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Q:  Please could you advise whether acupuncture is effective for dry eye syndrome or melbomian gland disfuction. I suffer from both these conditions and haven't had any relief from pharmaceutical medicines. I have read that acupuncture can help relieve symptoms,  but I'm not sure if it can help me.

A:  There is a small amount of research in the west into this condition, and a systematic review published a few years ago
 
http://www.ncbi.nlm.nih.gov/pubmed/20337604
 
concluded, as they invariably do, that there was insufficient evidence and that larger and better trials were necessary. Without going too much into the politics of research, it would be fair to say that we have serious reservations about the models of research favoured in the west, which don't really work that well with traditional acupuncture practice, and equally fair to say that even these inadequate models never attract the funding necessary to run larger trials.
 
However, dry eyes are a symptom as old as mankind, and the ancient Chinese has a number of ways of understanding how this symptom could arise. This rests, of course, on an entirely different understanding of the physiology of the body which is itself based on theories of the flow of energy, called 'qi', which is controlled by the functions of the Organs of the body. A practitioner's skill lies in determining whether a problem such as this is a sign of a local blockage, or whether it forms a part of a wider pattern of systemic unrest which needs to be treatment to get to the core of the problem. Indeed, in some of the older systems of traditional acupuncture, symptoms were not integral to the treatment plan; the practitioner treated the person in the simple but effective belief that a system in good balance repaired itself.
 
Our best advice is that you visit a BAcC member local to you to get a face to face assessment of your specific presentation, and whether the practitioner thinks that based on this acupuncture treatment may be of benefit to you.   
 

Q:  I have been told that I have wear in my 5th and 6th vertebra can acupuncture help this. I have also been told I have positional vertigo could it also help this?

A: Starting with positional vertigo, as our factsheet shows there is some evidence that acupuncture treatment may be helpful, as our factsheet shows:
 
 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/vertigo.html

 

There are a number of conventional treatments for positional vertigo, however, and some of these are well worth a go. Many involve peculiar sequences of movements to remove or re-position little bits of debris within the canals of the ear which appear to be linked to the problem. Acupuncture can help where there is evidence, from a Chinese medicine perspective, of some blockage in the flow of energy around the ears which, whether a local problem or systemic one, could be moved by using needles and reduce the impairment which causes the spinning feeling on movement.

 

The presentations of vertigo tend to be unique to the individual, though, and the best advice is to visit a BAcC member local to you for a brief face to face assessment of whether they think treatment may benefit you.

 

As far as the wear and tear in the 5th and 6th vertebrae is concerned, we're not sure which ones you're referring to, the cervical spine (neck) or the thoracic spine (back). If your cervical vertebrae are worn there is a possibility that you may suffer from some minor impingement which could cause secondary problems in the upper arms and neck. If this is affecting the movement of your neck and head it may be associated with your vertigo, although this would be a long shot.  In either case, what's gone has gone, and the best that acupuncture treatment might achieve would be some reduction in the inflammation and discomfort caused by the narrowing of vertebral gaps and attendant pressure on surrounding tissues. The only question would be how much relief from the discomfort, and how sustainable it turned out to be. If the effects can last weeks rather than days, there may be some value to having regular treatment.

 

The question which always manifests for us is that most people over the age of 50 have significant wear and tear in the spine, and it is not always the case that pains which appear in that area are directly caused by what the X-rays or scans show. If that was the case then it would be inconceivable that someone would improve, but we have encountered many clinical situations where the deterioration has remained but the symptoms have all vanished. The strength of Chinese medicine is that it is based on an entirely different view of how the body functions, and this can sometimes provide explanations for symptoms where conventional medicine is unable to explain adequately what is going on (this cuts the other way, by the way - the modern understanding of brain function, for example, explains problems which to the Chinese must have defied their attempts to understand and resolve). 

 

Again, however, we have to say that you are best served by seeing a BAcC member local to you for a face to face assessment of what might be possible. 
 

