Ask an expert - body - head - nose

16 questions

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


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.

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.

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 studyhttp://aim.bmj.com/content/21/4/153.longwhich 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.We have had a look through all of the databases again and found references to these four papers which give mixed outcomes for treatment
  1. Vent J, Wang DW, Damm M. Effects of traditional Chinese acupuncture in post-viral olfactory dysfunction. Otolaryngol Head Neck Surg. 2010;142:505–509. doi: 10.1016/j.otohns.2010.01.012.[PubMed] [Cross Ref]
  2. Silas J, Doty RL. No evidence for specific benefit of acupuncture over vitamin B complex in treating persons with olfactory dysfunction. Otolaryngol Head Neck Surg. 2010;143:603. [PubMed]
  3. Damm M, Vent J. Response to: no evidence for specific benefit of acupuncture over vitamin B complex in treating persons with olfactory dysfunction, by Jonathan Silas and Richard L. Doty. Otolaryngol Head Neck Surg. 2010;143:603–604. [PubMed]
  4. Anzinger A, Albrecht J, Kopietz R, Kleemann AM, Schöpf V, Demmel M, Schreder T, Eichhorn I, Wiesmann M. Effects of laserneedle acupuncture on olfactory sensitivity of healthy human subjects: a placebo-controlled, double-blinded, randomized trial. Rhinology. 2009;47:153–159. [PubMed]
and don't really give us much cause to be over-optimistic. However, what we said above about blockages and energetic weaknesses is probably a great deal more relevant than studies which are either too small to underpin any conclusions or too specific to one variant of anosmia. Chinese medicine was always and remains the treatment of the person, not the named condition, in the expectation that if the system is in good balance it will repair itself and function as it should. This seems to us a better statement of what we are trying to achieve than 'acupuncture treats x and y', and having used this kind of approach for many, many years we have seen enough problems resolve for which there was no evidence to suggest that a short course of treatment is always worth trying, and will certainly cause no harm.

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:  Query R.E problems breathing through nose.  For a long time ( many years) I seem to have a stuffy nose only at night time .( I used a Vick stick on and off for years ) any slight cold would cause problems and I would use vick spray . About 3 years ago I had a hysterectomy and a couple of months later I had some sort of virus that lasted approcimately 12 weeks which resulted in bad headaches. Doctors prescribed amitriptyline I was on 50g a day for about 2 years. During this time my problems with blocked nose got worse and affected  me 24 hours a day. I came off the amitriptyline gradually and stopped about 10 months ago .Last winter I was terrible for about 3-4 months and was constantly using Vicks spray. Doctors prescribed beconase and was ok during the summer, but have been having problems since September again . I also have slight post nasal drip
Can acupuncture help?

A:  First of all we need to congratulate your for getting off amitriptyline. Although it is not often regarded as a highly addictive drug we have had a number of patients over the years who have really struggled with the rebound symptoms from trying to come off a long term use. The fact that you have is a tribute to your determination.

 We have been asked questions before about allergic rhinitis and chronic rhinitis, both of which share similarities with your problems, and a typical answer has been:

Can acupuncture help chronic rhinitis?

There is a growing body of evidence that acupuncture treatment may help with a number of forms of rhinitis, as our factsheet shows:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/allergic-rhinitis.html
 
However, we know from our clinical experience that although there are some, indeed many, presentations which seem to respond well to acupuncture treatment, there are a number which have their root in some physical change or restriction in the nasal cavities, or from long-term sinus infections which have become resistant to treatment. If either of these is the case, there may be much more of a struggle involved in trying to reduce the impact of the symptoms.

From a Chinese medicine perspective, however, there are a number of clearly defined patterns involving a compromised defensive system (the Chinese didn't recognise the immune system as we do but certainly had a concept of defensive energy which when compromised generates the symptoms which we associate with rhinitis) and also digestive disorders which can manifest in the fluids of the body being excessive. A skilled practitioner will be looking at the symptoms someone has in the context of their whole system, and trying to ensure that treatment is aimed at the core of the problem, not simply the way in which it manifests.

Amongst the things which the practitioner would consider are also a number of digestive factors. From the Chinese medicine perspective the intake of too much dairy produce can often produce far too much mucus in the body, and it is not uncommon as a pattern. If this is the case, though, there will be a number of diagnostic signs which point clearly in this direction.

You would be well advised to visit a BAcC member local to you for face to face advice. Most are happy to give up a few minutes without charge to assess whether acupuncture treatment is the best thing for you. 

 The importance of this is that from a Chinese medicine perspective it doesn't really matter what the western medical name of a problem is. The symptoms which the patient reports, along with signs which the practitioner can observe, all point to disturbances in the flow, rhythm and balance of the energies of the body, and the skill and art of the practitioner lies in being able to make sense of them within the theoretical framework of Chinese medicine. This can mean that twenty people with the same 'named' condition can find themselves being treated in twenty different ways.

 As far as the advice we gave before is concerned there are probably a number of lifestyle recommendations about diet which a practitioner would make, especially relating to the kinds of food you are eating and also the times of day at which you are eating them. Small adjustments here can have a profound impact, especially when you consider that one of the main two digestive functions in Chinese medicine is also responsible for maintaining fluid flow and can create mucus and phlegm if it is impaired.

 We are surprised that in the earlier answer we did not mention Chinese herbal medicine. Although we routinely offer this as an alternative suggestion for skin problems we have also found that our colleagues who also use herbs are able to address some of the long term rhinitis issues rather well. The quickest way to find a qualified practitioner is to look on the website of the Register of Chinese Herbal Medicine, http://rchm.co.uk/. Most RCHM members are also members of the BAcC, and you can enjoy the best of both forms of treatment.

 As a first step we would advise you to talk to a BAcC member local to you. Most are very happy to give up a small amount of time without charge and can give you a brief face to face assessment which is far more likely to offer you a clear prognosis than we can offer at this remove.

 

Q:  I am 84 years old and have had no sense of taste or smell for about 20 years. I have seen an ear, nose and throat specialist and they have found nothing wrong. Can acupuncture help this condition?

A: We have been asked questions of a similar kind several times, and we have a very comprehensive answer quite recently which said:

As the NHS website on anosmia (loss of sense of smell) says


http://www.nhs.uk/conditions/anosmia/Pages/Introduction.aspx

around 80% of the taste of food depends on the sense of smell, but this does leave a residual 20% which does mean that food does have a taste. As we understand it, the sense of taste is largely confined to much more basic distinctions between sweet, salty, etc, but there are cases where people with no sense of smell appear to be able to make finer distinctions. The NHS website mentions a number of potential causes for loss of the sense of smell, but in most cases there really is no clear reason.

As far as the use of acupuncture to treat anosmia is concerned, 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 whenpractised 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. From a Chinese medicine perspective, however, the functions of taste and smell are assigned to specific, and different, parts of the system, and if there has been a functional disturbance in one it may not necessarily mean a loss of function in the other. It may be interesting to see what a practitioner can find, because if either function has been disturbed there will be other confirming evidence.

We think that this still represents the best advice we can give. The fact that you have had tests which suggest that there is nothing wrong is, from our perspective, rather strangely a cause for some hope. If there had been a physical or neurological change that might have made matters a little more difficult, Unexplained problems, which we see very often as you can imagine, are sometimes amenable to our style of working.

However, we are not in the business of encouraging people to chase rainbows, so if you did decide to give acupuncture treatment a try it would be worth drawing a sharp line after three or four sessions if there has been no overall progress. Otherwise it is quite easy to fall into a costly treatment habit when there is no sign of any progress.

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