Latest posts are at the bottom of this page.
Use the filter buttons above to help find answers - click on the boxes

Ask an expert - about acupuncture

340 questions

The short answer is 'no'. Traditional Chinese acupuncture has always been a generalist practice, and in that sense every practitioner should in theory be able to treat every person who comes to see them. The reason lies in the fact that each person's energy is unique and different, so somewhat confusingly to the western mind twenty people with the same named western condition might be treated in twenty different ways. Symptoms remain symptoms in all systems of medicine, but the paradigm of Chinese medicine weaves them into a great many more patterns for which other diagnostic signs like the pulse and tongue are the ultimate arbiters of choice. That is not to say it is an exclusively eastern preserve; the great Canadian physician William Osler used to say 'The good physician treats the disease; the great physician treats the patient who has the disease'.

This is particularly important in treating something like PTSD. Not only are there many different ways in which the condition can be expressed by the body, but also the precipitating cause can have an impact on the emotions and deeper aspects of the personality. From a Chinese medicine perspective the body mind and spirit are an indivisible whole, so it is able to make sense of the more subtle impacts of trauma and see the patterns which manifest on all levels.

That said, it can often be good to talk to someone who has experience of working with other patients with similar problems, and although we are in the process of formally recognising only paediatrics and obstetrics we are also aware that complex mental issues can potentially form another area of specialism. So while we would unhesitatingly recommend all of our members to be able to offer you help we suspect there may be one or two in your area who are the 'go to' practitioners for more complex problems, and these will be well known to any local member you call.

Our advice would be to contact one or two BAcC members local to you and see if they are prepared to offer you a few minutes face to face without charge to discuss whether and how they might be able to help you. This is far better than just booking in sight unseen, and will give you a sense of whether the practitioner is someone you can do business with. This may not be the most experienced or skilled, but can often be someone  with whom a prospective patient feels a level of empathy, which can be very helpful in the healing process.

What you report is a little unusual but not unknown. We have come across patients who have been treated for several sessions and only then shown a reaction to needles. Sometimes there is an obvious cause - change of needles, slightly deeper insertion in muscular areas - but most often it is an unpredictable reaction. The only concern would be if the blister/bite like bumps were a potential source of infection if they became open, or if they increased in severity. At this point a practitioner might just refer on to a GP for an onward referral to a dermatologist. In the vast majority of cases, however, this tends to be a short-lived phenomenon.

The other issue to consider is whether the reaction is not a physical one but a sign of some kind of energetic release. It is very much a part of Chinese medicine theory that some of the physical problems which affect the body are the result of pathogens entering the body or pathogens which have built up in the superficial tissues because of blockage or excess. When treatment 'bites' this can sometimes cause the skin and superficial tissue to become quite reactive, as well as in some cases generating rashes and areas of heat. If this is a treatment reaction it will be short-lived; the majority of what we call adverse events are transient and minor.

The best thing to do is to ask your practitioner if there has been any change of equipment or style from the first to the second session, and if so revert to the former. If not, then it is simply a matter of keeping an eye on the small bumps to ensure that they recede as swiftly as they came. We have come across patients in whom this is a benign and continuing reaction to treatment, and as long as it is managed with common sense there won't be a problem.

We are assuming that you are asking your question from the United States. If you aren't and we have misunderstood, our apologies.

As a UK-centred organisation we are probably not the best placed people to offer comment on this question. As far as we understand it the Medicare system seems to run along similar lines to some of the major private insurance programmes in the UK with a flavour of National Health Service provision, which is practically none.

The problem with acupuncture and other CAM provision is that it lacks the evidence base which is now a requirement for provision in the NHS and with leading private health insurers (PHIs). When allocating funding a provider needs to have some assurance that the modality will work, and an equal assurance that there is a finite limit to what it will cost. Since most research into acupuncture is not accepted (complex methodological issues and funding difficulties abound) and most treatment is offered on an open-ended basis, this is not beloved by the actuaries who have to cost out provision.

We note that that you can get acupuncture if you pay for a higher level of service, and this mirrors some of the PHIs in the UK who offer money purchase packages alongside their main policies which offer additional benefits at a price. This was led, we believe, by patient demand and an awareness that keeping this group of users happy protected the mainstream PHI provision. However, it would be fair to say that as CAM has become more popular so some sectors within conventional medicine have seen it as a subversive threat, and the opposition to its inclusion within mainstream provision has greatly increased, certainly in the UK.

