Ask an expert - body - head

92 questions

Q:  Can acupuncture help with treating glioblastoma or swelling in the brain. Coming off the steroids has been causing seizures.

A:  We have to be honest and say that there is no research which we can trace which suggests that acupuncture can be of proven benefit, but given the aggressive nature of many glioblastomas that is not a surprise. You will find a number of case histories on the web, rather similar to this one

http://www.ivanhoe.com/SMARTWOMAN/p_swstory.cfm?storyid=10695

but it is always difficult to generalise from individual cases because there may be any number of reasons why this particular individual had such a good result. We tend to work on the adage that there is always someone for whom everything works but rarely something which works for everyone.

However, the essence of traditional Chinese medicine is that it is based on an entirely different way of understanding the body, mind and spirit as a complex flow of energy, called 'qi', whose rhythms. flow and balance determine the health and well-being of the person. The symptoms from which someone suffers are interpreted through a sophisticated conceptual grid which has developed over 2000 years, and are made sense of within this grid. On occasion this can present options for treatment which can reduce some of the secondary effects of serious conditions, and in a small number of cases affect the condition itself.

Glioblastoma has a rather bad reputation as an untreatable condition, but there are good reasons to believe that treatment, both conventional and complementary, can on occasion slow down the progression of the problem and reduce some of the effects caused by the presence of the tumour in the frontal and temporal lobes.

Our best advice in your particular case is to visit a BAcC member local to you for an informal chat about what may be possible. You will clearly have a great deal of case history which is not touched on in your e-mail, and which will guide the practitioner towards a better understanding of the progression of the problem and with that a better assessment of whether acupuncture treatment may be of benefit.  

 

A:  We are somewhat surprised at how infrequent the requests have been for advice on sinus problems given the frequency with which they turn up in clinical practice. The last answer which we gave quite a while ago was:

Would you recommend an acupuncture for sinus problems?

A: We are assuming that your question is about whether we think acupuncture would be good for sinus problems. As our factsheet shows

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

Q:  Can acupuncture help with burning tongue syndrome? I have suffered for many years with no physiological reason for this and the constant pain is driving me mad.

There is a very small amount of encouraging evidence from small-scale studies such as this

http://www.ncbi.nlm.nih.gov/pubmed/23336607

as well as a number of studies which involve the use of electro-acupuncture and laser treatment. However, to be able to make a whole-hearted recommendation we would need to have a great deal more to go on.

However, the human physiology involved in Chinese medicine is very different from that which underpins conventional medicine. The central concept of qi, or energy, is similar to concepts of ki and prana in other South East Asian medical traditions, a life force which constitutes everything and whose balance, flow and movement determine overall health. The Organs of the body, which are much wider in meaning that the equivalent organs of the same name in western medicine, and the flow in the channels which they govern contribute to all our functions. A Chinese medicine practitioner will try to make sense of the symptoms which someone has as either a local blockage or a systemic problem of which this is the tip of the iceberg. In many cases it is both; a system out of balance tends to let small problems arise elsewhere which are not on the surface directly related to each other.

This is a rather long-winded way of saying that when a symptom like yours starts and persists, the practitioner will look at the whole system to see how it has manifested and what can be done to correct it. It goes without saying that each person is unique and different from this perspective, but the appearance of heat anywhere in the body can usually be made sense of within Chinese medicine, where the patterns often use the language of heat, cold, damp and other climate factors to describe some of the manifestations of disharmony.

The best advice we can give is to visit a BAcC member local to you for a brief face to face assessment. They are much better placed than we to offer advice, and may well pick up a number of factors in the system which point to why this has started. If so, they will be able to give you a reasonable idea of how much treatment you may need.

In conditions like this we tend to the view that there will always be some improvement, and the key question is how much improvement and how sustainable it is. This can sometimes become an issue of cost effectiveness - is the expense worth it for three or four days of relief - but what we ask members to avoid is getting locked into a long course of treatment without clear outcomes or reviews, and without any clear sign of improvement. If nothing happens after three or four sessions it is important to consider whether it is worth continuing.

A:  Difficult to answer without knowing exactly how the ear and throat are annoying you. Chinese medicine has addressed for over two thousand years all of the health problems from which modern people still suffer, and a traditional acupuncturist will always take a very full case history which covers the main problems you have, any other niggling chronic problems which you may have, your medical history and family medical history and lifestyle questions about sleeping, eating and eliminatory patterns. From all of this material the practitioner can assess whether this is a short term problem or whether it is the tip of a much larger iceberg. This in turn will determine how the treatment is undertaken.

