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Ask an expert - general

232 questions

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.

It is a little difficult to say what might have happened to you without a slightly more detailed description of where the needles were applied. It is possible that the insertion of needles has left a small bruise or bruises deep within the tissue. If these have consolidated then it will be rather like kneeling on a grain of rice or piece of grit. This can have a disproportionately large effect for the size of the irritant. However, for this to be the case the needles would have had to be inserted in an area where we would not normally expect a needle to be placed. As we said, without knowing more specifically where the needles were placed it is difficult to be sure.

What we cam be more certain about is the fact that acupuncture treatment very rarely causes permanent damage to body tissue, and even where there is bruising this usually resolves within a matter of days. If a needle has been inserted into an area where there is subsequent pressure from direct contact or from the flexing of muscles then this might cause some discomfort, but this will soon pass.

The other option which we have to bear in mind is that a small piece of needle has been broken off and lies within the tissue. This would be highly unusual, because most practitioners, certainly in the UK, use single-use disposable needles which are discarded after one insertion. The only reasons a needle can break are faulty manufacture or repeated re-use and sterilisation. This can make the steel brittle, and more likely to fracture. We haven't seen or heard of a case in the UK for well over twenty years, and even that was hotly disputed. If you are based elsewhere than the UK, though, this might be a relevant question to ask.

In any event, the best person to discuss this with is the practitioner who applied the needles. He or she will know exactly where they were placed, and this will give a much clearer indication of what might have happened. 

Of course, we always have to bear in mind that a symptom may not be directly related to a treatment. With over 4 million treatments in the UK alone each year it is always possible that a problem, even in the same area, may not have been caused by the treatment. Our advice is always the same - if something persists for more than 48 hours it is worth getting a medical opinion rather than getting into discussions about what caused it.  The medical assessment usually reveals what happened and the patient can then get the appropriate help as soon as possible.

We hope that the problem resolves of its own accord and that it has not put you off having further treatment.




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.

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