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Ask an expert - body - chest

47 questions

Q:  I have been diagnosed as having torn rib cartilage. I am currently resting as much as possible (not playing golf or going to gym). I intend to do this until the end of the year to give it a chance to heal.  Could acupuncture aid the recovery?

A:  A great many people attend acupuncture clinics with problems such as this, injuries which are healing well by themselves but could possibly be helped by forms of treatment which might speed up recovery.  There is very obviously not going to be any research on which we could base an answer. There are a number of studies which we could cite which refer to acupuncture and electroacupuncture as modalities frequently used for cases such as this, and we are aware that many physioptherapists who treat such conditions  will use acupuncture within their scope of practice to good effect, but this does not mean that we could say with certainty that it would help your particular case.
 
What we can say is that the underying intention of all Chinese medicine is to restore function, both in the Organs of the body (note the capital letter - the Chinese medicine concept of the Organ is far wider than that used in the west and takes in mental and emotional functions as well as physical ones) and in the tissues of the body. You will find, therefore, that acupuncture is used for many musculo-skeletal problems, and these, in fact, topped the list of conditions for which people most frequently sought treatment in a survey published in the eBMJ earlier this year (http://bmjopen.bmj.com/content/2/1/e000456.full). It is possible, therefore, that the Chinese medicine understanding of injury as a cause of blockage in the flow of energy, or 'qi' as it is called, may mean that using needles could help clear the blockage and help you to regain full function earlier.
 
When patients present with problems such as this at clinics it is common practice to set a very clearly defined limit to the number of sessions in the first instance, and to set measurable targets for recovery, to assess whether the treatment is having an effect. 'Feeling better' or 'feeling easier', while informative, is not really an adequate marker. A great many things can make people feel better, and nothing beats a measurable outcome, like moving a limb further or lifting a greater weight without twinges. We are not suggesting that people push themselves hard to see if they are getting better; like snakes and ladders, this is more likely to make them worse again. Most people, though, would be able to find something at the top end of the safe range of movement which would provide a good marker.
 
The best advice is to visit a BAcC member local to you for a brief face to face assessment of your current state to see whether they think that treatment may be of benefit in your specific case. 
 
 

 

Q:  I have swelling on my left side of my ribcage for over 2yrs.  I've had every test, scan, X-ray going, all of which has come back normal. My partner suggested acupuncture to relieve to pain.

 

A:  One of the great strengths of Chinese medicine is that it looks at the functioning of the body and mind in an entirely different way from conventional medicine. When someone presents with an unusual symptom for which all of the standard tests come back normal, there is often something in the way in which the symptom presents which is picked up in the diagnostic systems which Chinese medicine uses. These are premised on the belief that the body mind and spirit are all manifestations of an energy which the Chinese call 'qi', whose flow and balance is critical to good health. When the qi of the body is compromised in its flow, causing excesses and deficiencies in specific areas or suffering from blockages, symptoms and pain will result. The skill of the practitioner resides in being able to make sense of what is happening and then use needles to re-establish the correct flow.
 
The practitioner would ask a great deal more about your past medical history and the events in your life leading up to the problem emerging. Their own diagnostic tests, taking the pulse at the wrist, looking at the tongue and palpating the area to discern what kind of swelling you have, would be augmented by detailed case history to see how this might fit with other patterns of your daily life and with your personal history in the months prior to the problem emerging. There is almost always a causal background,, and even though someone could do worthwhile treatment based simply on what they observe, the patient's own account of how things developed is crucial to refine the treatment and make it more effective.
 
Sight unseen and with the few details you provide we wouldn't hazard a guess about what might be going on. We recommend that you visit a BAcC member local to you and seek their advice in a brief face to face consultation, and we trust that they will offer you a sensible and objective view of whether they can help, and if not what other alternatives there may be.
 

 

 

 

 

Q:  I have mild asthma but I believe this is well controlled. Related problems centre on excesss mucus production which means I have a permanent cough. This excess mucus production appears to relate to particulate matter e.g. dust, smoke, and chemicals e.g. scented candles, perfumes. Allergy tests show I have no problems with most biological materials e.g. cat, dog, feathers etc but a mild allergy to grass pollen. Could acupuncture help me?

 

A:  There is a growing body of research which indicates that acupuncture in conjunction with conventional treatment may significantly improve the symptoms of allergic rhinitis. Our factsheet please click here
 
 
gives details of a number of studies which show very encouraging results, although at this stage there are not enough nor enough of sufficient size to warrant an unqualified claim for benefit.
 