As an organisation we have been making representations to both NHS and PHIs throughout our whole existence to argue for the inclusion of acupuncture free at point of delivery within their offer. Some doctors and physios offer acupuncture within their existing scope of practice, and some PHIs will now pay for limited amounts of treatment. When patients ask for advice along the lines which you have done the best we can say is that you contact the local or national policy makers and try to make a case for your own needs. If you try to argue the national case you will not succeed unless you can get  a huge popular following, but you may be able to make a case for your own personal treatment if:

a) you can show that their is an evidence base for the condition with which you need help

b) you are able to make a case that a course of treatment is likely to cost less than any continuing care by conventional means. When you take into account the cost of doctor/hospital admissions and pharmaceutical products this is not a difficult case to make, especially if you have any low-cost community clinics in your area offering discounted treatment.

The best advice we can offer, though, is to talk to local acupuncture associations to see what they can advise. We are certain that they will have tried to address this issue, and will certainly have contacts whom you can follow up.

We wish you the best of luck!

There is no reason not to have acupuncture every week if it achieves the objective you want, in your case pain relief. We are often asked about treatment for pain, and we usually say that it becomes, somewhat sadly, a matter of how deep someone's pockets are.

From a traditional acupuncture perspective it is not entirely satisfactory to be treating someone every week. Our understanding of the nature of pain is that it arises because of blockages in the energy of the body, or excess and deficient energy in specific area or channels. We always hope that our work will reinstate correct flow, and that the pain will begin to subside such that we can increase the intervals between treatments. However, there are occasions when changes to the physical structure of the body, like arthritic change, are not reversible and will keep on generating inflammation in the same places. In these circumstances we might well consider treating weekly for as long as it takes.When this happens most practitioners tend to come to some sort of arrangement with patients to ensure that the treatment doesn't become a financial burden, but this is a matter for individual negotiation. People have different ideas of financial deprivation, and it call for honest and sensitive discussion. Many practitioners are now involved in the establishment of multi-bed clinics which provide treatment in a group setting at a reduced cost, and there may well be something in your area which offers treatment at significantly lower rates than in private practice.NHS provision, though, is seriously limited, and we have found that a six-session course is about the maximum that anyone is likely to be offered. It might be possible to make a financial case for acupuncture treatment if the alternative is expensive medication and greater costs to the health system as a whole, but there is a principle of equity at play and most Pain Clinics have long waiting lists of patients desperate to get a crack at pain relief through acupuncture, and we suspect that most take the view that if it works then people know that there is an alternative to medication that they can pursue themselves.This is not ideal, and we would be the first to argue for acupuncture to be free at point of delivery and on demand within the NHS, but that day is a long way off while basic services remain under-funded. We do our best to demonstrate that acupuncture treatment is cost effective, and some of our colleagues in York have undertaken research studies which clearly show that acupuncture treatment saves money in the long run, but this hasn't really impacted on policy makers yet.In the meantime we suspect that the best we can advise is that you contact local practitioners and see if anyone is prepared to come to an arrangement which offers the same level of relief at a cost which is not too burdensome.
This is a very good question, not least because it does allow for the possibility that the pain in the leg is purely coincidental. We often have to point out to enquirers that with over 4 million  treatments in the UK alone there are going to be occasions when the fact that something happened after a treatment may not mean it happened because of it.

There is a received wisdom in the profession that when we treat successfully symptoms tend to travel outwards, from the trunk to the limbs to the extremities. Indeed, with skin conditions this is almost predictable. The language of Chinese medicine talks about 'invasions' from the exterior to the interior, so when the pattern is reversed it is not surprising that there is a pattern of the pathogens moving to the end of the channels at the fingertips and toes.However, with lower back problems where the discs are worn this can sometimes arise where the treatment brings about a change in the structure of the back through re-educating the muscles, and in turn causes an impingement of the sciatic nerve. This is always a difficult call. The physiotherapists, who undertake as much lower back work as we do, tend to recommend to their practitioners to tread cautiously with lower backs. The body may be sustained in a rather angular fashion by muscles operating at a level of tension which would not be regarded as normal, and when these muscles relax, as they can do with acupuncture treatment, this can allow the spine to settle into a more normal position and cause nerve impingement which the abnormal position prevented.A great depends on whether the original pain persists, and whether the more acute pain in the leg has remained at the same level of intensity since it was caused. If the pain remains  identical and is intractable to treatment then it may be wise to consider postponing further treatment for a while, and looking at more gently options like cranial osteopathy which may be able to help. If the pain is still quite constant but its level is reducing then it may well be worth continuing.The best person with whom to have this conversation is the practitioner. This is very much a judgement call based on a view of the whole energy pattern of the body, and since each individual is unique it is really down to what the practitioner can see in the round. We are confident that the advice you get from them will be practical, sensible and have your wife's best interests in mind.
Page 1 of 68

Post a question

If you have any questions about acupuncture, browse our archive or ask an expert.

Ask an expert

BAcC Factsheets

Research based factsheets have been prepared for over 60 conditions especially for this website

Browse the facts