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Ask an expert - body

356 questions

 Interestingly enough, the issue of treating children is very much a live one in the BAcC at the moment. Our members have always treated children, but over the years there has been an increasing recognition that children are not the same as little adults. Specialist courses have developed, and the BAcC has now recognised that there are expert levels of practice which might entitle a member to advertise themselves as an expert in treating children. The guidelines which will underpin this are not quite ready for publication, and so at this point we cannot give out the names of members who might meet these standards.

 However, if you use google with your location, 'acupuncture' and 'children' we are fairly confident that you will quickly identify someone local to you who has undertaken specialist postgraduate training. That is not to say that the ordinary BAcC member cannot treat children, only that someone who makes the treatment of children a focus in their practice is likely to have greater experience about dealing with children and recognising the patterns of disease unique to children.

Using google will also very rapidly identify the two or three major course providers for paediatric acupuncture, and some of these provide drop down lists of practitioner by area.

It is also commonly held view in the profession that skin problems are particularly benefited by herbal medicine, and finding someone with this additional string to their bow might be an advantage. Our members are often very helpful at directing prospective patients to members within their area whom they know personally and trust as experts in their field, and if all else fails you could almost certainly get a good steer from a practitioner local to you.

This remains the best advice that we can offer. We have checked the research databases to see if anything further has been published than the studies reported in our factsheet

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/eczema-and-psoriasis.html

but the evidence is a little thin. However, it would be fair to say that the trials which have taken place are not always accurate reflections of how we treat people, so the fact that results are not that impressive doesn't surprise us.

We often find that there are complex reasons for someone having eczema, but the crucial thing is finding something which breaks the cycle leading to a flare-up. If this can be done then it can stop the feeling that once it appears a little it will become a full-blown attack, as the worry of a possible recurrence can sometimes do.

We hope that you manage to track down a suitably qualified practitioner. In our experience children are great responders; if treatment is going to work it usually does so quickly.

 

q:

Hi. I have a.bmi of 46.and am.currently 22 weeks pregnant and have pgp. Does bmi.effect how acupuncture works?

 

a:

We can say categorically that someone's BMI has no impact at all on whether acupuncture works. From a Chinese medicine perspective the body is seen as a complex flow of energy, called 'qi', and putting a needle into a point will have an effect whether the person's BMI is 15 or 50. Generally speaking there are often energetic reasons why someone gains a great deal of weight, over and above lifestyle considerations and straightforward heredity, and these may have an impact on how much progress someone can make, but that will all be a part of the picture which the practitioner builds up and works with.

Indeed, there is some very good evidence that acupuncture can help with PGP. Studies such as this one published in the BMJ

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC555858/ seem to be very encouraging. In fact the same researcher went on to look at whether there was any potential for harm and concluded that while there may be some minor transient effects there was no serious risk

https://www.ncbi.nlm.nih.gov/pubmed/18582370

We are by nature a generalist healthcare modality, i.e. we treat the person, not the specific problems they have. In practice, of course, we are all able to go after specific symptoms as well as balancing up the whole system, but we believe that treating a symptom without regard to the whole is leaving things half finished. This means that we regard all of our members as capable of treating any patient who comes to them. However, we are close to reaching agreement on the treatment of pregnant women as an area of expert practice for which we have recognised postgraduate training. In the circumstances it would be highly advisable to go to someone who has had this kind of training and who has spent more time looking at the specific issues of pregnancy.

Unfortunately we haven't signed this work off yet, but we are pretty sure that if you type into google your place of residence, acupuncture and pregnancy it will generate a number of hits of our members who specialise in fertility and pregnancy issues. Failing that you could always call a local BAcC member and ask them to point you towards someone locally who has these skills. We are always very keen to see patients get the exact care they need.
 

 

 

 

 

Q: Does acupuncture help in the treatment of tinnitus associated with severe Menieres Disease? It has left me totally deaf. I have had successful acupuncture before for arthritis and muscle strains.

