Ask an expert - general - swelling

6 questions

A:  This is quite a difficult question to answer without knowing a little more about the swelling. There are all sorts of reasons why a thyroid gland can swell, from a benign cyst which can be drained through to the goitres one would associate with Hashimoto's Disease or Graves Disease. If we are talking about the latter, where the swelling is a part of a larger pattern of pathological changes in the body, then acupuncture may be more relevant but the advice less specific.

If this is a pattern of thyroid enlargement causing hyperthyroidism (over-active thyroid) then the evidence from research for the use of acupuncture is not that encouraging or plentiful. Our factsheet

cites three studies which address some of the more common manifestations of hyperthyroidism, but while the results are quite positive the samples are too small to generalise.  there are some Chinese studies of the treatment of benign thyroid nodules, and these again, while encouraging, are quite small.

However, one of the great dangers in trading in symptoms from a conventional medical perspective is that it does not do justice to Chinese medicine theory which has developed over 2500 years. Thyroid problems are not new, and although the ancient Chinese would not have understood hormone levels and thyroid function as we know it, they would certainly have made sense of all of the symptoms associated with thyroid hyperactivity, and would have been able to address them within the system of medicine. That does not mean that they would always be able to treat them successfully, and we have to be very careful not to let our maxim of 'treating the person, not the disease' lead people to believe that anything is possible. However, it does mean that there is a chance of bringing the symptoms under control.

However, without more specific information we would struggle to say more. It may simply be a benign swelling, in which case there may be more cause for optimism about what treatment can achieve. What we always say, though, is that if you are on medication for thyroid malfunction we always tread with great care. It can take a long time to achieve a good working balance from a diseased thyroid, and treatment can affect a good balance which has taken months of establish. We tend to work as closely as we can with a patient's medical team to ensure that everything is managed to maintain a good and stable pattern.

The best advice we can give is that you pop along to see one of our members local to you. This will give you the best chance to describe in greater detail what is going on and to be able to get from them a better idea of what may be possible. 

A:  From a Chinese medicine perspective the $64,000 question is what is causing the fluid retention, and your question illustrates perfectly how difficult it is to take a symptom by itself and offer a view about its treatability. There are a number of reasons in Chinese medicine why someone might start to retain fluid, many of which track back to under-performance in one or two organs (we capitalise the word because an organ in Chinese medicine is not simply a physical object but a description of a range of functions in body, mind and emotion). The fact that we can then say that a spleen or kidney is under-performing leads to the next level of questioning: what is it about
the overall balance in the person's system which causes this part to malfunction? Is the problem in the organ itself, or is it caused by another organ not working well and having a knock-on effect?

This again leads to questions about the person's lifestyle and daily routines. As an example, many cases of fluid retention track back to the Spleen, which in Chinese thought is responsible both for sending fluids around the body and also for holding things up, a sort of internal gravity. When it does not work well, fluids gather and tend to sink, so many people end up with swelling in the middle and lower part of the body and then related problems like varicose veins. The Spleen does not thrive on cold and damp conditions, so a diet rich in raw fruit and vegetables, dairy produce and other cold, damp foods will already put pressure on the Spleen even if it is healthy,
and in one which is already under-performing push it a stage further into malfunction. Treatment might then be supplemented by dietary advice.

However, this is jumping the gun! The very first thing that a practitioner might do would be to look at the circulation in the area, not just the blood circulation from a western point of view but the energy circulation from a Chinese medicine perspective. There are often functional disturbances behind problems like this, but there can also be much simpler superficial disturbances, the treatment of which can be much more straightforward.

To have a really good idea of what is going on, and to avoid guessing at how problems like this might respond to treatment it is always best to trot along to a local BAcC member who with very little investigation will probably be able to offer you a reasonably accurate estimate of what may be possible after looking at your feet and asking you a number of questions. Crucially they will also be able to take the pulse at the wrist and look at the tongue, both Chinese methods of diagnosis that can very rapidly point to major areas of disturbance and change. On this basis they are likely to be able to give you a fairly good idea of what may be possible.

