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Ask an expert - about acupuncture

353 questions

 A: This is a very difficult question to answer. Although twenty people might present with exactly the same symptoms in traditional acupuncture the emphasis is on the unique nature of the balance of someone's energies, and that might mean twenty different treatments. If someone is in great shape and there is a mechanical reason why the sciatica has developed, such as an injury, then it would be a great deal easier to shift than a sciatica which was set against a backdrop of general poor health.

 The old received wisdom used to be that a condition took as many months to treat as the years that it had been a problem, but we have never found this to be the vase with sciatica. The crucial issue is that the practitioner draws a line in the sand if nothing is changing and stops treating. If after, say, five or six treatments there has been no improvement, even for a short time, then it might be worth looking at other options like osteopathy or chiropractic or other form of manipulation. While traditional acupuncture can and does sort our structural problems there are times when it is easier to go to a manipulative therapy first and then use acupuncture to consolidate the gains.

The best way to proceed is always to seek the advice of a practitioner based on a face to face consultation. This can give you a much clearer idea than we can at a distance.

 

Q: Can I have acupuncture treatments two days in a row? Is it harmful in any way? I am in a time crunch before vacation so hoping it’s ok!

A: There is no safety reason to stop you having treatment on consecutive days. Indeed, in China it is not unusual for someone to have a course of treatment daily for up to two weeks.

However, this is usually reserved for acute conditions of chronic conditions which are proving stubborn to shift. For most of the regular constitutional work it wouldn't be necessary, and might even be a waste of money. One of our old teachers used to say that if you were clearing mud from the bottom of a garden pond you would stir the water up and wouldn't be able to see how effective you had been until a couple of days later when the remaining mud sank. He always believed that it was impossible to judge whether what you had done was the best possible treatment until you had given the body time to react.

Our advice, then, would depend on the kind of condition which took you to acupuncture treatment. If it is a long term hard to shift problem or a short term acute one then consecutive treatments might be advisable. If it is a more subtle problem there is probably nothing to be gained by having more treatments. Your practitioner is best placed to advise you. They will be able to make a professional judgement about what is best for your unique circumstances.

Q:I have had three session and I think things are improving but I cannot bare the needle at the colon 4 point. The depth of the ache when it goes in is dreadful and my anxiety levels increase. The practitioner says he has never known someone with such sensitivity. I suffer with a degree of anxiety and depression, maybe this has something to do with it. Should I continue with the acupuncture?

A:  If you feel that things are improving they probably are. A wise practitioner once said to us that in order for change to be noticeable it has to be quite considerable, so this sounds encouraging. The important point to stress is that in the treatment room you have a greater degree of control than perhaps you realise. Treatment can only happen with your consent, and if you don't like a particular point, then you can simply ask the practitioner not to use it. This expert used to tell his practitioner not to needle a point on the base of the foot.

The wonderful thing about traditional acupuncture is that we are treating the person, not simply the problem, so there are no exact prescriptions for treating specific conditions. The fact that we are treating the whole system means that we are able to address systemic problems in several ways. Sometimes we have no choice. If someone has had cancerous lymph nodes removed we aren't allowed to needle the limb below the affected area, so that means we have to be creative in how we work, and one of our colleagues, Beverley de Valois, has undertaken some fascinating research to show that you can achieve just as good results from elsewhere on the body.

Even when it comes to using the same points, it is possible to make life a great deal easier for the patient. A point can be needled to less depth, manipulated less vigorously or even needled with a finer needle, all of which can greatly reduce the impact. The dull aching feeling, called 'deqi' in traditional acupuncture, is believed to be a requisite in mainstream Chinese styles but completely avoided in many Japanese styles. A practitioner usually has the versatility to suit the needs of the patient.

The best advice we can give is that you discuss this with your practitioner and ask them what they can do to take away the anxiety you are feeling. Our advice if they say that they can't is to decide whether the short term nature of the discomfort is offset by the gains. If the discomfort is going to stop you having a treatment that works, then you'd be better off finding someone who worked in a way you could get on with. We strongly suspect, though, that your current practitioner will find a way around the problem.

Q:  I had an acupuncture session to help with my lower back pain and when the needles were inserted into my lower back my bum area I had a spasm in my leg. I also had pain in the other side where the other needle was all the rest seems to be fine. When I spoke to the practitioner he said this was normal as he had use larger Needles. It has now been over two weeks and I’m still suffering from pain at the side of the needle insertion and also from shooting pains and pins and needles especially in the side where the spasm occurred. Please help me is this normal as I have used acupuncture as treatment for my ME and migratory arthritis previously and have never experienced this.

