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Ask an expert - about acupuncture

329 questions

We're not quite sure whether you are asking about having sessions of acupuncture with your GP or whether you are considering asking your GP whether it is OK to have acupuncture.

If it is the former, then we suspect you may not get very far. There are quite a few doctors who now incorporate acupuncture within their day to day practice, but generally speaking they are normally only allowed to do so when there is an evidence base for the condition which they are trying to treat. For a variety of complex reasons most of the research into acupuncture doesn't pass muster with the UK regulatory agencies, and chronic lower back pain is one of the few that does. Unfortunately NICE, which used to recommend ten sessions of acupuncture for chronic lower back pain, has recently reversed its ruling, so it is now unlikely that your GP will take advantage of this to refer you on or to treat you themselves.

There is nothing to stop you asking your GP if he or she is happy to give you acupuncture treatment, and most GP practices have at least one partner who uses acupuncture regularly. In terms of getting treatment free at point of delivery, this is perhaps your one and only option.

In terms of safety with the problems which you have, there is nothing in the literature to suggest that any of your health issues might make acupuncture a bad idea. We have experience of treating people with all of these problems. We are always careful with epileptic patients, but that is mainly because many want to get off their medications and we would never make that recommendation, however successful treatment may appear to be. When a condition is well controlled even GPs are reluctant to interfere with the treatment plan. As far as mental health issues are concerned we advise members to be aware of their limitations. Although we take detailed case histories and explore many problems with patients there are some areas where a practitioner needs specific skills in addition to acupuncture training to be able to understand the kinds of problems with which they are dealing. We regard mental health issues as one such area, and we are in the process of exploring standards for expert practice which would define what additional training a practitioner should have.

As far as the back problems are concerned, we feel confident that acupuncture treatment may well be able to help, but you may find it worthwhile to discuss your complex health background with a local practitioner before committing to treatment. Most acupuncturists are happy to give up a little time without charge to discuss with prospective patients whether acupuncture is the best option for them.

 


Unfortunately by its very nature traditional acupuncture, if undertaken according to classical principles, is a generalist practice. Indeed, in ancient times the specialists were somewhat disparaged for being limited in  their scope of practice, and the generalists were regarded as the supreme physicians. This very much fits with the idea that each individual is unique and different, and the true skill of the practitioner lies in looking at why these specific symptoms arose in this particular patient. This explains why twenty people with the same named condition might be treated in twenty different ways.



That said, we understand from the rather unusual nature of the problem you have that you might prefer to see someone who had seen this kind of problem before. This might prove tricky because the only two areas where we have advanced towards recognising degrees of specialism are obstetrics and paediatrics. There aren't really that many practitioners who are working in environments where the bulk of their patient work would be in the neuro/psychological sector. 



The one thing you do have going for you in York is a long-established college, the Northern College of Acupuncture. While the clinical work there will mainly be undertaken by students the faculty contains some of the most experienced acupuncture practitioners in the country, especially its principals. You could do a great deal worse than seeking a view from them about whether there is someone amongst them who has seen or worked with something similar. We tend to find that groups of practitioners very often know better than we could hope to track who specialises in areas of work or has spoken of such treatments.



We would be bound to say, however, that if you have seen someone in the past whose services have been very good, you would probably find that these would still be the best choice, especially if you have already had experience of their work and found them good.



 

With a problem like nerve pain there might just be an outside chance that you might qualify for some sessions at your local NHS Pain Clinic.

The provision of acupuncture within the NHS and free at point of delivery is not that good. Very few of our members now have contracts to provide a service with the current pressure on funding, and while a number of doctors may choose to offer some treatment, the majority of treatment available comes from physios who tend to use it within their scope of practice. The catch is that i someone chooses to offer treatment they have to have a good evidence base and the treatment has to fall within their scope of practice. In both cases this might lessen your chance of finding treatment locally with either a physio or doctor. You could, though, ask your GP for a referral in case he or she does know someone who could help.

Most areas have pain clinics, though, and these very often use acupuncture for chronic pain management. There is a relatively solid evidence base for acupuncture as a tool for pain relief, and if you can get a referral this might be one of the options you are offered. However, there does tend to be a limit to the number of sessions you will be offered, so it may not prove a long term solution.

It always pays to ask around our members for any info they have about other ways of getting affordable treatment. Most of us are prepared to reduce fees if there is a good case, although we tend not to advertise this fact because we end up with a great deal of bargaining by people who can usually well afford to pay but would like to strike a deal. Another option would be to see if there is a multi-bed facility in your area. Some members are offering treatments in a group setting a much lower rates, and details of these can be found on  http://acmac.net/.

Perhaps the best first steep, though, would be to talk to a local BAcC member to see whether the nerve pain you have is suitable for treatment. Most are, but some aren't, and it would be useful to know if it is worth pursuing something. Most of our colleagues are happy to give up a little time without charge to discuss treatment with prospective patients, and this might be a useful strategy for finding out if treatment is worth going after and whether they know of someone locally who may be able to help.

With a problem like nerve pain there might just be an outside chance that you might qualify for some sessions at your local NHS Pain Clinic.

The provision of acupuncture within the NHS and free at point of delivery is not that good. Very few of our members now have contracts to provide a service with the current pressure on funding, and while a number of doctors may choose to offer some treatment, the majority of treatment available comes from physios who tend to use it within their scope of practice. The catch is that i someone chooses to offer treatment they have to have a good evidence base and the treatment has to fall within their scope of practice. In both cases this might lessen your chance of finding treatment locally with either a physio or doctor. You could, though, ask your GP for a referral in case he or she does know someone who could help.

Most areas have pain clinics, though, and these very often use acupuncture for chronic pain management. There is a relatively solid evidence base for acupuncture as a tool for pain relief, and if you can get a referral this might be one of the options you are offered. However, there does tend to be a limit to the number of sessions you will be offered, so it may not prove a long term solution.

It always pays to ask around our members for any info they have about other ways of getting affordable treatment. Most of us are prepared to reduce fees if there is a good case, although we tend not to advertise this fact because we end up with a great deal of bargaining by people who can usually well afford to pay but would like to strike a deal. Another option would be to see if there is a multi-bed facility in your area. Some members are offering treatments in a group setting a much lower rates, and details of these can be found on  http://acmac.net/.

Perhaps the best first steep, though, would be to talk to a local BAcC member to see whether the nerve pain you have is suitable for treatment. Most are, but some aren't, and it would be useful to know if it is worth pursuing something. Most of our colleagues are happy to give up a little time without charge to discuss treatment with prospective patients, and this might be a useful strategy for finding out if treatment is worth going after and whether they know of someone locally who may be able to help.

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 http://acmac.net/. 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.

 

 

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