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We are very sorry to hear that you have lost your practitioner after so many years. Sadly as we become a more mature profession this has started to happen a little more frequently. We know just how much people value the fact that there is someone who has seen them through a great deal and with whom there is no need to go over ground that is already long familiar.

In these situations we always advise people to contact other local practitioners, and for want of a better word 'interview' them. You will find that nearly all will agree to talking to you for a long enough time to see if they and where they work are to your taste, and if they won't then to some extent you have already saved yourself the bother of someone who probably isn't going to be the one for you. From the practitioner's perspective this makes perfect sense. You have shown a commitment to long term treatment, and as such they would be 'inheriting' someone who is very likely to be coming to them for some time.

Although it should be possible for any new practitioner to get hold of the existing notes we find that most patients and practitioners in this situation like to make a fresh start. We all have slightly different ways of approaching our work, and although case history is important there are other factors which are likely to be more central to a new beginning.

You will probably find that if someone has been around for a very long time there are going to be colleagues who have been inspired by him and try to emulate the way he worked. This might well make your selection a great deal easier because it is very likely that you will be directed towards people with whom he was in close contact. 

There is occasionally some merit in having a trial session. We knew of one practitioner whose manner with patients was wonderful but whose needle technique might have been described as 'brusque'. It is, after all, acupuncture that you are signing up to, so if someone really doesn't suit you in that department it would be good to find out sooner rather than later.

We hope that this helps and that you find someone who will last at least another thirty years.

As far as we are aware, the BAcC retains all the materials relating to complaints about a practitioner's conduct or behaviour indefinitely. There are very few each year, so there is no logistical problem about keeping them. The logic behind retaining them indefinitely is that if a pattern emerges over time then even where a complaint is not pursued or no ruling is made. 

The only minor complication would arise if the complaint were not to be about the conduct or performance of a practitioner but about the consequences of a treatment, i.e. the basis for an insurance claim. Along with most other healthcare professions members of the BAcC are required to retain their treatment notes for a minimum of seven years (or seven years after the age of majority for a child under sixteen, so theoretically as much as twenty three years) for insurance purposes. The insurers rarely have claims arising after three years from point of treatment, and although the insurance cover lasts indefinitely if the member was insured at the time, there are a number of data protection issues about holding on to historical information about past patients.

This might mean that although the BAcC may have a record of a complaint eight years ago and all of the attendant statements from the time, the primary record may no longer exist. In most cases this is not so; unless we are pressed for storage space we tend to hold on to files for much longer because people do return after a decade for treatment. There does come a point, though, where it is unreasonable to be holding personal information taken a very long time ago, and where there can be no real justification for hanging on to material.

We hope this answers your question. If you wish to re-visit the matter then you can always contact our Ethics Secretary on This email address is being protected from spambots. You need JavaScript enabled to view it. for specific advice.

There is no reason not to have acupuncture when suffering from diabetes.  There are no absolute contraindications of which we are aware, and we have seen no case reports of adverse events where acupuncture treatment has affected someone's diabetic control.

We do, however, issue a couple of cautions to members. The first is that if you see a traditional acupuncturist you are very likely to have treatment for the constitution as well as local treatment for the elbow. There is a small but mentionworthy risk that the treatment may stimulate the residual pancreatic function and cause an increase in body insulin. If this happens and someone has a balanced intake of medications it can force a slight hypo. This is more of a risk with insulin, where the effect is more rapid and a hypo really can cause serious problems. On the meds which people usually have for Type 2 diabetes this is less likely to occur.

The second issue is that long term diabetes can begin to impact on circulation and wound healing, and if the practitioner make a  judgement that this is beginning to be the case he or she may well choose to swab all of the points they use to protect against infection from the needle insertion. This is pretty much only a theoretical risk at best - in the UK there are almost no reports of infections from needle insertion - but where a theoretical risk exists modern best practice is to address it by swabbing. Otherwise we follow generally accepted practice in the NHS for not swabbing unless there is an identifiable risk where a patient might be more vulnerable.

We hope that this reassures you and that the treatment of your elbow is successful.

We would advise you not to worry too much about short term adverse effects after a first treatment. The vast majority of these are short-lived, and we would not be at all surprised to hear that by the time you receive this reply they will have gone. Our experience is that this usually only happens after the first treatment, and you should have no reason to feel any trepidation about the next treatment.

There are a number of possible explanations for this. When someone has had Western medical acupuncture, which we suspect is the case, there may well be some sinus involvement in the pain and the treatment may well have provoked some clearing of the sinus which, in this particular expert's personal experience, can be a very painful business. In Chinese medicine terms we often describe this as the energy of the area being reinstated, but because we treat the person, not simply the condition or pain which they have, there can often be secondary consequences as the system as a whole rebalances. Pathogens are often seen by the Chinese are 'going into' the system, so the process of health can lead to a reverse of this which can cause ripples in the energy as they leave. This can leave the patient feeling a little unwell for a day or two.

It is very important to let the practitioner know exactly what has happened. There may be aspects of the treatment which he or she can adjust. Some people are highly sensitive to treatment, and using fewer needles with less manipulation can make a big difference to the experience of the treatment without lessening the effect.

At any rate we hope that you feel comfortable with continuing, and hope that the treatment deals with your pain

We are very sorry to hear of your problem.

Long-lasting side effects from acupuncture treatment are very rare. Where these happen they are generally to do with the 'wound' of the needle, i.e. puncturing or touching a part of the body. Surface responses are usually transient, lasting no more than 48-72 hours. Where these occur it can result from one or two special cases. First is a possible allergy to the stainless steel of the needle. Needles are usually composite material, and one or two types contain a small amount of nickel to which some people are very allergic. This can trigger a response which can last for some time. The other possibility is that the needles has a silicon coating. This has been a modern development to make the needle insertion smoother, but again there are some patients who find silicon can generate nasty side effects.

Leaving aside the technical causes, there is a small chance that this is a reaction to the treatment in terms of the stirring up of energies which have raised but not removed an internal pathogen. It depends to some extent on the kind of acupuncture you were having - traditional or medical - but in our experience a medical acupuncturist can generate what we call an energetic reaction without having any idea that this is what they are doing. If this does happen, though, it does tend to dissipate relatively quickly, so it would be unlikely to be causing longstanding pain.

Another possibility is that there has been a failure of hygienic practice, and there has been some form of transfer of surface material to areas of the skin where it is not checked. We advise members to take extra care where someone has just had surgery, and to treat them as though they were immuno-compromised because the chance of infection is a little higher.

Finally, there is also a possibility that this has got nothing to do with the acupuncture and may simply be a coincidence. With over four million treatments a year there are going to be a number of cases where something just happens to start at the same time and a spurious causality is assumed. This always sounds overly defensive - 'it wasn't me' - but we have seen a number of cases where the problem simply could not have arisen from the treatment, however it may have appeared to be the cause.

The most important thing, though, is to find out what is happening, and for this you will need to get a referral to a dermatologist via your GP. It would be helpful if you can provide information from your acupuncture practitioner about where needles have been inserted because this will help to establish potential causal factors.

More than this we are sorry to say we cannot say. Sight unseen it is very difficult to give a definitive view when an adverse effect arises, but we hope that we have given you enough information to consider what might have been the case and to find an effective way to get rid of the irritation and pain.

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