Generally speaking, even with short term problems in the ear and throat the  treatment may not be entirely local. There may be some needles near the head and ears, but it is equally possible that needles could be applied anywhere. The internal connections or pathways are such that points on the foot will affect the head, and vice versa, and there is a very strong likelihood that if constitutional points are used for a systemic problem, the needles will be applied in the first instance to points on the arm below the elbow or on the leg below the knee. These are often the 'starter for ten' needles to assess what strength and frequency of treatment may be necessary, and often are sufficient in themselves.

Does it hurt? Not really. The needles are very fine, much thinner than sewing needles, and they are usually inserted through a plastic guide tube which both guarantees sterility and also applies a light pressure to the skin which masks the sense of the needle going in. Sometimes people can feel the slight prick as the needle penetrates the skin, but a much more common sensation is a dull ache, either on or shortly after insertion of the needle. The Chinese call this sensation 'deqi', pronounced 'derchee', and regard it as essential for a good result. the Japanese, however, are exactly the opposite, and try very hard to make sure that the needles are not felt on entry. Whichever approach a practitioner uses it is highly unlikely to hurt very much at all. let's face it, men have acupuncture treatment, so it can't be that bad.

The best advice we can give, without more information to go on, is that you visit a BAcC member local to you for a brief chat and face to face assessment of how, or if, they think acupuncture treatment might help you. Most are happy to give up a little time without charge and equally happy to refer on to other forms of healthcare practice if they think that it may be more effective for you.

Q:  Do you know of a dentist in London who practices acupuncture and offers NHS treatment?  I don't mind where in London as long as I find one.

A: If you are looking for someone who incorporates the use of acupuncture into their dental work, the best bet is to contact the British Dental Acupuncture Society. However, we have had a few problems trying to locate them of late, their web address not seeming to work. It may be worthwhile contacting the British Medical Acupuncture Society with whom many dentists undertake training. This group can be contacted at www.medical-acupuncture.co.uk.

The majority of dental treatments are for calming the gag reflex rather than managing pain through the consultation. It is possible that anyone trained by the BMAS may have wider skills to hand, the only requirement for training being a registrant of a statutorily regulated healthcare profession, but whether they are entitled to treat conditions other than dental pain is something you would have to explore with them. The text on one of the dental insurers' sites is very useful in this respect:

Q. I am a dental hygienist with training in acupuncture. Am I allowed to use these techniques in the dental setting and do I need any additional indemnity?

There are some aspects of the provision of dental treatment that the General Dental Council's Scope of Practice simply does not cover. Acupuncture would be a good example. In the past the GDC has been a little cautious about its use in dentistry, presumably because they are not quite sure where it fits in. The use of holistic medicine and hypnosis would be other good examples. This lack of clarity from the GDC is not helpful, although they would probably argue that there does have to be a point where the scope of practice has to be at the registrant's discretion.

If a registrant is to consider using these techniques, they would need to demonstrate that they are competent to do so and have acquired the necessary training. A training course run for DCPs by a UK dental hospital would probably be regarded as appropriate training.

The difficulty would be how you might decide to use this additional skill in the dental surgery. As a hygienist, using acupuncture as some form of relaxation technique would not seem unreasonable. If you intended using acupuncture for the treatment of TMJ dysfunction this would be quite a different matter. For obvious reasons this type of treatment is a long way outside the scope of practice for a hygienist.

The use of acupuncture for a condition that was unrelated to dentistry would also be unacceptable. Indeed it would be necessary to ensure that a clear distinction was made between this alternative practice and the practice of dentistry. You could not, for example, advertise yourself as being a hygienist and in some way give additional credence to the treatment you provide from your GDC registration. On these occasions you would need to obtain additional indemnity from another provider.

There are overlaps which tend to complicate matters even further. It is, for example, the duty of all clinicians to provide advice on smoking cessation and to encourage patients to give up the habit. In the past, acupuncture (rather like hypnosis) has been shown to be quite successful in this respect. It is debatable whether the use of acupuncture in such a way is part of the practice of dentistry, or outside the dental field.

From Dental Protection's point of view, provided you are using acupuncture as part of dental treatment, there is no particular difficulty in relation to recieving an indemnity as a benefit of dental membership. This may change in the future if the GDC should decide that it falls outside the scope of practice for a hygienist.

Any DCP members finding themselves in a similar situation are invited to contact Dental Protection for advice.

We have done a brief web search for a dentist using acupuncture on the NHS in London and come up with nothing,so it may well be only through direct enquiry that you manage to locate someone. In this context it may well be worth contacting Guy's dental school http://www.guysandstthomas.nhs.uk/our-services/dental/overview.aspx. They offer emergency cover at all times and often seem to be in the forefront of new dental services. It may well be that someone there could advise you.

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