Ask an expert - general

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The first thing we would ask in cases like this is what investigations you may have had already. There are a number of medical conditions like blocked tear ducts and the related dry eye syndrome which may be the cause of the swelling, and this can impact on the success for which one might hope. We answered a question on both a couple of years ago, and the answer is worth repeating for the wider context in which it places treatment. 




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 paperhttps://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, however, the bags under the eyes are a result of loss of muscle tone, then we enter the area of facial or cosmetic acupuncture which has been in vogue for the last few years. There is no doubt that there is some basis for this work, as studies like this one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745857/suggest. There may also be reasons to do with straightforward blockage where treatment may have an effect. Our belief, though, is that treatment of local blockages really needs to be done in the context of a wider diagnosis of a person's balance, and only by doing this can the results be maintained.The last decade has seen a proliferation in people training to do 'facial acupuncture' or 'cosmetic acupuncture', many of whom have no background in acupuncture at all. We are not being protectionist in saying that in the courses which people do, many of which are of one or two day's duration, we do not think that anyone can learn properly skills which form a part of a three year training programme. If you do decide to seek the help of someone offering facial or cosmetic acupuncture we would fully recommend that you make sure it is someone who is also properly trained as a professional acupuncture practitioner.

We are sorry to hear of your experience with your practitioner. Making a good rapport with a patient is seen as central to what we do, and our training standards for students make this an important feature of our work. We depend on people feeling comfortable with sharing information with us, and since in traditional acupuncture we treat the whole person anything and everything which may help us is important. We can sometimes make predictive statements based on what the diagnostic signs tell us, but not at the expense of giving the patient plenty of time first to tell us what is going on. 'Rushed' does seem to be the key word.

As far as treatment of vertigo is concerned, acupuncture has a fairly good research base, as you can see from our factsheet

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

and various balance problems like vertigo, Meniere's disease, labyrinthitis and the like have always formed a good percentage of our regular referrals. However, we are aware that treating problems like this can take several sessions, and more to the point where blockage is involved, it can cause a few ripples on the surface when treatment starts. This 'expert' along with many of his colleagues is usually unwilling to start a course of treatment for many chronic conditions immediately before someone goes away because the chances of an immediate positive outcome are slim, but the chances of a short term disruption are often quite high. The last thing any of us wants is a patient with a reaction to treatment over a thousand miles away with no access to treatment.

We don't want to over-dramatise the situation, and in the vast majority of cases nothing would happen. However, simply in terms of being able to work incrementally with a patient building on the results of the previous treatment it doesn't make sense to do a single session and then wait a few weeks to follow up. If there has been some momentum then we want to be able to capitalise on this. Only in very acute situations of chronic pain or immobility do we feel that a one-off session is usually worthwhile.

However, if you use the postcode database search function on our home page www.acupuncture.org,uk you will find a number of BAcC member within easy reach, and it may well be worth your while contacting one or two with a view to finding someone better attuned to your needs ready for when you get back. It may be that they find something which is a kind of 'holding' treatment to take the edge off what you are experiencing without too much risk, and that could well make the different between a good journey and a great one.

We are very pleased to hear that you managed to stop smoking with the help of acupuncture. However, weight loss is a slightly more problematic area. We used to be asked about this a great deal, and a typical answer (probably an answer within an answer as we read it) which we gave was:

Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect on weight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problem and eastern diagnosis are the same is extremely difficult. In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.

However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someone lose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change. Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.

The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to give someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncture treatment that itself would be a very positive outcome.

There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.

This is probably the best advice that we can give. Our clinical experience is that their are often subtle emotional and spiritual issues underpinning the loss of control which people have of their weight, and some of these are amenable to acupuncture treatment. We have answered many questions on anxiety and depression, and we find quite often that a response to depression is to comfort eat. Helping with the depression may well reduce the desire to use food in this way.

