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380 questions

Q: My 3 weeks old baby has been diagnosed with moderate hearing loss due to issues with inner ear. We found some articles talking about benefits of acupuncture treatment in such cases. Can you please advise if this is something that is proven to work and whether this can be done on babies?

A:  There are no age restrictions on treatment, and we have known people to have treated babies that are a day or two old. However, we do increasingly take the view that it requires slightly more specialist postgraduate training to approach treating the very young. However, in our specialist guidelines which are still under development treatment on children under the age of six months is not favoured because of the unreliability of many of the usual diagnostic signs at this age. We don't simply stick needles in where the problem is, and trying to work on the extremely young would be only undertaken if there was a very clear syndrome with some very specific treatments.

As far as the research itself is concerned, we have seen one or two studies which suggest that acupuncture may have a role to play in treating inner ear issues, but none which we would regard as robust enough to underpin a recommendation.

Indeed, this expert, if faced with a request like this, would almost invariably recommend that a parent took their child to a cranial osteopath. Many of the problems with neonates can arise from the pressures on the skull during delivery, and the treatment itself is extremely gentle as well as being effective for many birth problems. If you did decide to try acupuncture, however, we would recommend that you seek out someone who has attended a structured postgraduate training in the treatment of children. There are two or three course providers, whom we cannot unfortunately name, who are recognised by our community as the acknowledged experts in the field. Someone who has trained with them will know their limitations, and that is the most important thing to consider, whether it is appropriate to use acupuncture with a child so young.

A:  We have a factsheet on the treatment of menopausal  symptoms

which makes some very encouraging noises about the treatment of some aspects of menopause. Hot flushes always feature heavily in these trials, and meet with some success, but most trials are conducted testing 'real' treatment against 'sham' treatment, which we are far from believing is a satisfactory way of assessing the benefits of treatment. We don't believe for a moment that the sham treatments have no effect!

The studies cited in our factsheet are quite old, and there have been some more recent ones which have been very positive. Examples such as


make just as interesting reading.

However, hot flushes are not the only menopausal symptoms, and unless we had more specific information it would be foolish for us to be too definite. What we can say, though, is that menopausal treatments have been a part of Chinese medicine for over 2000 years, and the Chinese view of the energetic transformations which take place as women age can really help to inform treatment in a way that is much more sophisticated than simply using set protocols for specific symptoms, which is how most trials are conducted. Traditional Acupuncture treats the individual and seeks to understand the ageing process by looking at how generic changes in the system affect someone's unique balance. This can have a significant bearing on how successful treatment might be.

Our advice in these situations is always to visit a local BAcC member to discuss your particular presentation. This will give you the best possible chance to make an informed decision about whether treatment may be beneficial. We suspect that the answer will be that it could well be, but sight unseen it is not proper for us to make a recommendation.

Q. Is there any evidence that acupuncture can help with urology problems ie enlarged prostrate.. P s a 7.5 blood reading,am on wait and see for next 6 months advised.

A. There isn't a great deal of research evidence for the treatment of prostate problems, which we find rather surprising given that it is one of the more frequently occurring problems and more recently the most prevalent cancer in men.

There was a systematic review published exactly a year ago

which made encouraging noises but as usual said that more and better research was needed. Systematic reviews are the top of the pile in research terms. Because they accumulate the results of several trials they tend to iron our anomalies, and so random excessively good and bad results get evened out. If there is a general report of good results that is good news.

Of course, prostate problems are not a modern invention! That said, there is much about the modern lifestyle which predisposes men to issues in this area. The issues which men have in terms of discomfort, problems with passing water and occasional blood in the water have affected men since time began, and the diagnostic systems of Chinese medicine have ways of looking at the symptoms which are the same whatever the system of medicine in use and placing them within a framework which interprets them as blockages and changes in the flow of energy.

The great strength of Chinese medicine is that if places these disturbances in the context of the overall pattern of energy. This causes what many western physicians find problematic, the same disease being treated in as many different ways as there are patients. This means that the symptoms are seen as alarm bells that the whole system is out of balance, and rather than simply treat what appears to be wrong, Chinese medicine tries to address the underlying causes.

This means that in practice we find it quite difficult to say 'yes it will ' or 'no it won't' without seeing the patient in whom the condition manifests. We are not alone in this; the great Canadian physician William Osler often said 'The good physician treats the disease; the great physician treats the patient who has the disease'. This is, we believe, the way to achieve lasting change.

The best advice we can give, then, is that you visit a BAcC member local to you and see if they can offer you a brief chat about whether they think that acupuncture treatment would be beneficial for you. Most are happy to give up a little time without charge to prospective patients, and it means that someone can make a properly informed choice about what to do.


Q. I want to ask if any member has experience treating gastritis and silent reflux

A. We are often asked about acid reflux, although it is usually the version defined as GERD rather than silent reflux, but as a long answer (in italics below) earlier this year demonstrates, from a Chinese medicine perspective this is not always a meaningful distinction:

There is surprisingly little research on the use of acupuncture for the treatment of acid reflux even though it is a very common presenting condition in our clinics. There are one or two studies like this


and occasional articles like this one

which suggest other possibilities for the appearance of heartburn symptoms, but not the solid body of evidence one might expect based on the usually quite effective treatment of this problem.

Obviously there are physical problems such as hiatus hernia where there has been a physical change in structure of the oesophageal tract which can cause heartburn. If this is the case, then it will seriously limit the possibilities for treatment in any system of medicine. If investigations show that this is not the case, however, then there may be some value in using acupuncture treatment.

