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We have been asked this self same question this morning, and our response was:



We have been asked about it a number of times, and  we have factsheets about both facial pain and neuropathic pain


There evidence underpinning a recommendation for acupuncture treatment is limited, but as you can see from the evidence button on the neuropathic pain sheet acupuncture has on several occasions been shown to be superior to the standard drug treatment, which suggests that it is worth trying. 


In a previous response on the same question we said:


If you look through these various responses, however, you will see much the same advice in each one. The evidence is encouraging but far from conclusive, although it would be fair to say that the gold standard of research in western medicine, the randomised double blind control trial is not the most appropriate tool for assessing traditional acupuncture. However, there are a number of treatment possibilities within the paradigm of Chinese medicine, to do with blockages or deficiencies in the flow of energy, or 'qi' as it is called, which a practitioner might be able to identify and correct. Your best bet here is to contact a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture may be of benefit.


We have to say, however, that trigeminal neuralgia or neuropathy does appear to be a rather intractable condition, and we are usually relatively cautious about the prognosis when we take on patients in whom this is their main complaint. You will note that in one or two replies we have suggested that cranial osteopathy may offer another treatment option. The pathway of the trigeminal nerve is easily compromised by some of the physical structures around the tempero-mandibular joint, and subtle manipulation may offer possibilities.


We think that this remains the best advice that we can give. We have no doubt that acupuncture treatment can deliver temporary pain relief, and the amount of research which has been done to investigate this aspect of acupuncture's effects has been very considerable. However, as with all forms of pain relief, it is relief, not removal altogether which is what the treatment delivers, and even when treatment works the extent of the relief it can give and its sustainability do not seem to us to be sufficient to warrant making a recommendation to try to use acupuncture as a long-term pain relief option.


If you did decide to visit a practitioner local to you, we would recommend that you are very clear about the review periods at which you can assess how successful the treatment has been, and also that you try to establish very clear outcome measures, i.e. changes which you can actually measure rather than simply soundings based on how you feel on the day. With conditions like this there are good days and bad days, or more accurately bad days and worse days, and it helps to try to bring a measure of objectivity where possible to the proceedings.


From our perspective it is always possible to achieve a certain amount of pain relief in almost any condition, whether this be because of the acupuncture treatment or as  our critics would have it some kind of placebo effect. The question is always how much pain relief and how sustainable this is. Clearly a treatment which works for twelve hours is not going to be very useful, although we have known cases where people have targeted treatment at times when they are going to need to be on top form for athletic events or important meetings. If the effects last longer but never quite increase in depth or duration then it may become a financial consideration, i.e. if someone can afford weekly treatment indefinitely because that is how long it lasts then having deep pockets is an advantage (although we have known members offer reductions for this kind of maintenance). Most of us, though, do not like to see someone remaining in pain for months, and we tend to look closely at other options if what we are doing isn't really taking off. Cranial osteopathy is one possibility, but practitioners will be aware of many other forms of treatment in their areas who might offer a useful solution.



If you want to trace a practitioner near you the simplest way is to use the postcode search facility on our home page 




We have been asked about knee problems many times over the years, but those relating to osteoarthritis of the knee focus on the pain, as in this response:

If there is serious osteooarthritic degeneration of the joint, probably the best that one could do with acupuncture treatment is to reduce some of the inflammation. With the underlying condition in severe deterioration unlikely to change, the only issue is how much relief the treatment can offer and how sustainable it may be. This may come down to a question of finances; if the cost of regular treatment is outweighed by the benefits it gives, then it may well be worth pursuing. The chances are, however, that only replacement surgery will make a great difference.

There was a huge trial in Germany some years ago, called the GERAC trial, which involved an assessment of hundreds of thousands of treatments.

The outcomes for osteoarthritis of the knee were particularly impressive, and it was a source of deep annoyance to our medical colleagues that acupuncture was not included in the NICE guidelines because the placebo control scored nearly as well as the real acupuncture. In their view, both were so much better than the conventional treatment that it would still make sense to use acupuncture even as a placebo, but that is not the way of modern healthcare policy.

The best advice that we can give is that you visit a BAcC member local to you and see what they make of the specific presentation you have. It may, for example, that there are lifestyle issues like work which keeps you on your feet all day which might adversely impact on treatment outcomes, or it may be that there are specific reasons for the pain like injury or accident which would have to be factored in to their assessment.

Such is the unique nature of each presentation of osteoarthritis of the knee it really is best to have someone have a look at the specific nature of the problem and the context in which it sits. Chinese medicine is premised on the treatment of the person, not the condition, and this is one of its great strengths. Treating symptoms alone can sometimes be successful but treatment of then person as a whole is more likely to keep the symptoms at bay. We are not alone in taking this view. The great Canadian physician William Osler often said 'The good physician treats the disease; the great physician treats the patient who has the disease.'

The only issue we had with the German trials was that they were largely formula treatments undertaken by doctors. This is all very well, but in Chinese medicine there is a concept vaguely akin to arthritis called 'Bi Syndrome'. This looks at arthritic conditions in terms of the more general changes in the energy of the body and how they reflect in particular joints, but what we have at our disposal here is a range of options for looking at joint problems in terms of how they present. Hence, stiffness and lack of mobility with discomfort but not actual pain would point in some very specific directions when seen in the context of the whole system. A mixture of local and systemic treatment may well be able to achieve some improvement. The only thing we aren't able to predict is the extent of the improvement and how well or easily it can be sustained.

