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87 questions

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: My meibomiem glands are blocked causing swelling below my eye. Can acupuncture unblock these?

A: If you search the internet for problems with the meibomian glands and the use of acupuncture you will come across the occasional study like this one

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

which is cited quite frequently in the treatment of dry eye syndrome. There are a couple of others of a similar nature, but the main concern is with a functional disturbance in the work of the glands as a contributor to the symptom rather than a straightforward blockage.

Of course, when you talk to acupuncture practitioners about blockages they tend to light up. Our work, after all is based on an understanding of the body as a complex flow of energies, and using needles to unblock areas which have become stuck is very much a part of what we do. When someone reports an area of the body where things have become 'stuck' we always feel that the use of needles may well help to unstick them.

However, we are always looking at the person as a whole, not simply the symptoms which they have, and an important concern is that the symptoms is not the tip of a much larger iceberg. Although symptoms like yours tend to be local rather than systemic, there are times when a general change in the character or viscosity of body fluids can cause accumulations in areas where the physical conduits or channels are narrow, and an experienced practitioner will want to understand your local symptom in its wider context before giving you a prognosis.

The best advice that we can give is that you visit a local BAcC member and let them have a look at the problem face to face. This will give them a much better idea of what may be possible than we can offer at a distance. The one caveat with problems like this, though, is that people can sometimes carry on with treatment far longer than the results justify. If it is a simple and local blockage there should be changes within a session or two. If there aren't then it is worth drawing a line very quickly before committing large sums of money getting nowhere, unless the practitioner is absolutely sure that there is a wider pattern which underlies and sustains the symptom.

Q: Can acupuncture help anosmia?

A: We have been asked this question a number of times, and our answer has always been:

Google is a massively powerful search facility, and if you google 'acupuncture anosmia' it looks as though there are a number of studies which give cause for hope. If you look carefully, however, you will see that there is but one study http://aim.bmj.com/content/21/4/153.long which is frequently quoted, generating a number of secondary references. This study, what we call an n=1 case study because it is the report of a single case, is important because it suggests that there may be something worth looking at in the use of acupuncture treatment. The weakness of n=1 studies, of course, is that they are not designed to test acupuncture, and the positive outcome could have arisen for any number of reasons, especially since the case study can provide no evidence for the sudden onset of the problem.

That is not to say that acupuncture treatment is not worth trying. The use of Traditional Chinese medicine involves a great deal of questioning and examination to determine the state and flow of the energies of the body, called 'qi', and the state of the organs which are responsible for all of the functional aspects of the body. Even where there is no obvious cause from a conventional medical point of view, it is rare for a symptom to stand alone in Chinese medicine other than where it derives from a blockage. In this case, if the blockage is removed, the function is restored. We strongly suspect that this is what happened in the case study, and blockages of this kind can sometimes occur for no obvious reason.

Generally speaking, though, a pattern of disharmony will generate a number of symptoms or changes in function, not all of which are clinically significant from a conventional perspective, and these may point t specific imbalances affecting Organic function. Note that we capitalise the word 'Organ' - what we understand by this in Chinese medicine is a great deal more than a physical unit in the body. The Chinese understanding of an Organ embraced functions on all levels, body mind and spirit, and when practised properly Chinese medicine can legitimately claim to be holistic.

The best advice we can give is that you visit a BAcC member local to you for advice on whether they think that acupuncture treatment may be of benefit, and to discuss briefly with you the other aspects of your health which may indicate wider patterns which in turn may link to your problem. That is not to say that there may not be as simple a treatment as the one described in the paper, and one of the points used has the Chinese name 'Welcome Fragrance' suggesting that it may have a direct bearing on the sense of smell. You would certainly not do any harm. However, we would be more likely to look at this as a functional disturbance and be looking at other factors in the system which might point to a treatable pattern.

There is not much more that we can say than this.  We have re-checked the research databases, and there has been nothing new to report. However, we have come across a couple of anecdotal accounts from colleagues, so we would not say that treatment definitely could not help, but that it would be unusual if it did.

Of course, a great deal does depend on the reasons why the condition may have developed, which is why we would always recommending talking to someone face to face. This may offer useful clues which could increase the chances of some improvement if the causes were more physical than neurological.

Q: Is Accupuncture beneficial in the treatment of Tinnitus?

A: 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 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.

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