One has to be realistic, however. Some of the psychological issues are not best suited by long term acupuncture treatment and really do need to be addressed directly by someone skilled in this area. There are also many occasions when the 'habit energy' to eat is so well entrenched that a direct intervention like hypnotherapy or cognitive behavioural therapy is appropriate because it goes straight to the point. We also have to tell some patients, sensitively we hope, that oaks breed oaks and willows breed willows. If a family are all size 18, then the chances are that trying to be a size 8 is not going to be likely.

The best advice we can give is that visiting a BAcC member local to you will be able to provide you with advice based on a brief face to face assessment. This is very likely to offer you the best range of options for you. All of our members are concerned to ensure that a patient gets the help they need, which is not always what they have to offer. We often refer to other colleagues if we feel something would work better. Each patient is unique, and finding what works for each individual case is the best guarantee of success.

This rather doom laden response was written at a time when there had been a proliferation of shops offering rapid weight loss, and we felt a strong need to rebut what we regarded as unsustainable claims. That said, it would substantially remain the same advice we would give now. The main benefit of acupuncture, we suspect, is to support people with the drive and determination to keep on track, as well as helping their systems to adjust to the positive changes which weight loss brings.

The one very solid piece of evidence in your favour is that fact that you managed to stop smoking with treatment. This is a very good sign, and encourages us to believe that you are likely to be someone who can benefit for weight loss. Results will not be impactful as the finite end of a habit, but as long as there is consistent progress and the treatment is geared to long term change (i.e. not weekly treatment indefinitely) we think that you may well find that acupuncture can help you.

If we took your question as face value as one about peripheral neuropathy then we might be tempted to use an answer we gave quite recently:

There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html
shows but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achievement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.

This is quite a useful start because it sets out some basic principles and also emphasises that for conditions like diabetic neuropathy in the language of modern sales talk, 'once it's gone, it's gone.'

However, without any further elaboration of the health condition which may be the root cause of your symptoms we would be looking at them as they were in  themselves and trying to make sense of them within the framework of Chinese medicine. As our factsheet on vertigo shows

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

there is a growing body of evidence which suggests that acupuncture might be of benefit, but even here we would say that vertigo is simply a label for someone's experience, and that once it is put in the context of someone's overall balance it can be the result of any number of possible imbalances from a Chinese medicine perspective. That is why we invariably recommend that someone sees a BAcC member for an informal chat. Most are happy to give up a little time without charge to discuss based on a first hand view whether acupuncture treatment might the best option for you. We have confidence that if it isn't they will say so. There are alternatives if this seemed to be the case.

It does illustrate very well for us, though, how working backwards from symptoms to a disease label can make a huge difference to how one perceives a problem. The great strength of Chinese medicine is that it see symptoms in their wider context as manifestations of the disease, not necessarily the disease itself.

If we took your question as face value as one about peripheral neuropathy then we might be tempted to use an answer we gave quite recently:

There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html
shows but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achievement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.

This is quite a useful start because it sets out some basic principles and also emphasises that for conditions like diabetic neuropathy in the language of modern sales talk, 'once it's gone, it's gone.'

However, without any further elaboration of the health condition which may be the root cause of your symptoms we would be looking at them as they were in  themselves and trying to make sense of them within the framework of Chinese medicine. As our factsheet on vertigo shows

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

there is a growing body of evidence which suggests that acupuncture might be of benefit, but even here we would say that vertigo is simply a label for someone's experience, and that once it is put in the context of someone's overall balance it can be the result of any number of possible imbalances from a Chinese medicine perspective. That is why we invariably recommend that someone sees a BAcC member for an informal chat. Most are happy to give up a little time without charge to discuss based on a first hand view whether acupuncture treatment might the best option for you. We have confidence that if it isn't they will say so. There are alternatives if this seemed to be the case.

It does illustrate very well for us, though, how working backwards from symptoms to a disease label can make a huge difference to how one perceives a problem. The great strength of Chinese medicine is that it see symptoms in their wider context as manifestations of the disease, not necessarily the disease itself.

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