The advice we gave in the previous answer, to visit a local BAcC member, holds good especially in your case. Someone taking a look at not simply the joint itself but the context in which the problems have developed (systemic issues, accidents or repeated use, etc) will be able to give you a very good idea of what may be possible.


There is certainly some good-ish evidence for the treatment of cervical spondylosis with acupuncture. As our factsheet shows


there are several good quality trials which suggest that acupuncture can reduce the neck pain with which it is associated. We have searched the databases for any further and more recent research, but while two studies are in development there is nothing else to report.



We always tread with caution when advising on the use of acupuncture, though. From a western medicine point of view this is a 'wear and tear' problem for the treatment of which the best that can be achieved is a reduction in the deterioration, getting worse slower, and some reduction in the pain caused by the inflammation. If the pain and discomfort is a recent phenomenon it suggest that the inflammation caused by the problem is not yet too severe, and that there may be some hope of significant reduction.



From a Chinese medicine perspective pain arises from blockage and stagnation in the flow of energy, and the use of needles is intended to restore normal flow and balance. Physical problems, changes in structure, can have an impact on the flows of energy, especially in the neck, and while acupuncture is never going to correct the changes in physical structure, it can often restore flow and remove pain.We see this quite often with lower back pain associated with crumbling of the lumbar spine, or shall we say attributed to the damage seen on X-ray. We have seen many cases where the X-ray remains unchanged but the pain has reduced.



As far as cost and frequency of treatment is concerned, that is almost impossible to say. In Greater London the cost of a first session is often in the £50-£70 range with follow up sessions perhaps £40-£60, where in the rest of the UK prices are likely to be £10 lower. There are a number of community based multi-bed clinics where treatment is offered in a group setting at much lower rates, and most members are prepared to discount treatment for those with financial issues. NHS treatment free at point of delivery has become a great deal more difficult to find, and it is a matter of luck whether you have a doctor near you who may be able to offer a number of sessions within GP practice.



Frequency of treatment is usually more predictable. Unless someone has acute pain treatment tends to be weekly, but with chronic conditions with an underlying physical change of structure you will find that most practitioners will review progress after four or five sessions to see what has happened. At this stage it is worth establishing clearly whether there has been a change and how sustainable any change has been. If the effect has been small and short-lived it may be worth exploring other treatment options.



The best advice is to contact a local BAcC member and see if they are happy to give up a little time without charge to have a face to face chat and look at the problem. Most do, and this will give you a very clear idea of what may be possible in your specific case. 



An interesting and unusual question! Battlefield acupuncture is  not really within the usual scope of traditional acupuncture, and derives mainly from the work of Richard Niemtzow and his colleagues in the last two decades. This 'expert' recalls seeing one of his first major presentations of the technique at a BAcC conference in the early 2000s, and there was no mention of any specific cautions over and above the safe and hygienic methods we all use anyway when inserting needles.

The best steer we can find is from advice given to people who have had body piercings. These are much larger and if there was a risk then this would be massively amplified by a more substantial piece of metal. The only real caution we could find was that it would be better to avoid using a sunbed in the first two or three weeks after a piercing has been inserted in order not to aggravate the wound. We strongly suspect that this would be the best advice we could offer.

Of course, the person who will be best equipped to field this question will be the practitioner who inserted the needles. On the assumption that they have trained in the technique rather than self-taught by the use of books and videos, it is highly likely that they will have been alerted to possible risks like this. However, we have also searched the adverse events databases and haven't found any reports to suggest that there is a risk from using a sunbed after acupuncture. 




There is very little risk associated with the treatment of low back pain in pregnancy. In this journal article from Acupuncture in Medicine

the house journal of the British Medical Acupuncture Society, the author makes it quite clear that low back pain in pregnancy is one of the more frequent problems addressed by acupuncture in pregnancy, alongside morning sickness and migraine. He also spells out the key risk factors, namely using some of a series of 'forbidden' points, especially during the first trimester. No properly qualified practitioner would ever use these points anyway, but it has to be said that there are very few western practitioners who needle points as vigorously as the Chinese for whom these proscriptions applied.

The treatment of back pain generally is one of the better proven uses of acupuncture (by the rather inappropriate research measures which are in the ascendant in the west). Research into the use of acupuncture for back pain in pregnancy is limited, but that which exists is largely positive. 

Although we have not yet finalised our work on specialist practice, we are looking at recognising postgraduate qualifications in obstetric acupuncture. If you are looking for a practitioner it may well be using a google search under acupuncture and pregnancy alongside your home area to identify someone who has had specialist training. There are some advantages from visiting someone who spends more time than the average practitioner treating pregnant women. We are all generalists, but there are times when a more in depth knowledge of a field of expertise is valuable.

Trigger point therapy itself is a slightly more western approach to acupuncture with slightly different diagnostic principles. In practice the needles tend to get inserted in the same place but for different reasons, but if trigger point needling is what you specifically want then you may have to check out the registers of the medical acupuncturists (BMAS and AACP) who use this technique as a stock intervention. However, we are confident that the use of traditional acupuncture would prove equally as effective, and potentially more so insofar as it looks at the performance of the whole system, not simply the presenting symptom. 


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