A: We have been asked about Meniere's Disease on a number of occasions, and a typical answer has been:

There are a number of conditions like Meniere's disease, vertigo, labyrinthitis and so on, where changes in the structure or infections in the inner ear area can cause significant balance problems as well as generating other symptoms like nausea and headaches. Because there is no precise overlap between the classifications of conventional medicine and Chinese medicine, there may be many different ways of treating the same named condition depending on what else a practitioner finds to be out of kilter in a system. This means that it can be quite easy on occasion to identify a group of signs and symptoms which are likely to be amenable to treatment and which enable one to treat with confidence. On other occasions it can be very unclear, and when this happens we have to rely on the very basic premise of Chinese medicine, that if the energy ('qi') of the body is balanced and free-flowing, then symptoms will resolve through the body's capacity to heal itself.
 
There is a fair measure of evidence for a number of balance related problems, as our factsheet shows but we would have to admit that many of the trials which do report success are not conducted by using Chinese medicine as it is practised, and while we would contend that the personalisation of treatment to the unique individual is a far stronger treatment than a treatment repeated formulaically several times, this latter is the basis on which most research is conducted to meet the current 'gold standard.' One trial of this kind, for example,

 
http://www.ncbi.nlm.nih.gov/pubmed/19606509
 
generated some very interesting results, but the formula applied would not be appropriate for everyone.
 
For a generic problem such as this which might present against a vast range of contexts there is no substitute for visiting a BAcC member local to you to ask for a brief face to face assessment of the potential benefits of treatment. This will enable them to give you a far better informed view than we can do at a distance

We think this is about the best that we can say. When patients come to us the first thing we establish is what exactly is wrong with the inner ear. There are a number of physiological changes to the ear which can mean that conditions like this have to be regarded as permanent, so a practitioner will first want to assess whether this is something which is even amenable to treatment - there's no point in wasting time and money on something which isn't going to work.

As far as how long the treatment lasts is concerned, this is the proverbial piece of string. We always aim to treat the overall picture, not simply the symptom as it presents itself, because we believe that doing only symptomatic treatment is like turning off an alarm bell because you don't like the noise. If we treat the whole system, and the treatment is successful, there is no reason why someone who looks after themselves shouldn't remain relatively symptom free. In reality this tends to be a little less likely than a case where someone will experience some positive change which they have to 'top up' from time to time.

What we always aim to do, though, is to review progress after four or five sessions, and if there is no obvious sign of improvement to draw a sharp line in the sand before committing someone to what may turn out to be a long, fruitless and expensive process.

We believe that this still covers most of the ground pretty well. We have undertaken a survey of more recent research and there is a paper
https://www.ncbi.nlm.nih.gov/pubmed/26055400

which gives a guarded but generally positive view of the value of acupuncture treatment for these types of cases.

This doesn't mention tinnitus directly, although the studies often mention tinnitus and deafness as a part of the constellation of symptoms, and where the deafness accompanies balance problems there is often an all-round improvement.

We have had a further look at papers which directly refer to hearing loss and tinnitus, and we found this one

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980515/

which concludes that balance problems can be helped but not hearing problems. However, the selfsame reason why the authors qualify positive statements about balance - small trials, poor methodology - are the ones which they cite to not write off acupuncture for hearing problems too quickly.

We used to be quite downbeat about tinnitus treatment, but as a recent answer said:

Our experience in practice was that tinnitus could prove intractable to treatment. However, as our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tinnitus.html

and as some recent personal experience in clinic has shown too, there may be some hope.

The problem with measuring the success of treatment for tinnitus is that its appearance and disappearance can be entirely random. If you read the tinnitus association's magazine you will see stories along the lines of 'I tried everything and then x worked' and an equal number of stories which say 'I had tinnitus for five years and then one day it just went.'  Research trials tend to be quite reliable - it would be a remarkable coincidence if half the trial participants experienced a spontaneous improvement - but one-off cases could be a coincidence, with acupuncture just happening to be the therapy of choice when the change happened.

