms once the body has been 'invaded' by cold it sometimes needs to be removed rather than just being left to dissipate.

 The other possibilities are what we would call systemic, involving the under-performance of parts of the system which supply energy to the extremities. If this is the  case they are very likely to be generating other symptoms in the body that someone may not even recognise as symptoms, like bloating after eating or becoming slightly less good at concentrating. A skilled practitioner looks at the way the system is performing for even the smallest of problems in the extremities because the small symptom can be the tip of a much larger iceberg.

 The best advice we can give, and which we invariably do, is to visit a BAcC member local to you and seek a brief face to face assessment. Most members are happy to give up a little time without charge, and this gives you a chance to meet them and see where they work before committing to treatment. Seeing the wider context within which you have this problem is invaluable in giving an informed view of whether acupuncture can or may help. 

Q:  I have been recommended to have acupuncture for possible migraine. I have polymyalgia rheumatica and take steroids. Is it ok to have acupuncture ?

A:  There is no reason of which we are aware that suggests that acupuncture treatment was at all contra-indicated for someone taking steroids for PMR. In fact, a great many patients using steroids as a long term treatment for PMR seek treatment to see if over time they can reduce their steroid use. Clearly our members are very cautious in these situations and always advise the patient only to reduce a dose of medication with the knowledge and prior agreement of their doctor. As you are no doubt very well aware, a sudden reduction in a steroid dose can have serious consequences.

 As far as the treatment of migraine itself is concerned, you may well have looked at the details on our website, but if you haven't there is a fact sheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/migraines.html

 which provides some of best current research information about the treatment. In clinical practice migraine remains one of the more frequent reasons why patients seek acupuncture treatment. 

 As long as you are very clear about your situation when your practitioner goes through the initial interview there will not be a problem. Our members are all highly trained and take a full medical history to ensure that any and every factor in someone's health is taken into account.

Q:  After treatment 2 years ago with high dose oral steroids I experienced a raft of adverse effects, including fatty deposits on my left lower leg and foot that caused extensive nerve damage and paralysis [juxta-articular adiposis dolorosa].  Clinicians tell me that there is no way of removing the fatty lumps; however, I wonder if acupuncture could stimulate the body's own mechanisms. Any information you can offer would be most appreciated.


A:  This is one of the sorts of question where we tread with great caution. Acupuncture treatment is often a treatment of last resort and we are always concerned about raising expectations where the chances of improvement are slim. However, there have been for nearly every condition we have seen cases where there has been a remarkable turnaround, and although this is often described as 'spontaneous remission or cure', often much to our colleagues annoyance, the reality is that this is the exception rather than the rule, even if it were demonstrably caused by the treatment.

 There is, as you might have expected, no research of which we are aware or could find which suggest that acupuncture treatment might help. The condition is rare, and research studies would need a much larger cohort of people to work with to have any meaningful outcome. We have not even been able to find a case study.

 However, problems such as this have been around for thousands of years, whatever the cause, and Chinese medicine would have been used to address the manifestation, just as it would for any other condition which we now recognise under a western name. Traditional acupuncture, based as it is on a flow of energy called 'qi', would have and still does look at problems like this as blockages in the flow of qi or accumulations of energy caused by stagnation. The practitioner would be keen to establish whether it was a local problem or a local manifestation of a systemic problem, and then use the needles to try to move the qi and disperse the problem.

 All sounds rather easy when put like this, but the reality is that the growth of new tissue in the body as a consequence of conventional treatment has proved very difficult to address, and if you were to present at our clinic the best that we would ever say is that it may be worth a few treatments to see if there was any noticeable change, and if so to discuss how much and how sustainable. The problem is always to determine a scale by which change can be measured. If there are clear signs that it impairs movement or causes local pain then there are scales which one can use to determine what effect the treatment has. If it's simply a matter of trying to measure the size of a fatty lump, that would be much more difficult.

 The best advice which we can give is to visit a local BAcC member to see what they make of the presentation in the context of your overall health picture. There may be something in the systemic presentation which suggests that treatment may have an impact, but in any event it would enable much more detailed advice than we can give at a distance. Most members are happy to give up a little time without charge to help prospective patients make informed decisions about their health and healthcare options.

 In summary, we think it might be a long shot to try acupuncture treatment for this problem, but we would never say 'don't' because our work is not simply about trying to get rid of specific conditions but about trying to balance the energies of the body to enable it to function as best it can. The ancient Chinese used to believe that this would enable to body to heal itself, and we have certainly seen cases where change happened against out expectations.

 

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