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47 questions

Q:  Are there any adverse effects of acupuncture on pacemakers?

A:  As far as we are aware, there have been no reported adverse events from the use of manual acupuncture alone in relation to pacemakers. We publish a guide for our members' use which adds background advice and best practice suggestions to help them to comply with the Code of Safe Practice, and the advice we give there relates only to electro-acupuncture (EA):

Patients who have a pacemaker should not be treated with electro-acupuncture since there is a risk that the electrical stimulus of the acupuncture device may interfere with the pacemaker

If you search the internet you will find case reports such as this one:

http://www.ncbi.nlm.nih.gov/pubmed/21386114

which suggest that EA is safe to use for pain relief even when a pacemaker is fitted, but also reports such as

http://www.ncbi.nlm.nih.gov/pubmed/7471851

which suggest there is a measurable effect from using EA with a pacemaker in place.

The leading authority on EA in the UK, David Mayor, recommends in his comprehensive textbook on electroacupuncture that EA must be absolutely contra-indicated for anyone using a demand led pacemaker

 

 

Q: My 34 year old daughter has suffered with asthma and eczema to a greater or lesser degree for most of her life.   She has also had a skin condition for a year or so which I understand is called Prurigo Nodularis.   She is having perscribed treatment under the NHS which involves medication and UV light treatment.  In particular her main discomfort is the itchyness particularly at night time. I wonder if acupunture could improve this situation ?

A: We have been asked about prurigo nodularis a couple of times, and our most recent answer was:
 

 

Can acupuncture help in treating prurigo nodularis

 

There is not a great deal of evidence that acupuncture has been used successfully for treating this condition. This becomes very clear when you undertake any searches for evidence. There is a single paper for the use of acupuncture and hypnotherapy ('hypnopuncture')

 

http://www.ncbi.nlm.nih.gov/pubmed/21598842

 

which is cited over and over again without any further additions, a certain sign that there is no other evidence. We are sure that there are probably a large number of trials which have been undertaken in China, but the great majority of these have not been translated and are often regarded in the West as methodologically flawed.

 

However, skin diseases are as old as mankind, and the systems of Chinese medicine do have ways of interpreting the signs and symptoms of diseases like prurigo within its framework. These often use terms like 'invasions' of 'heat', 'wind' or 'damp' which sound alien to the western ear but describe the effects of climate (as experienced by a largely agrarian population) on the flow of energy, called 'qi', especially where this disrupted the flow, rhythm and balance near the skin surface. Everyone is aware of the short term effects of exposure to extremes of climate, and from a Chinese medicine perspective, whether this is the primary cause of a problem, or whether there is an underlying weakness which makes particular people vulnerable, the skill of the practitioner lies in assessing the overall balance as well as the presenting symptoms, and attempting to restore balance.

 

The best advice that we can give you is that you visit a BAcC member local to you for a brief face to face assessment of the problem. Crucial  to this assessment will be whether the problem is local or widespread. In broad terms, the more localised, the more treatment options there are. We would also recommend that you might want to see advice from someone who also does Chinese herbal medicine. The majority of the members of the Register of Chinese Herbal Medicine are also BAcC members. We say this because herbal medicine has developed a very good reputation over the years for treating skin conditions, the daily dose of herbs helping to maintain a treatment momentum. It may be that a combination of acupuncture and herbal medicine may prove a more potent force in helping your problem, but to what extent would depend on a more thorough assessment than we can give here.

 

We would not want to add anything to this advice about the prurigo, but the fact that it has appeared against a longstanding backdrop of asthma and skin problems suggests that it may be quite a difficult condition to influence. As our review paper on the use of acupuncture for the treatment of asthma shows

 

 

 

there is a growing body of evidence that acupuncture may be of benefit. However, there is a close correlation between ashma and ezcema in Chinese medicine which suggests a constitutional weakness which may impact on how successful treatment may be. That said, there are a number of what we call 'empirical points', points which have been discovered over the years to have specific effects no matter what the underlying constutional position may be, and one or two of these have been shown to be highly effective at reducing itching across the body, especially where this is impacting on someone's sleep.

Q:  I have recently been diagnosed with coronary artery disease and unstable angina, for which I have been prescribed a raft of drugs. Please can you advise me as to whether acupuncture would be appropriate treatment, and if it would whether it could offer an alternative route to all the drugs.

A:  We have to say straight away that all of our members are under strict instruction not to interfere with prescriptions issued by a patient's GP, either by asking them to change or stop or, as importantly, supporting a patient's decision to stop taking a drug which may be life sustaining. There are, of course, a huge number of medications prescribed on a 'use as needed' basis, and if someone finds that acupuncture treatment means that they can do without the meds, so much the better.
 
In your case, however, both conditions carry a high risk factor if untreated, and it would be potentially very dangerous to stop taking your prescribed medications. That does not mean that acupuncture cannot help, and if you did decide to go ahead with treatment, you may well find that some of the symptoms are relieved. The problem you would then have is to convince a doctor who has made the prescription that the acupuncture, and not the medication, has had the desired effect. Most will conclude that the drugs are working, and be all the more reluctant to let you stop.
 
The best course of action is to discuss with your doctor what might be possible by way of a planned reduction over time, and what markers they would be looking for, whether these be achieved by medication or acupuncture. In this way it remains an open question as to what is working, but the end result is the same.
 
