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We are very pleased to hear that you managed to stop smoking with the help of acupuncture. However, weight loss is a slightly more problematic area. We used to be asked about this a great deal, and a typical answer (probably an answer within an answer as we read it) which we gave was:

Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect on weight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problem and eastern diagnosis are the same is extremely difficult. In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.

However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someone lose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change. Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.

The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to give someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncture treatment that itself would be a very positive outcome.

There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.

This is probably the best advice that we can give. Our clinical experience is that their are often subtle emotional and spiritual issues underpinning the loss of control which people have of their weight, and some of these are amenable to acupuncture treatment. We have answered many questions on anxiety and depression, and we find quite often that a response to depression is to comfort eat. Helping with the depression may well reduce the desire to use food in this way.

One has to be realistic, however. Some of the psychological issues are not best suited by long term acupuncture treatment and really do need to be addressed directly by someone skilled in this area. There are also many occasions when the 'habit energy' to eat is so well entrenched that a direct intervention like hypnotherapy or cognitive behavioural therapy is appropriate because it goes straight to the point. We also have to tell some patients, sensitively we hope, that oaks breed oaks and willows breed willows. If a family are all size 18, then the chances are that trying to be a size 8 is not going to be likely.

The best advice we can give is that visiting a BAcC member local to you will be able to provide you with advice based on a brief face to face assessment. This is very likely to offer you the best range of options for you. All of our members are concerned to ensure that a patient gets the help they need, which is not always what they have to offer. We often refer to other colleagues if we feel something would work better. Each patient is unique, and finding what works for each individual case is the best guarantee of success.

This rather doom laden response was written at a time when there had been a proliferation of shops offering rapid weight loss, and we felt a strong need to rebut what we regarded as unsustainable claims. That said, it would substantially remain the same advice we would give now. The main benefit of acupuncture, we suspect, is to support people with the drive and determination to keep on track, as well as helping their systems to adjust to the positive changes which weight loss brings.

The one very solid piece of evidence in your favour is that fact that you managed to stop smoking with treatment. This is a very good sign, and encourages us to believe that you are likely to be someone who can benefit for weight loss. Results will not be impactful as the finite end of a habit, but as long as there is consistent progress and the treatment is geared to long term change (i.e. not weekly treatment indefinitely) we think that you may well find that acupuncture can help you.

It will probably come as no great surprise to you that there hasn't been a great deal of research into this problem, and none that we can find about the use of acupuncture treatment. Searching the internet does generate one or two personal stories where the effect of Chinese medicine in the form of acupuncture and Chinese medicine has been tremendous, and two or three very detailed differential diagnoses by Chinese practitioners of what lichen planus may represent in TCM terms. However, evidence like this, while encouraging, is far from proof, and wouldn't in itself be the basis for a recommendation.

This is where we believe that Chinese medicine is very well placed to respond to conditions which for the most part have very few effective treatments in conventional medicine save for the almost universal use of steroids. The symptoms remains the same whichever system of medicine one uses, but the diagnostic categories of Chinese medicine have different ways of interpreting them which are often more literal and sound rather strange to the western ear - invasions of heat and damp, fire poisons and the like. However, most patients find that these sorts of labels often describe their experience of the problem to a tee.

The key thing about this kind of description and Chinese medicine categories is that it is quite rare to see a single symptom that isn't accompanied by other systemic changes which a patient may not regard as pathological, and treating the person as a whole can often mean removing a deeper layer of imbalance of which the symptom is just visible evidence. In fact, in the oldest traditional systems symptoms were almost disregarded on the simple basis that if the body as a whole was in balance then symptoms would disappear naturally.

The best advice that we can give is that you visit a local BAcC member to see what they make of the overall picture which you present. They may well see patterns which are treatable, and as such may be able to offer a good idea of how effective treatment may be. The consensus on websites suggests that a mixture of acupuncture and herbal medicine might be a good idea, and looking at the Register of Chinese Herbal Medicine list will almost certainly generate a hit of someone who belongs to both bodies. However, any BAcC member will be able to give you an idea of what may be possible.

This is a very good question. It is the received wisdom inside the profession that treatment should be started as soon as possible after a stroke, and that the potential for change and improvement diminishes over time. This is driven in part by the fact that in China it is not at all unusual for someone to start having treatment on the day of a stroke, the logic being that the energy of the body has been disturbed and the sooner that it is corrected, the less likely the disturbance is to be 'set' in the system. 

We have some sympathy with this view. There have been several books published in the last couple of decades which have explored the possibility that once an energetic pattern has become established it is no longer seen as a pathological factor but becomes the essence of the person. This means that someone can in a rather peculiar way become invested in the post-illness state as their reality, with the attendant difficulty in getting things to change. If you talk to people who teach the Alexander Technique you find the same model; once the body has  a set pattern it takes a long time to re-train it.