The available evidence, however, suggests that it might be worth a try with the proviso that progress is reviewed at regular intervals, and some kind of objective measure can be found, i.e. how much it interferes with a radio set at a particular level. It might also repay investigation of what makes it worse and what makes it better. A long n-1 case study this expert conducted had very little impact on the condition but did increase the sufferer's ability to deal with it.

The best advice is to visit a BAcC member local to you  for an informal face to face assessment of what may be possible. There are one or two clearly recognisable syndromes within Chinese medicine which might offer considerable confidence that muting the problem may be possible, but even a general balancing of the system may bear fruit.


Invariably we check for more evidence when we are asked a question to which we have responded before, and the evidence trail for the fact sheet stops some time ago. We found a number of small studies like this one

https://www.ncbi.nlm.nih.gov/pubmed/26747258

which seem on the face of it to encourage the belief that there is a recognised connection between acupuncture treatment and symptom relief. There is also a systematic review, a 'trial of all trials' beloved of researchers because it aggregates to a much more powerful study than the individual ones.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3493359/

This draws the usual sorts of conclusion about the need for more and better trials, but the authors do conclude that acupuncture is worth trying as a safe alternative which seemed to have shown some success in addressing the problem.

The advice we gave before, though, holds good. Each case is unique and different, as is each treatment plan, and the best advice you can get will always come from someone who can see your problem in its overall context.

Q: My son who is 14 has had Labyrinthitis for two weeks and slowly recovering. His dizzy spells are reducing but he still haves some vertigo.
Is it possible that Acupuncture could help?.
He is one of the countrys top bmx racers in his age group and due to race in the World championships
in the USE at the end of July. At the moment we are very worried he may not be able to compete.
Your early reply would be most appreciated.

A: We are sorry to hear of your son's predicament. We have a factsheet on our website

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/2599-vertigo.html

which gives a fair bit of evidence for trials which are very encouraging about the use of acupuncture for a variety of balance problems. We quoted this some time ago in an answer about the generic problems of the inner ear, in which we said:

There are a number of conditions like Meniere's disease, vertigo, labyrinthitis and so on, where changes in the structure or infections in the inner ear area can cause significant balance problems as well as generating other symptoms like nausea and headaches. Because there is no precise overlap between the classifications of conventional medicine and Chinese medicine, there may be many different ways of treating the same named condition depending on what else a practitioner finds to be out of kilter in a system. This means that it can be quite easy on occasion to identify a group of signs and symptoms which are likely to be amenable to treatment and which enable one to treat with confidence. On other occasions it can be very unclear, and when this happens we have to rely on the very basic premise of Chinese medicine, that if the energy ('qi') of the body is balanced and free-flowing, then symptoms will resolve through the body's capacity to heal itself.
 
There is a fair measure of evidence for a number of balance related problems, as our factsheet shows but we would have to admit that many of the trials which do report success are not conducted by using Chinese medicine as it is practised, and while we would contend that the personalisation of treatment to the unique individual is a far stronger treatment than a treatment repeated formulaically several times, this latter is the basis on which most research is conducted to meet the current 'gold standard.' One trial of this kind, for example,

http://www.ncbi.nlm.nih.gov/pubmed/19606509
 
generated some very interesting results, but the formula applied would not be appropriate for everyone.
 
For a generic problem such as this which might present against a vast range of contexts there is no substitute for visiting a BAcC member local to you to ask for a brief face to face assessment of the potential benefits of treatment. This will enable them to give you a far better informed view than we can do at a distance

We think this is about the best that we can say. When patients come to us the first thing we establish is what exactly is wrong with the inner ear. There are a number of physiological changes to the ear which can mean that conditions like this have to be regarded as permanent, so a practitioner will first want to assess whether this is something which is even amenable to treatment - there's no point in wasting time and money on something which isn't going to work.

As far as how long the treatment lasts is concerned, this is the proverbial piece of string. We always aim to treat the overall picture, not simply the symptom as it presents itself, because we believe that doing only symptomatic treatment is like turning off an alarm bell because you don't like the noise. If we treat the whole system, and the treatment is successful, there is no reason why someone who looks after themselves shouldn't remain relatively symptom free. In reality this tends to be a little less likely than a case where someone will experience some positive change which they have to 'top up' from time to time.