We have to say, though, that with both of these conditions, the chances are that the doctor will not entertain a reduction unless there were very significant and measurable changes in your heart function which made him or her confident that you were a very low risk.
 
As far as the symptoms themselves are concerned, there is a small amount of research for the use of acupuncture, but as this systematic review
 
http://www.ncbi.nlm.nih.gov/pubmed/23427379
 
clearly says, there would need to be many more trials of greater power and number to assess properly whether acupuncture is a viable treatment option.
 
It may well be worth talking to a BAcC member local to you, though, because a face to face assessment will be much more helpful than what we can offer at a distance, and we are understandably cautious when we have to work from brief descriptions of a problem.
 
 

Q:  Have wondered if acupuncture would help with hay fever. I have been given steroidal nasal spray (by doctor) for severe running eyes and nose. Don`t want to keep the steroids up. Tablets (anti-histamine) make me very drowsy, although they advertise that they shouldn't.   I also seem to be alergic to dust etc.

A:  Hay fever is usually grouped under the generci term 'allergic rhinitis', and as the BAcC fact sheet shows
 
Please click here

 it has been a frequently researched condition over the years because the diagnosis is easy to make from the cluster of symptoms and willing patients are plentiful. Unfortunately a great deal of the research is on too small a scale or methodologically flawed, so the results are often inconclusive, encouraging but some way short of saying that acupuncture is guaranteed to deliver. There are a number of reasons for this to do with the level of evidence required in the West, the randomised control trial, which is not the best way to assess traditional acupuncture, but even allowing for that, our clinical experience is that there are patients for whom treatment makes not a jot of difference.
 
That said, allergic rhinitis is not a new phenomenon, and Chinese medicine, which developed in treating people whose lives were mainly spent outdoors, has a number of ways of understanding how the  symptoms present in terms of the systems of Chinese medicine and also how this can derive from a number of systemic weaknesses. This latter enterprise has been the subject of a great deal of debate amongst modern practitioners as the number of environmental factors which can create similar symptoms has escalated alarmingly. In short, Chinese medicine has a number of strategies for dealing with the various presentations of the condition, and also a way of looking at the overall health of the patient as a potential underlying factor which predisposes someone to the problem. This means that in many cases treatment is aimed at the person, not the symptoms, a strategy which underpinned a great deal of the practice of the ancients.
 
The received wisdom inside the modern profession is that it is better to commence treatment before the time that the condition, if it is seasonal, would norally present, and our clinical experience has been that once the condition has kicked in, a reduction in the severity of the symptoms is the best that one can hope for. If the condition is always present, it can sometimes be a long haul to bring the system back to a point where the symptoms are minor and bearable.
 
Each sufferer is unique and different, however, and the best thing you can do is to find a BAcC member local to you and arrange for a brief chat so that he or she can establish whether acupuncture treatment might be of benefit to you.
 
 
 
 
 
 

Q:  My 31/2 year old soon has chronic coughing, doctors are note sure if its asthma yet. But he coughs all winter and vomits with it so he has lost a lot of weight. Antibiotics, steroids etc don't seem to help and so I'm looking for safe alternatives. would acupuncture help with this? he also has an IGA deficiency. Im desperate .

 

A: As you can see from our quite detailed review paper on bronchial asthma
 
Please click here

in amount of evidence that acupuncture can benefit someone suffering from asthma, although as the introduction says, there are insufficient trials to be able to make positive recommendations and equally a number of methodological problems about setting up meaningful tests of acupuncture if there is insistence on using randomised controlled trials which are more appropriate for drug testing.
 
However, the most important point to make in this context is that children are not simply little adults for the purposes of making a diagnosis in Chinese medicine, and there are some quite sophisticated ways in which the developing child's energy is understodd in Chinese medicine terms. This can sometimes offer treatment possibilities which may not be applicable to adults, and may be able to offer a little more hope than one might want to give in the case of an adult. A fundamental problem is that once people are dependent on medication for the treatment of asthma it is very difficult to make a case for stopping the medication, since in western medicine this is perceived as increasing the risk of a potentially fatal attack.
 
Chinese medicine has been dealing with the same problems as western medicine for over two thousand years, and there are a number of different protocols for the treatment of breathing problems which a skilled practitioner might employ. Even treatment at a constitutional level, in the simply belief that a system in balance rights itself, may offer possibilities.
 
We do not recognise specialisms because we have a commitment to generalism - all of our members are capable of using Chinese medicine effectively with any patient they see. However, over the last thirty years a significant number have focused their work on specific target groups such as women in pregnancy or children, and there are a number of postgraduate courses which we are currently examining in detail to assess whether our members can lay claim to expertise in their advertising. We cannot give recommendations for individual practitioners until and unless we agree these standards, but there are two or three well-known courses which maintain databases of practitioners who have met the appropriate standards, and we are fairly sure that if you google 'acupuncture' and 'treatment of children' you will see the main ones. You might also usefully add your location to see if anyone who has undertaken this training works near you.
 
Based on what you have said we believe that there may be some benefit which your son may derive from acupuncture treatment, but there is no substitute for a face to face assessment, and if you can find someone suitably trained near you they will almsot certainly be able to advise you on the best options for your son, whether this involves acupuncture treatment or other forms of complementary medicine such as cranial osteopathy which is also used for many children's health problems.

 

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