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Ask an expert - body

372 questions

We have been asked many times about tinnitus, and our most recent reply has been:

We tend to be very conservative in the advice we give about tinnitus. One recent response said:We used to be a great deal more downbeat about the treatment of tinnitus than we are now because our experience in practice was that it could prove intractable to treatment. However, as our factsheet showshttp://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tinnitus.htmland 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 onehttps://www.ncbi.nlm.nih.gov/pubmed/26747258which 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.So, in answer to your question, there is some evidence that acupuncture treatment may help tinnitus, but not yet enough for us to say with any certainty that a result is guaranteed.As far as specialists are concerned, by its very nature Chinese medicine is generalist. Indeed in ancient China specialists were regarded as decidedly inferior because they only treated single conditions. From the Chinese medicine perspective it is the patient who has the problem, not the problem which is the primary focus. Each manifestation of a problem is unique and different, and twenty people with the same named problem might be treated in twenty different ways.On this basis we are happy to recommend any of our members to offer the same exemplary level of care, and using the postcode search on our home page www.acupuncture.org.uk will direct you to the geographically closest.
Our factsheet on nausea and vomiting

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html
talks a great deal about the evidence for acupuncture treatment helping with this distressing side effect of chemotherapy. This quotes a study by Ezzo which is now over a decade old but which points clearly to a level of efficacy. It is in the form of a systematic review, a consolidated account of all available trials of suitable quality, and very much loved by research statisticians for giving a far clearer idea than single trials of whether something really works.We always undertake a review of literature and studies which may have been published more recently and have found several overviews for the use of acupuncture treatment with cancer treatment as a whole. One rather useful one ishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577953/which looks at all aspects of the management of cancer and its treatment. It's a little technical, as many of these studies are, but not beyond most people to be able to find some useful material. This studyhttps://www.ncbi.nlm.nih.gov/pubmed/24815460also provides useful background.The key thing we have to be clear about with all cancer patients is the limit within which we work. As you have no doubt read we always claim to treat people, not diseases, but if we are not careful this is extended to 'treating people with diseases' and then truncated to 'treating diseases'. When someone has cancer this is a message they would like to hear, but there is no evidence that acupuncture treatment can treat cancer per se. Where it can be really effective is in reducing the side effects of the conventional treatments for cancer which are often debilitating and distressing. We also believe that treating the person, not simply the problem which they have, also mobilises the body's own healing responses to address many aspects of the strain under which conventional treatment places the body and the mind.The best advice we can give is that you visit a local BAcC to discuss with them what may be possible for you. Most are willing to give up a little time to prospective patients without charge to see at first hand what they might be able to offer. This also gives you a chance to meet them and see where they work before committing to treatment.
We are sorry to hear of your father's problem. We are aware from clinical experience just how much suffering this can cause because of its relentless nature.

There isn't a great deal of published evidence for the treatment of itching as such, although what there is is quite positive, as this systematic review shows: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430643/

Most of the research which would prove relevant is buried away in studies of diabetes and kidney problems where the itching is a part of a wider clinical picture.We suspect that there is no easy fix for this problem. There is a very strong chance that the changes in blood chemistry caused by the diabetes and kidney disease are the drivers for the itching, and these are not likely to relent as his age increases. What acupuncture may be able to do, though, is to break the cycle of discontent which can mean that the anxiety and distress caused by the problem become one of the factors which ensures that it escalates. Many conventional medicines are prescribed in this way to stop thins building on themselves, and there are certainly points used in Chinese medicine which would accomplish relief both from itching and anxiety at the same time. The only major question is now much relief and how sustainable it is.However, Chinese medicine looks at the whole person, not simply at the condition which someone has, and there would be a great deal of questioning about where the itching was, what made it better or worse, and so on, and looking at this within the context of the overall functioning of the body. There is a tendency sometimes to ascribe any symptoms to the headline conditions which people have, and this may not be the case. There may be all sorts of treatable reasons why someone develops itching, and a skilled practitioner might find something eminently treatable.The best advice as always is to try to get your father to visit a local BAcC member for an informal chat. Most are more than happy to give up a little time without charge to prospective patients, and this will allow someone to give your father a much better idea of what may be possible.  

We were asked a similar question a number of years ago, and our answer then contained the following paragraphs:

Chinese medicine is based on an entirely different theoretical basis from conventional medicine, what is often called a different paradigm. The essence of Chinese medicine is a belief that the body, mind, emotions and spirit are all manifestations of an energy called 'qi' whose proper flow and balance means that everything functions the way it is supposed to. If this flow becomes blocked or disturbed in any way, then functional disturbances appear, often affecting all 'levels' of the system and for which needles are used by the practitioner to restore flow.