What we always aim to do, though, is to review progress after four or five sessions, and if there is no obvious sign of improvement to draw a sharp line in the sand before committing someone to what may turn out to be a long, fruitless and expensive process.

We believe that this still covers most of the ground pretty well. We have undertaken a survey of more recent research and there are a couple of papers

https://www.ncbi.nlm.nih.gov/pubmed/26055400

https://www.ncbi.nlm.nih.gov/pubmed/26055400

which give a guarded but generally positive view of the value of acupuncture treatment for these types of cases.

There is plenty of time between now and your son's championship for acupuncture to take effect, if it is going to work. Even if it didn't do as much as we expect it could, there are other options which you might want to explore. Amongst the more promising is cranial osteopathy, which can often offer help for problems where a small but significant shift in the subtle structure of the skull could have an impact on balance. We would assume that as a serious BMXer your son is used to the odd tumble, and it may well be that a succession of these have contributed to the problem.

Whatever option you choose to pursue we are confident that the network of practitioners in your area will be able to point you towards whatever help will best suit your son.

And if he/you do choose acupuncture and he wins, we'd love a namecheck!

 

 

Q: Hi. I suffer from ventricular ectopics,I have seen Drs regularly and take beta blockers which work to a degree. I have periods when things aren't too bad and periods when things are really bad,I do get quite down during these times. Do you think acupuncture would help?

A: We have been asked similar questions before, and in reply to one we said:

One has to be very careful answering questions such as these. Taking the pulse a the wrist is one of the key diagnostic techniques in Chinese medicine, along with looking at the tongue and a number of other evaluations. The irregular pulse has clinical significance in the tradition, and point to specific disorders of organic function as understood within this paradigm of medicine. However, these may not all involve the heart - in fact, most of them don't - and any suggestion that this is treating the heart as it is understood in the west needs to be set aside.

From a conventional medicine point of view, there is not a great deal of evidence that acupuncture can treat these problems, although what little there is does tend to be very positive, although not always methodologically sound enough to use as the basis for a recommendation. A good example of a systematic review is:

http://www.ncbi.nlm.nih.gov/pubmed/18992625

Some of the published research also involves animal experiments, sometimes called 'ratpuncture' in the trade, and although the results here may be promising it is quite a large assumption to believe that human physiology will respond in the same way.

We think that it would certainly be worthwhile talking to a BAcC member local to you about what the conditions may be telling them about the way your system as a whole is functioning. From our perspective all of our members are equally well-qualified to deal with the vast majority of patients who present at their clinics, and it is obvious from what we have said earlier that there are no specialists in heart problems per se - Chinese medicine primarily treats the person, not the condition which someone has.


There have been a couple of other systematic reviews

https://www.ncbi.nlm.nih.gov/pubmed/28432528

http://www.internationaljournalofcardiology.com/article/S0167-5273(11)00227-0/fulltext

which make largely positive noises, but as in all of these kinds of studies the treatment which is given is largely formulaic, and does not really represent what a traditional acupuncturist does, which is to gear treatment to the individual and his/her unique balance of energies. Where trials offer designs which allow the practitioner to do what they might normally do, so called 'black box' trials, the results tend to get better and better.

The bottom line, though, is that from a Chinese medicine perspective there are often functional disturbances which can generate symptoms, often far away from the source of the manifesting problem. The skill and art of the practitioner is to make sense of the diagnostic information and treat the root of the problem. This can often cause a symptom to reduce or even disappear without there having been any apparent connection between where the needles were placed and the part of the body in distress.

The advice we gave before still holds good, to visit a local BAcC member for advice and a short face to face assessment of what may be happening. Most BAcC members are only too happy to give a small amount of time without charge to prospective patients to enable them to assess whether acupuncture is the best treatment for their problem. This will obviously give a far better idea of what may be possible than what we can say at a distance.

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