From a Chinese medicine perspective the classic presentation of reflux or heartburn is described as Stomach Fire or Rebellious Stomach Qi where the energy of the Stomach does not follow its normal pattern of causing food to descend but lets it stay in the Stomach or reverse its flow to create the classic symptoms with which people suffer. Knowing the immediate precipitating cause, however, does not mean that one goes straight to this for treatment. The flow of energy in the body, called 'qi' in Chinese, is a complex interweaving of channels connecting Organs whose functions are also inter-related. The art and skill of the practitioner lies in determining what the primary underlying imbalances are, in the belief that treating here will cause the symptom to go and stay gone rather than be treated simply as a symptom.

This is one of the primary differences between Chinese and conventional medicine. From the Chinese medicine perspective the symptom is an alarm bell telling the practitioner that the system is out of balance. Thus twenty patients with the same symptom could have twenty different underlying causes and therefore twenty different treatments, in contrast to the standard western procedures which have two or three main strategies for a problem. In Chinese medicine the balance of the system is unique in every patient, and this means that each treatment plan is also unique.

It follows that this does limit what we can say about individual cases and why we invariably advise people to visit a local BAcC member for an informal assessment of what is going on and whether treatment would be of benefit. Most practitioners can get an idea in a very short time of what is going on and as a consequence give a good informed view of what might be possible. This would invariably take into account other changes in the way that everything functions which are perhaps not significant enough to concern anyone but from our perspective enrich the picture which we have. Reflux and heartburn are often accompanied by changes in digestion and bowel habit, and secondary information can refine the diagnosis a great deal. A practitioner can take all sorts of other factors into account, including mental and emotional ones, to offer you a much more precise assessment of what may be possible.

We have to say that this still probably represents the best advice for a prospective patient, to visit a practitioner and let them see bow the symptom manifests exactly in you.

To the extent that a component of the problem may be an excess of acid in the stomach the advice and explanation above hold good. However, in many cases of LPR. however, there is a general failure of all of the mechanisms which prevent stomach acids reaching the throat, and in cases like this reducing the acidity of the stomach may only have limited value. However, we have to believe that if treatment can help with GERD, which it often appears to do, then in principle there is no reason why it should not help LPR. Certainly one of the common experiences of LPR, the lump in the throat, is a recognised symptom within Chinese medicine where is it called 'plum pit throat - the feeling of having a plum stone stuck in the throat- and for which several clearly defined strategies exist.

As in the earlier answer we would advise that you discuss this with a local practitioner face to face. This will give you a much clearer answer than we can manage here, and also give you a chance to meet them and see where they work before committing to treatment

As to whether there are practitioners who have treated this the answer is all of us. It seems to be a common manifestation of the stresses of modern life and the strain it puts on the parts of the system which affect orderly digestion, and the proliferation of over the counter indigestion preparations is evidence of this. Even where people come in with other main complaints entirely it is very common for them to say that they are getting heartburn or indigestion on a regular basis. The immediate presenting cause is often quite obvious, but as we said in the answer above, symptoms are often alarm bells, not the problem itself, and the skill of the practitioner lies not in turning off the warning sound for a while but making it stay gone.

Q.  Is accuputure any good for sinus problems?

A. For such a common problem it is surprising how infrequently we are asked about whether acupuncture can help. An answer which we have given and which still seems current was:

As our factsheet shows

the evidence from the few trials there have been of sinus problems have not been that encouraging. This reflects the clinical experience of many practitioners, that sinus problems can be intractable and defy all attempts to relieve them. It would be good to be able to conclude that surgical options like rhinoplasty and sinus washes were the best alternative, but many acupuncture patients who come to treatment with sinus problems find that surgery has only offered temporary relief.

A great deal depends on the wider backdrop of your health against which the problems can be seen. Chinese medicine looks at the whole picture of someone's health, and it would be unusual for someone to be troubled by a single, quite unpleasant problem without their being other health issues, even if these are not particularly troublesome in themselves. It is this whole complex picture which can give the practitioner a better idea of what is happening and by the same logic a better idea of how difficult or how straightforward it will be to treat a problem. The best advice is to visit a BAcC member local to you so that they can offer a better assessment based on a face to face chat.

What we often find, however, is that there is often a lifestyle factor such as diet which is at least contributory to the problem. Many people eat a great deal of dairy produce in the form of milk or cheese, and this can often have aa significant effect on the body's fluids, from a Chinese medicine perspective making them more thick and less free-flowing. Cutting out some of these foods can often have a profound effect. A practitioner would very quickly be able to assess whether this was the case, and also consider other common contributory factors.
We think that this still remains pretty good advice. Each person is unique and different from a Chinese medicine perspective, and there are occasions when it becomes clear very quickly that the sinus problems have an obvious cause which is responsive to treatment. More often, though, people usually come to acupuncture treatment when the problem has existed for some time, and by this stage it has actually become a more fixed problem in itself, whatever the original cause. Your best bet is, as we said in the earlier response, to visit a BAcC member local to you for a more informed assessment based on seeing what is actually going on.

We have checked the databases again, and there is nothing new of interest. However, this is not entirely surprising; sinus problems are usually multifactorial, i.e. involving a number of separate causes, and it is quite difficult to design trials which can compare like with like.

The advice which we pretty much always give in these situations is to visit a local BAcC member for a quick chat about what might be possible. Five minutes face to face is often enough to make an assessment on the run about whether someone has factors which point to the potential benefit of acupuncture treatment, and most members are quite happy to give up a few minutes without charge to help prospective patients to make an informed choice.

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