When someone reports blockages it makes one question immediately whether the energy of that area is flowing as well as it might, and a skilled and experienced practitioner could determine quite quickly whether, from the Chinese medicine perspective, there was something which might be done. Even if there were no immediately obvious signs in the area itself, the principles of Chinese medicine are founded on a notion of overall balance which means that symptoms are less critical, being indicators of a wider imbalance in the system rather than the necessary focus of attention. It would be worth your while to visit a BAcC practitioner local to you for an informal assessment of whether they believe that acupuncture treatment may be of benefit to you.

That said, we have to say that the research evidence for the treatment of both conditions with acupuncture is a little bit thin. There are a few studies, but one of the key factors in undertaking research from a conventional perspective is trying to reduce the variables, and this means being able to define clearly what the problem is. Blocked tear ducts  have several possible causes, and this means that comparing like with like becomes more difficult, and the results less reliable. What research we have identified is of relatively poor quality, and if we were making recommendations based solely on that we would have to say that it would not be worth pursuing. However, our clinical experience is that where there are clear energetic blockages treatment can sometimes have a very direct effect, and it would certainly be worth seeking advice from a BAcC member local to you.  

There are, in fact, some quite useful studies of related problems like dry eye syndrome, and although it is rather technical this paper

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355143/

is both realistic and encouraging.

This expert has to admit that it has not been the most successful area of his practice. While few patients have come specifically for this as a problem several have had it as a secondary problem, and even where the main problems have responded well this hasn't. That said, in the minority of cases where there has been a positive change the result has been welcomed with great joy.

Acupuncture treatment is always worth a try. There is very little chance of an adverse effect, and there are enough reports of treatment working for this problem to suggest that it is worth a go. The only issue for cases where there is less evidence is to make sure that a patient doesn't get tied into a long and potentially expensive course of treatment without any tangible benefit. In another context, Dr Johnson once described something as 'the triumph of hope over experience', and we always ask our members not to succumb to joining patients in a desperate hope for good outcomes. If there is nothing happening after four or five sessions it may well mean that nothing will happen.

If you do decide to go for treatment, we hope that your case is one of the ones which does respond.

It is often difficult to answer questions like yours because there are so many variations on this particular theme. This happens not least because the term IBS has become so elastic that it covers nearly every digestive problem from one end of the digestive tract to the other.

The first thing to say is that if you are experiencing or have experienced any episodes of diarrhoea then we are assuming, and hoping, that your GP is fully aware of this. The management of chronic diarrhoea involves ensuring that a person remains adequately hydrated and also does not develop deficiencies in some of the vital trace elements which are re-absorbed in the lower gut. We are not suggesting that you should be taking preparations like diarolyte, but we think that your doctor should be making suggestions about what it is best to do, along with organising investigations like stool tests and endoscopy to ensure that there is nothing more serious going on.

The second thing we would do, if you were a patient, would be to have one of those discussions which we enjoy (!) about what you are actually describing. Chinese medicine works from an entirely different theoretical basis from conventional medicine, with a complex understanding of the energies of the body. The term 'diarrhoea' is used to cover a wide range of presentations, and the treatment for all in conventional medicine is often the same. From a Chinese medicine perspective there are some crucial variations, which is why we need to establish exactly what is happening. There is a considerable difference between, say, the kind of explosive and often unpleasant bowel movement which often feels like heat leaving the body and the less well-formed stool that needs to be passed urgently and quickly. These point to entirely different pathologies in the system, and that would mean very different kinds of treatment.

The research evidence for the treatment of IBS is not great, as our factsheet shows

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html

but this has a great deal to do with the difficulty of assembling test and control groups with identical presentations and causes of problem. Our clinical practice involves treating many people with IBS, often as a part of a wider pattern of problems, and we usually feel confident about being able to make some progress. The question for us is often how much and how sustainable, rather than does it work, and oddly for a therapy about encouraging movement and flow we are often more able to bring loose movements under control than to deal with constipation which often forms part of a wider pattern of 'stuckness.'

IBS often sits as a part of a wider pattern of imbalance, and the strength of Chinese medicine is that in treating the person, not simply the named condition, it aims to remove underlying causes as much as addressing the symptoms alone.

The best advice that we can give is that you visit a local BAcC member for an informal chat about whether acupuncture may be appropriate for you. Most of our colleagues are willing to do this without charge so that they can give an informed view before a patient commits to treatment.

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