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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.
The British Acupuncture Council works closely with its sister organisation, the British Acupuncture Accreditation Board, which accredits courses the  graduates of which have automatic eligibility to join the BAcC directly without interview. In that sense, the courses which they have accredited, which you can find here

 https://baab.co.uk/accredited-courses.htmlare what we would regard as 'recommended' courses. Obviously there are other professional associations with their own feeder courses, and other courses operating independently of any professional association structure, but we are not really in a position to comment on them.Of the accredited courses, several are degree programmes which are either housed in universities or have their courses validated by universities, but the acupuncture training is identical in all respects, and it is really a matter of personal choice about obtaining a degree alongside a licence to practise. University courses do tend to cost more, but because they are formally recognised within the higher and further education sector it does mean that grant and support arrangements may be available which would not be automatically possible for a student at a non-university course. This is something which you might need to discuss with the course organisers.Some of the more recently accredited courses have a greater degree of online and distance learning, but there is no substitute for the clinical hours which form a substantial part of each course and which involve in the second and third year of training a greater degree of attendance. We have come across people who have undertaken a year's training and then headed for China to take a three or six month intensive clinical training, often as a way of shortening the length of training and reducing the cost. Our Admissions people have tended to take a rather suspicious view of people trying to beat the system in this way, and often find that the consequence of a rapid training is that people are not really properly ready, in our view, to start in independent practice.This may seem a little protectionist, but our sincerely held belief is that three years of training is the basic minimum to allow sufficient time for reflection and growth in becoming a practitioner. The basic principles of Chinese medicine are relatively easy to learn, but a huge amount of the diagnostic and treatment process depends on experience and observation over time, neither of which can be easily shoe-horned into a short training.There are training courses in Southern Ireland which we understand to be of good quality, and it may be worth exploring whether these may also offer alternatives for you. In any event we wish you good luck in pursuing what we believe to be a truly satisfying and worthwhile career.

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:

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

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:

https://www.baab.co.uk/

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:

https://baab.co.uk/accredited-courses.html 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!

Q: I am pretty confused because I would like to study Microsystems Acupuncture to use it in my relaxation therapy sessions.  I've found different short courses open to anyone. I wonder if they are reliable courses and if I will be able to perform ear, hand and face acupuncture safely.   My concern is can I do it  without breaking the laws about the practice. I see a full acupuncturist degree lasts 3 years so I am pretty perplexed by the difference. 

A:  Let's begin with the basics. Since there is no statutory regulation of acupuncture in the UK the only laws relating to the practice of acupuncture are to do with the registration or licensing of premises in which the practice takes place. There are different laws in place depending on where you are based, but they are mainly concerned with the health and safety aspects of practice - clean and suitable premises, proper techniques for the safe use and disposal of acupuncture needles and other clinical waste and maintenance of the premises themselves. An increasing number of authorities are beginning to check someone's training credentials, and this may have an impact on those with very little training, but the majority of bona fide UK courses will pass muster.

 We obviously are committed to the idea of a degree level training as the minimum standard for a traditional acupuncturist in independent practice. However, many of the microsystems in common use, like ear acupuncture, are relatively modern. Auricular acupuncture, for example, was mainly a development by a Frenchman called Paul Nogier in the 1950s, and other systems, while based loosely on classical principles, are often modern innovations, scalp acupuncture being one such.

 When all the acupuncture groups met to discuss the possibility of statutory regulation the microsystems groups worked out pretty quickly that they would be unlikely to meet the standard for statutory regulation, likely to have been agreed at degree equivalent, and formed a working group to seek recognition through the Complementary and Natural Healthcare Council. This they achieved. The CNHC website itself is rather unhelpful, mainly identifying individual practitioners rather than the organisations which generated them and which provided their training. However, you can still find a listing on what had been the site of the Microsystems Acupuncture Regulatory Working Group here http://www.macrwg.org/html/group_members.html, and the names and addresses look pretty current.

 Some of these groups are mainly 5-point detox organisations, and probably not what you have in mind. The others offer different forms of microsystems acupuncture based on holistic principles, and while it is not our place to comment on them individually, the majority are credible bodies which offer specific training within precise limits of competence. As long as someone works within their scope of practice the work they do can be very effective. We would obviously prefer it if everyone learned to practise traditional acupuncture at degree level, but there are likely to be all sorts of constraints which make that impossible for some.

 Of the different varieties of microsystem work the one which does give us the greatest concern is facial or cosmetic acupuncture. We have reservations about the extent to which people are taught how to use needles safely in an area where mistakes could prove very costly for their insurers, and some of the courses we have seen have been very rudimentary. We are also working hard to establish safety standards for regulated healthcare professionals whose short training courses has led to a number of serious accidents, so we would advise that you check this aspect of the training very carefully. We would not wish to see you expose yourself to risk because you don't know what you don't know, if that doesn't sound too cryptic. Acupuncture seems to deceptively simple at times - find point, stick needle in - that people forget what is going on inside the body they are puncturing, even people who should know better. 


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