 

A: We would hesitate to use the word 'normal' for anything which a patient might experience which is unpleasant, but adverse effects can happen after treatment. The vast majority are transient and have disappeared within 24 - 48 hours, but some can linger a little longer.

 This can particularly be the case when someone is using a slightly heavier gauge needle and inserting the needles quite deeply. The two go hand in hand; although it is possible to insert a fine needle to a considerable depth it is much more usual to use a slightly thicker needle to ensure that the tip is not diverted and twisted out of true. This does mean, unfortunately, that this can sometimes cause small bruises deep within the tissue but not necessarily visible at the skin surface. If these bruises are near to the passage of nerves there can be some impingement. This can generate sharp pains or even pins and needles. Such bruising can take a couple of weeks to disperse during which time there may be intermittent odd symptoms.

If this does persist, however, then it would be wise to make an appointment to see your GP just to ensure that everything is OK. The chances of something serious having happened are quite remote; acupuncture remains one of the safest modalities in use. It may be worth eliminating other possibilities, though, and a visit to the GP will undoubtedly provide reassurance that this is nothing more than a transient adverse event.

 We are sorry to hear that this has happened, and hope that it has not discouraged you from further treatment. We are confident that your practitioner will be able to ensure by using lighter gauge needles, shallower insertions and less manipulation that there is no recurrence of such unpleasant symptoms.

Q:  I've read the BAC fact sheet about Moxibustion.
I have a couple of questions regarding Moxibustion to treat a slight muscular ache in R/H shoulder of a male px, 70kgs, 54yrs old.
What is this specic training a practionerer must have undertaken to be considered compent under BAC guidelines and how does a patient verify qulifications?
How many points would be a recomended treatment for Direct Non Scaring Moxibustion?
Could there be any side effects or damage to muscle or nerves (ie: neck or spine) surronding shoulder if too many points are treated in 1 session?
If patient complains of strong pain deep in shoulder joint half way through treatment should the practioneer stop?
A:  All members of the BAcC will have undertaken training in the use of moxa as a part of their undergraduate training. The most accessible assembly of documents can be found on the website of the British Acupuncture Accreditation Board

https://baab.co.uk/downloads/key-accreditation-documents.html

notably the SETA and SPAS documents which outline the basis of what an accredited college must provide students who graduate with automatic eligibility to join the BAcC subject to health and criminal record checks. These spell out what student must learn, although the precise method if training will vary from institution to institution. All students usually practise on each other when training, and tend to be the harshest of judges. No-one whose competence was in question would be allowed to proceed to graduation. A patient can verify qualifications by contacting the BAcC who can say where and when a practitioner trained. If necessary, the patient could then contact the teaching institution directly.

There is no recommended number of points. The usual deciding factor is the patient's tolerance of the treatment and the amount of heat being generated. Most practitioners would err on the side of caution to avoid burning a patient. There are no accounts or records of which we are aware on secondary damage to muscles and tendons as a consequence of moxibustion. The only adverse effects of which we are aware are burns. By its very nature moxibustion will always cause a small number of burns each year, and the practitioner's main challenge is to reduce the risk as much as possible. We do not believe it would be possible to completely eradicate all risk. We have never seen case reports suggesting that moxibustion has caused the problems you mention, and as you can imagine we do monitor all reports of adverse events across the world very carefully. 

If someone complains of a pain arising during a session it would be a matter of professional judgement whether the treatment was stopped then and there. By their nature some treatments can cause pain to increase slightly, and there are occasions when the effect of treatment on the body's energies can cause a dull aching sensation, called 'deqi', to arise. This is very much sought after in Chinese styles of treatment, although Japanese styles tend to be more conservative. A practitioner might judge that this was evidence that treatment was working. Of course, it someone directly asks the practitioner to stop, then stop they must. To carry on in the face of requests not to continue might be construed as assault, and would certainly indicate a withdrawal of consent without which treatment cannot take place.

If you are dissatisfied with the standards of treatment which you have received, this page from our website

https://baab.co.uk/downloads/key-accreditation-documents.html

details how you may go about making this known and seeking a more formal account of what has happened to you.

We hope, however, that any side effects which have arisen through treatment are transient and have already started to resolve while this reply has been in transit.

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