One of the great strengths of Chinese medicine, however, is that it is premised on understanding symptoms within the context of the functioning of the body as a whole. That is not to say that conventional medicine doesn't, but quite often specialisation means that the focus on problems and their treatment is quite narrow. In Chinese medicine excess mucus production in an area of the body is seen in its wider context, and very often as a problem which manifests in one place but is actually a consequence of a systemic weakness. The practitioner's aim would be to establish whether this was the case, and if so treat the underlying problem, without doing which local treatment would sometimes not achieve sustainable results.
 
Our best advice is to visit a BAcC member local to you and seek their advice on whether acupuncture could be of benefit to your specific circumstances. It may simply be that the tissues in the upper respiratory tract have become hyper-sensitive over the years to the kinds of allergens which cause you problems, and the research trials seem to indicate that the mixture of acupuncture and conventional medication can help to bring this under control. If, however, there are broader patterns of imbalance the practitioner can advise you more accurately based on what is going on within your system as a whole.
 

Q:  I am looking for a qualified acupuncturist for my dad who is 73.  He has bilateral vocal cord paralysis and is encoutering breathing difficulties even though he has had a cordotomy.  Can you help him?

 

A:  There are a relatively small number of studies which report successed in treating vocal cord paralysis, two examples of which are
 
http://www.ncbi.nlm.nih.gov/pubmed/2741280
 
http://www.ncbi.nlm.nih.gov/pubmed/848460
 
The abstracts of the papers do not cite the exact treatments used, and both speak of acupuncture being used in conjunction with other forms of treatment. In one paper, as is commonly found to be the case, the use of acupuncture alongside the conventional treatment appears to speed up the patient's recovery.  However, it is best to consider these papers as indicative rather than conclusive; there are no large scale studies which make a confident prediction possible. A great deal will also depend on the extent of the cordotomy. The operation is not supposed to interfere with a patient's vocal capacity if they recover naturally, but as with all surgical procedures there is an inherent risk that some of the changes are not reversible.
 
We suspect that some of the treatment offered in the studies was local, i.e. in the area near the problem, and this can often be very effectively in stimulating a return to good function. However, a practitioner may well want to establish whether this is simply a local problem or whether this is the tip of a much larger iceberg - this would have implications for how much treatment may be required and whether it is worthwhile attempting to address this as a local issue if there is a backdrop of much more extensive imbalance.
 
If we were being brutally honest we would say that treatment may be more in hope than in expectation, but acupuncture treatment has a reputation for occasionally achieving unexpected but significant results,. so we would be happy to advise you to seek a face to face assessment with a BAcC member local to you who can give you a much better assessment by looking at the problem and your father's health in the round. 
 
 

Q:  Can accupuncture help relieve regular and sometimes continuous heart palpitations called supra ventricular complexes?

 

A:  There is not a great deal of published research on supra ventricular complexes as a general grouping. Occasionally studies such as this one:
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312232/on atrial fibrillation show some encouraging signs of the effectiveness of acupuncture treatment. It has to be said, however, that the repeated use of a specific point to treat a problem would be highly unusual in Chinese medicine, and this can often be a problem when research shows positive results, and even more so when it shows inconclusive results. We are reluctant to make a fuss about research of this kind which seems to be successful but the kind of treatment which we do, which is dynamic and evolutionary, i.e. changes in relation to feedback, will never satisfy the requirements of the western gold standard of research, the randomised double blind control trial, and is rarely applied in testing efficacy.
 
That said, palpitations have been around for thousands of years, and Chinese medicine has built up over this period some well defined syndromes which make sense of their occurrence from a Chinese medical perspective. Even when as a symptom it cannot be immediately assigned to a clearly defined pattern the initial premise of Chinese medicine was that symptoms were merely the alarm bells of internal disharmony, and that balancing the system as a whole was a legitimate strategy for reducing or removing them. In practice treatment often operates on both levels at the same time, supporting the specific problem while ensuring that the system as a whole is balanced and can retain the gains which have been achieved. It would be worthwhile seeking the advice of a BAcC member local to you in a short face to face chat to see what their view of the appropriateness of treatment is.
 
One cautionary note is that many patients have prescribed medications for PSVT-type conditions, and are very keen not to have to take them. We advise our members to be very careful not to let people's enthusiasm get the better of them. The consequences of an attack, as you know well, can be severe and debilitating, and not the sort of thing you would want happening at 70mph in the outside lane of a motorway. If the incidence of episodes reduces with treatment the patient should be referred back to the GP for advice on how best to reduce their meds.  
 
 
 

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