However, our clinical experience with post-stroke patients is rather more mixed than this. Whilst we have always warned patients who come in many months or years after the initial stroke that progress may be slow or in some cases non-existent, we have found that some people do have a marked and immediate response to treatment, often in direct proportion to their underlying constitutional health. A person who was strong and energetically in good shape before the CVA often has a greater power to recover.

There has been a mountain of research into this area, as you can see from the rather long review paper which we have on our website

but which may be a little technical for many readers. It has long been our hope that the evidence will reach a critical mass where we can argue a case for early intervention within the NHS with acupuncture treatment, if for no other reason than the fact that increasing the speed of recovery would save the NHS millions of pounds in rehabilitation costs. We have some hope that familiarity with the Chinese system will encourage some trials in the UK.

As far as your brother is concerned, however, it is rather difficult to say what might be possible without a face to face assessment. What you and he will find, however, is that most of our members are very happy to give up a little time without charge to prospective patients to see whether acupuncture treatment would be a good option. Most of us are very frank about someone's chances because the disappointment of achieving nothing or very little is just as palpable by the practitioner as the patient. We get it wrong - some people we think we can't help recover amazingly and we think we can help don't. In the main, however, we tend to recognise those people for whom acupuncture is well worth a try.

The crucial thing is to try to set measurable outcomes so that improvements are not just a matter of feeling better in oneself, good as this is, but visible through verifiable markers - better range of movement, greater endurance in in walking, and so on. This avoids the problem of running up a large bill without really getting anything back. If it isn't working after five to ten sessions it is better to draw a line unless there are secondary improvements which render the treatment worthwhile.

We are really sorry to hear of your son's problem. These extremely uncomfortable but largely undiagnosable problems often create what the doctors call heartsink patients, the ones for whom they do not have an immediate answer and for whom they run out of options fairly quickly.

We were asked about a similar problem some years ago and our answer then encapsulates the general response to these sorts of problems:

We wish that we were able to say with confidence that acupuncture treatment would be of benefit. However, as far as the research goes, which is the only basis on which we are able to make claims to efficacy, there is very, very little. This probably has a great deal to do with the fact that conditions like tenesmus and anismus often spontaneously reverse, and are therefore quite difficult to research because gathering a trial and control group is hard. The other problem is that most people are trying just about everything at the same time, so a clear difference between acupuncture and acupuncture plus the normal treatment is not easy. Most people simply say 'throw everything at it.'

Clearly from a Chinese medicine perspective, based as it is on the underlying belief in an energy, called 'qi', and the understanding of its balance, flow and rhythm, there are ways of looking at conditions like this which are different from a conventional western medicine understanding. These could range from a simple consideration of what is flowing in the area, i.e. which channels might be affected, to a functional concern, i.e. which part of the system maintains good function in the end of the colon and rectum, and a broader look at what might have caused the problem to begin. The ancient Chinese, for example, had a very complex understanding of the effects of heat, cold and damp on the system, and very often attributed griping and spasmodic pain to the invasion of cold into a body orifice. For a race which was largely agricultural this kind of phenomenon was seen to be based on common sense. Although it is not as common in modern life to be exposed to extremes of climate in this way we have seen several cases where people have literally been exposed to cold breezes while inadequately dressed and suffered symptoms such as these.

From the Chinese medicine perspective, however, there would also be other signs and symptoms in the patient's presentation which would guide the practitioner's strategy, and these might just as easily point to a systemic problem of which your husband's symptom was a small manifestation.

Our only advice in cases like this is to visit a BAcC member local to you and seek their advice in person. This is the sort of case where there is no effective substitute for discussing with the patient what is happening, and offering a more rounded judgement on the potential benefit of acupuncture treatment.     

We have checked again for any research trials which might have surfaced since we gave this advice, but have found none. There are occasional sites like this one,

whose provenance we cannot check and which is riddled with advertisements and referrals on which we cannot comment, but what it does do is to offer some very real interpretations in Chinese medicines for what is happening and the relevant treatments. This kind of 'named condition - Chinese medicine treatment' is not how we believe we work, although it is becoming increasingly common in China, but it has to be said that for cases of acute pain it is often an approach that will bear fruit. 

The advice we gave in the earlier response holds good, though. If your son visits a BAcC member local to him for a brief chat about what may be possible we are confident that the practitioner will be able to make some sense in Chinese medicine terms of what is going on and give a balanced view of whether acupuncture treatment may be able to help him. 

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. 

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