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350 questions

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.

Q: I’ve had two acupuncture sessions recently, my first ever. I’ve found that the needles put in my toes are really painful and just wondered if this could be indicative of anything? I should add I’m 9 months pregnant. 

A: At the risk of sounding facetious we would be quite surprised if needles in the toes didn't hurt. While the vast majority of points on the body (there are 365 main ones and dozens of recognised 'extra' points) do not cause much sensation when they are used, the ones near the toenails and at the base of the toe can fee disproportionately painful when they are needled. We say 'painful' but in many cases it isn't quite pain so much as a very intense feeling which seems altogether too much for what is a small needle.

 Part of the explanation for this comes from the way that the energy of the body circulates. The anatomical position is very similar to that famous Da Vinci cartoon of the man with his arms and legs outstretched. When energy travels to the ends of the arms and legs and returns it has a kind of slingshot effect as it recoils, which means that points on the extremities have a great deal of kinetic potential. When they are needled it is like a surge of energy. What people often describe as a dull ache or mild tingling for most points can feel like a very large nail sending a shockwave along the limb. Fortunately it is usually very shortlived, and most people acknowledge that the short measure of discomfort is more than offset by the benefits of treatment.

However, if it really more than you can take at this stage of your pregnancy then your practitioner should be able to use other less painful points to achieve much the same effect, or use the tried and trusted ways of making treatment more benign - fewer needles, shallower insertion, less manipulation.

Hope all goes well with the birth!

Q:  I’m an Australian and British citizen completing a Bhsc degree of Acupuncture in Australia next month. What are the possibilities of working and registering as an acupuncturist in the UK?

A: There is very little  restriction on working as an acupuncturist in the UK. There is no statutory regulation, and the only laws which govern what we do are the skin piercing regulations under which we have to be registered and which are mainly concerned with hygiene and safety. In mist of the UK this is administered by local rather than central government under Local Government Miscellaneous Provisions Act 1982, and involves a one-off registration payment for every practice in which you work. In Greater London there is annual licensing under the London Local Authorities

Act 1991, but membership of some professional bodies (we are one such) makes members exempt from licensing. In Scotland the Skin Piercing regulations of 2006 mean that all practitioners who are not statutorily regulated healthcare practitioners have to be annually licensed.

Costs vary. One off registration can be between £200 and £400, and annual licensing rather similar. Some authorities have begun to examine qualifications to assess whether someone is fit and proper to practice but the majority don't. An Australian qualification would more than meet the criteria. As long as you have the appropriate visas and work permits that would be that. Professional insurance is essential, and the main broker for individual practitioners currently charges just over £100 per annum for a rather good policy on a 'claims occurring' basis.

Obviously joining a professional body makes life a great deal easier, and while we regard the BAcC as the creme de la creme there are other associations, most of whom would be satisfied by an Australian qualification. Unfortunately at this point we do not have reciprocal recognition of qualifications in the BAcC, so someone from outside the UK has to follow the external applicant rout outlined here

https://www.acupuncture.org.uk/public-content/join-the-bacc/3915-join-the-bacc.html

but eventually we hope to move forward with reciprocity to make transitions easier.

Q:  I am in my final year ( third year) student at Meiji University center for Acupuncture and Physiotherapy in Kyoto, Japan. What should I do exactly to gain membership at the British Acupuncture council?

A: This is somewhat tricky. If you meant coming to work in the UK , then it would simply be a matter of applying to us by following the process outlined on this page of our website

 https://www.acupuncture.org.uk/public-content/join-the-bacc/3915-join-the-bacc.html

 As long as there were no issues about work permits and visas the process is straightforward and takes three to four months from start to finish.

However, if you meant becoming an Overseas member that would be more of a challenge to our systems. Many years ago we amended our constitution to restrict Overseas membership to only those people who had been Full members already or who had graduated from a recognised accredited college in the UK. We had become aware that some Overseas members were using the status inappropriately and implying that we had more jurisdiction over their work than was possible at distance, and could provide assurances about people's standards and insurance. We do not have the resources to do this, so we chose to restrict membership to those whose standards we are more confident about.

 However, there are always exceptions to every rule, and in some cases it might be possible to make an application. We don't think that it is very likely to be accepted, given the rules for Overseas Membership are so precise, but things change, and if you lodge an interest there may be a chance that in future a category of membership will arise and enable you to join.

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