Q:  Is there a treatment for fibrolipoma.(large midline subcutaneous cervico-dorsal lipoma measuring 15.5(cc)x71.(AP)x16.3(Tr)CM in size

A: There is little or no research evidence to suggest that acupuncture treatment can be used with fibrolopomas of this size, indeed little or no evidence for the treatment of fibrolipomas at all. However, this does not mean that they have not been treated, simply that there has been no systematic attempt to gather a trial group together and test acupuncture against a suitable control group.
Traditional acupuncture is premised on the flow of energy, called 'qi', whose flow and balance is seen to be integral to the maintenance of good health and absence of symptoms. Where conditions like fibrolipomas develop, this is generically viewed as a blockage in the flow, and also at a very generic level often seen as an accumulation of fluid, called Damp in Chinese medicine, which has become more solid under the influence of Heat or other factors to form Phlegm, the Chinese name for these kinds of lumps and bumps.
In theory, there are both systemic and local treaments for dealing with these problems, and all of us have good anecdotal accounts of addressing problems like these on a relatively small scale. However, if we have read the dimensions correctly, this is an immense growth, and we would not expect acupuncture treatment to make a great deal of impact on such a lipoma. When things have reached this stage, surgical options may the best thing to consider. It might be worth establishing whether there is an energetic imbalance which contributes to the pattern, so that after surgery there is more chance of ensuring that the fibrolipoma does not return, but we do not think that acupuncture would be a very good primary treatment for the problem.      

Q: My left ankle and foot often swell up a lot.   This happens most often in times of hot weather, if I have had less than about 6 hrs of sleep at night, during or prior to my period and with alcohol consumption.   It is usually very uncomfortable - creating a feeling of pressure and 'dull ache' around my ankle and up my leg.   I was told by someone who suffers similar symptoms that this may be due to my lymphatic system not working or draining properly (this is what she was diagnosed with). I am a  29yr old female, and do light exercise.   I am wondering whether acupuncture could help. 


A: Although systems of medicine can be entirely different in their basic frameworks and understanding of how the body works, all start from the same point - the symptom with which a patient presents at the clinic and the observations and tests which the practitioner makes within the system they use. Your pattern of symptoms is certainly one which would immediately suggest three or four possibilities to a Chinese medicine practitioner, and their first thought would probably be to look at other aspects of your physical health and function to see what else was going on. It is rare for symptoms to stand alone; there is generally a pattern affecting the body in a number of ways. although a patient may not think this was so. The failure of the short term memory or a recent tendency to bruise quite easily might not seem particularly relevant, but were either of these to occur alongside what you are experiencing a practitioner might find them to be useful confirming evidence.




Even where there is not a direct connection to a specific malfunction in the system it is important to remember that the essence of traditional chinese medicine is to achieve balance in the whole system with the simple premise in mind that a system in balance does not generate symptoms. many practitioners work in this way equally as successfully as those whose training is more syndrome focussed.




Our best advice to you is to visit a BAcC member local to you and seek their advice. From what you describe very clearly, there are a number of factors which make your problem manifest which point to imbalances in the system, and we would expect one of our members to be able to give you a very clear idea of whether you could benefit from treatment.




Q:   Can an  armpit lump be treated by acupuncture sessions. On average how many sessions are requried for such kind of health conditions ?


A:  Our first response to this question would be to ask whether you have had this problem examined by your GP. Any unusual lump on the body needs to be examined carefully, and especially in the areas where there is a concentration of lymph glands. If you have not done so already we advise you to see your GP soon to have the lump examined. The majority of lumps are benign but if this indicates a problem the sooner it is dealt with the better.
From a Chinese medicine perspective there are a number of systemic reasons why lumps appear, and also local blockages. In either case a practitioner should be able to give you a rough indication of whether they think it can be treated with acupuncture and if so how likely it is to resolve. Most BAcC members are very careful not to commit patients to extended treatment unless the treatment is showing signs of really benefiting the problem, and most again would not go beyond four or five sessions if there was no real sign of change. They would at very least review the position with a patient at this point.
It would be impossible to say how many treatments would be needed, however. There is such a large variety of possible causes, some of which might be easier to treat than others. we advise you to seek the advice of a BAcC member local to you. They will be able to give you a much clearer idea in a brief face to face assessment. 

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