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Ask an expert - about acupuncture

324 questions

We are not quite sure from your question whether you are not paying for your treatment because it is being paid for by a health insurance company or whether it is being provided free at point of delivery within an NHS Pain Management Unit or perhaps delivered by an NHS physiotherapist. However, we are pretty sure that you would know if you were covered by private insurance so you must be one of the fortunate ones who has managed to find treatment inside the NHS. This is not as common as it was, say, a decade ago, although more prevalent in Pain Management facilities.

Generally speaking, we have always heard that people referred to Pain Clinics are offered a fixed number of sessions in order to ensure that everyone can have access to the service. The NHS Choices website says that up to ten sessions of acupuncture may be available in a course of treatment, but this can vary greatly with supply and demand. Your doctor, through whom you presumably were referred, can both let you know and make a case for you if you feel that the sessions are of benefit and need to be carried on.

While NHS provision is the only treatment free at point of delivery you will find that many acupuncture practitioners are prepared to discount treatment fees if someone is in need of help but not able to pay the standard fee. There has to be an element of professional judgement in this; not everyone shares the same sense of poverty. This 'expert' was asked for reduced fees through poverty by a patient who revealed during the session that his brand new BMW had broken down but it was under warranty so he was happy.

There are also a growing number of community acupuncture clinics which offer treatment in a group setting for a lower fee, partly to ensure that all income groups can have access to treatment. A national listing of clinics in this scheme can be found here This might provide another option if your NHS funding ceases.

We hope that you manage to get your MRI within the limit of treatments you've been offered, but if that doesn't work we hope that we've given you other useful options.



Q: I have been for 3 acupuncture session over the last week. I am going for various reasons, CFS/ME, anxiety and the flu amongst some other moans and groans. After the first session I was pretty ill with indigestion and nausea and aching. Nothing much after the second session but a headache. After the third session however I am feeling very strange, I feel almost out of it for lack of a better description. I cant seem to get myself to focus at work no matter what I do and had a panick attack which I don't usually suffer from. I am spaced and feel removed. I am also a bit nauseous. Is this normal and has anyone else described this. When will it pass? I need to work and I am getting anxious. Is it a good sign.

A: It's always very difficult for us to comment when we do not have a full case history in front of us, and better still, an actual patient. We are always aware that if we take issue with what someone has done without knowing the full picture we might make an unfair criticism for which we might be held to account.

What we do wonder, though, is whether it is entirely wise to do as much treatment in a week to someone with a background of MS/CFS who has reacted very strongly to the initial session. In people whose immune systems have been weakened by long term illness it is always wisest to start slowly with the strength of treatment and to row back if they throw quite severe reactions. This is not a universal rule, but it is impossible to tell after a single session whether the effects are a clearing of imbalances or an adverse reaction to treatment.

We suppose that since the second treatment didn't really cause anything over-dramatic the practitioner decided that it was the former, a mild-ish reaction which could indicate the beginning of the process of healing, and treated again. In the event, the further reactions after the third session might call for a review of that judgement.

It is highly likely that if you have been slightly overtreated the effects will not last that long. Acupuncture is a remarkably safe therapy, and the only serious incidents involve the penetration of organs with needles, and these occasions are very rare. If someone has a strong reaction to treatment then it normally lasts no more than 48 hours at most, and usually less. We suspect that by the time you receive this you will already be feeling a great deal more 'normal'.

It may, of course, be that the problems are not at all connected to the treatment; CFS issues can often come up at any time. However, it does look like the treatment is implicated, so it is really important that you discuss this with your practitioner in determining how to proceed. This might mean less frequent or less powerful treatment, and we are sure that a properly trained and qualified practitioner will listen to your concerns and respond accordingly.

We did say, though, that without looking at you and the case history we could not say for sure whether the practitioner was in any way at fault, and it may well be that he or she is surprised by this outcome and well able to respond positively to the feedback you are providing. Treatment is sometimes like a voyage of discovery where a practitioner can only find out what the best strategy is by setting off as normal and then reacting if the signs are that the treatment is too much for the patient. The practitioner may well have made a judgement that you needed frequent treatment based on your case notes, but your reactions might suggest that this is not the best way forward.

Q: What are the principles and practices of acupuncture?

A: We like a challenge but this is a little steep even for us. Not that we can't answer your question, but because the answer would run to several thousand words, which is a little beyond our remit.

Our website,, has a number of sections under the 'about us' and 'traditional acupuncture' buttons which provide a very brief and rudimentary explanation of what we do. For something more comprehensive, though, you would probably need to get hold of a book which explains in greater detail how the systems we use where and how they originated. The 'go to' text when we all trained in the latter part of the last century was Ted Kaptchuk's book 'The Web that has no Weaver' but since that time there have been a few more books by senior practitioners like John and Angela Hicks, or Peter Mole, which give thorough explanations of what we do and why we do it.

