Ask an expert - body - chest

45 questions

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.  
 
 
 

Q I suffer from atrial fibrillation and have heard that acupuncture can help restore the heart to its normal sinus rythm. Is this the case? If so how would I find an acupuncturist who specialised in this field?

 

A: There are some early indications that acupuncture may have an anti-arrhythmic effect in patients with atrial fibrillation. A study published earlier this year
 
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312232/
 
concluded that there appeared to be benefits and that further large scale trials would be valuable to test the hypothesis more carefully.
 
However, it is only fair to say that needling a single point such as Neiguan repeatedly is not a fair representation of what a traditional acupuncturist does in practice. Although there is considerable overlap between eastern and western systems the arrhythmia typical of AF could be classified in several different ways within Chinese medicine, and the practitioner would be guided by evidence other than simply a reading of the rate of the pulse. That in turn would mean that ten people with AF might receive ten different treatments. To that extent, it is not that straightforward to extrapolate from research studies like this and conclude that 'acupuncture works'. 
 
The skill of the practitioner lies in making sense of the symptom of AF within an entirely different theoretical framework, and understanding each presentation in each individual patient as unique. The best advice we can give any prosepctive patient is to contact a BAcC member local to them to seek a short face to face consultation at which they can be given a better assessment of whether acupuncture might benefit them.
 
The one caution with AF is that most patients are taking some form of medication to control the problem, and the cessation of medication can quickly provoke a return of the symptoms. For people involved in highly technical or responsible work this might represent a serious risk. We would always recommend that any member contemplating treating someone with a condition like AF should talk to the patient's GP to esnure that nothing they do will undermine the current treatment regime. 
 
 

The majority of cases of venous insufficiency involve the circulation in the lower limbs, and while there is very little specific western research on this, we have to remind people that Chinese medicine has dealt with problems liek this for centuries, and has a number of treatment strategies for problems in which this is one of the symptoms.

 

 

It is important to be aware that Chinese medicine operates from an entirely different conceptual basis in which the flow of energy, called 'qi' in Chinese, is central to the effective flow of all body fluids and to the overall balance of the system. The practitioner of Chinese medicine uses his or her skills to try to determine how the system is out of balance and then devises treatment strategies to correct imbalances. In some cases this is symptom led, and in other cases, the treatment is much more general, aimed at correcting the overall balance premised on the simple belief that when a system is in balance, symptoms repair themselves.

 

The best course of action is to visit a BAcC member local to you to seek their advice on whether your particular case makes sense from a Chinese medicine perspective and what they would advise. In many cases acupuncture would be an appropriate treatment, but there may be other options which a practitioner may recommend as better suited for what specifically troubles you.

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