The challenge for any author in the West is how to present a 2500 year tradition in a comprehensible way when the very culture in which the original theories was embedded is vastly different from the western culture in which we live. Chinese language is able to express subtle shades between black and white in a way our language cannot, and the kind of internal logic of the language and concepts of yin and yang are embedded in the way that people actually think. Getting this across in a language and structure of thought which is very different can be a problem.

Not only this, whereas western medicine can be viewed as an expanding ball developing from a commonly agreed centre, Chinese medicine is inherently pluralistic. This arises in part from the fact that until the mid-1950s it was very much an apprentice trained tradition. There are many textbooks which have been handed on for thousands of years, but the basic principles have been applied in a myriad ways, some of which can actually be contradictory but nonetheless part of a practitioner's basic skill set. You can imagine the challenge that this represents even to learn the various systems, let alone try to explain the whole field thoroughly to an interested party.

If you are trying to get hold of a much briefer introduction there is a small pocket book which cnan be found here

We used to sell copies of this from the office to members who wanted something small to lend or sell to prospective patients. While it could do with a minor update it still offers a very simple but useful overview of what we do.

We are sorry that we can't go into much greater depth here, but the resources available online and in books are now so good that it wouldn't make sense to give a partial and over-short explanation here. We hope that you enjoy finding out about what we do.

Q: Doed obtaining the Chiway swiss Diploma in Acupuncture and Tuina entitle one to be registered in the Uk as a licensed acupuncturist?

A: The first and most important thing to say is that in the absence of statutory regulation in the UK there is no single registration process for someone to become a licensed acupuncturist. Under what is termed common law, anyone can set up practice without any restriction. The only legal requirements are those which involve registration with local authorities under a number of different byelaws which regulate skin piercing activities. These mainly concern the standards of hygiene and waste disposal in a practice, but in recent years there has been an increase in interest in the standards of training which people who are trying to register have. We have heard stories of people with very short training courses behind them, perhaps a two weekend course, being refused registration. However, the majority of courses of this nature are provided for medical health professionals like doctors and physios who are usually exempt from registration anyway, so in practice there are very few people trying to become licensed as traditional acupuncturists on the basis of rudimentary training.

The majority of UK practitioners belong to one of a number of different acupuncture associations, membership of some of them giving people exemption from licensing in the Greater London area. Most have clearly identified and published entry standards, and it would really be a matter of whether your training from Switzerland met the minimum criteria for membership. None of the associations of which we are aware has any reciprocal recognition of qualifications, so we suspect that you would have to make an individual application and be interviewed about the extent of your training. We have looked at the website of the school which provided your training, and on the surface it looks fairly comprehensive, but we have seen similar programmes for course which lasted a couple of weeks, so without a course transcript detailing hours of training it would be difficult to say how easy it would be to register in the UK.

Our own standards and entry process are to be found here:

where our Admissions process is described, and a broader outline of training standards can be found on the website of our sister organisation, the British Acupuncture Accreditation Board here:

The documentation here outlines the degree level training which accredited courses have and which lead to automatic eligibility to join the BAcC. All other applicants are interviewed and assessed individually.

Q: I am considering a career change to acupuncture but am suffering with mild osteoarthritis in both my hands. I wonder if this will affect my ability to practise, or is most of the work of a fairly gentle nature? I know this is hard to answer, but I am trying to assess whether this is a sensible career path for me. I am 48 years old.

A: There is no doubt that acupuncture is a gentle therapy, and it would be most unlikely for you to have to anything which involved great pressure or strength. The majority of needles are inserted with the help of guide tubes, which require only the strength necessary to tap the needle in, and there is not a great deal beyond this which would be a must. Some teaching institutions have training sessions in tui na, a form of Chinese massage, which you may find a little problematic, but this is not something which is a must for successful practice.

The only challenge which you might face is fine manipulation and control of the needle if the condition becomes more serious. This would have to be a very significant deterioration, because we had a colleague with rheumatoid arthritis whose hands were terribly deformed and painful who still comfortably managed a successful and busy practice. However, it is something worth exploring because there is a level of dexterity which you will need.

The best way to get advice would be to contact the nearest teaching institution or, better still, visit ones which have Open Days for people to drop in and discuss the possibility of training. We have a sister body, the British Acupuncture Accreditation Board,. which accredits courses offering automatic eligibility for membership of the BAcC on graduation, and a full list of the accredited courses can be found here: The website also contains a wealth of information about studying acupuncture and the benefits of acupuncture as a career.

The only caveat to bear in mind is that teaching bodies are often obliged to take on students without necessarily having to take into account their ability to practise or to register as professionals afterwards, i.e. someone can insist on being trained and a college can't turn them away. So, being pronounced fit for study may not be the same as being fit to practise. We are as sure as we can be that no-one would be unscrupulous enough to take you on if they felt that you really would struggle to carry on in the career, but we are aware that this is the legal extent of their responsibility.

Anyway, we hope that you get good news about this and decide to take the plunge. This particular expert is thirty years in and still enjoying every moment of it, and still learning!

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