 

 

A:  We are not quite sure from your question whether you are referring to a nasal drip or post-nasal drip, and also whether you have this an an allergic reaction or as a non-allergic condition. As a systematic review of treatment options for both allergic and non-allergic rhinitis demonstrates
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121056/
 
a great deal more research has been undertaken into the allergic variety, and acupuncture tested more for this than for the non-allergic kind, where only one significant trial has been done. Our own BAcC factsheet offers a comprehensive summary of the allergic rhinitis tests.
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/allergic-rhinitis.html
 
However, while the evidence from trials on both conditions remains inconclusive but encouraging, the real strength of Chinese medicine lies in its entirely different paradigm or way of understanding the body, mind and emotions as an integreated whole. When someone has a symptom like a nasal drip, the symptom itself will only make sense in the wider context of the energy of the body, and could in this case be a functional disturbance in the mechanisms, from a Chinese medicine perspective, which control the flow and accumulation of fluids in the body, or a wider disturbance in the system as a whole which equated to what we might describe in modern terms as a weakness in the immune system. The skill of the practitioner lies in being able to make sense of the symptom in the context of the other diagnostic signs, and offering each patient a treatment programme unique to their own needs.
 
With not much to go on by way of context all that we can say is that we have treated people who have presented with this as a main symptom, so it does not fall into the category of 'not worth trying'. However, to get a sense of whether acupuncture will work for you, it would be best to contact a BAcC member local to you and seek a brief face to face consultation, hopefully without charge, in which they can offer you a better and more informed view of whether acupuncture treatment might be worthwhile for you.   

A:  We had a very strong temptation to say 'no', but a quick piece of internet research revealed a number of case studies such as this one
 
http://www.ncbi.nlm.nih.gov/pubmed/20569038
 
which may give some hope.
 
Our reasons for thinking that 'no' would be the best answer are rooted in our clinical experience that many people come to us having had polyps removed several times, and after each removal there is a short period of grace after which the polyps reform. To us this seems rather like harvesting an unwanted crop which will simply keep on growing.
 
From a Chinese medicine perspective polyps are seen either as a result of local blockages in the flow of energy, or 'qi' as it is called, or as one of a number of symptoms pointing to a systemic problem with specific Organs (capitalised to distinguish the concept of Organ in Chinese medicine from the slightly more limited understanding of organs in western medicine). In either case there is a possibility that treating the local blockage or tonifying the whole system may clear the accumulated fluids and make then less likely to recur. However, our clinical experience has not been that great, and we have often wondered how much the peristent attempts to deal with things by surgery has piled complication upon complication in trying to deal with the problem.
 
You could certainly not do any harm by visiting a BAcC member local to you and getting a more accurate face to face assessment of what might be possible than we can give here, but if you did decide to have treatment as a consequence, we would recommend clearly defined outcomes and frequent review periods to ensure that you do not get locked into a long sequence of treatment with little or no change being visible.  

Q:  Can acupuncture help with optic nerve atrophy and if so are there any specialists in London?

A :  A recently published meta-analysis
 
http://www.ncbi.nlm.nih.gov/pubmed/23545824
 
makes some very encouraging noises about the use of acupuncture treatment alongside conventional treatment, but concludes, as does every systematic review or meta-analysis, that more research needs to be done, and on a greater number of subjects.
 
However, we are always cautious about the kind of trials which generate these results. The gold standard applied to western scientific research is the randomised control trial, and to make these work, the treatment has to be standardised and the condition under investigation has to be the only outcome variable. Whatever else the patient may have by way of health related issue is discounted. From a Chinese medicine perspective, both of these positions are not best practice. Treatment is dynamic and evolutionary, building on the progress, or lack of it, and refining the treatment as it goes along. The symptom which serves as the focus of the research is also seen in a far wider context, and it would not be surprising if twenty people with optic nerve atrophy had twenty different diagnoses from a Chinese medicine perspective. The symptom is only an alarm bell which alerts the practitioner to patterns of imbalance or blockage, and these will be unique to each individual.
 
This means that we have to be careful with research studies. Many will be unfairly inconclusive, but equally others will be falsely encouraging, building on a fortuitous outcome that the patients selected for a small trial happened to have treatment which helped their underlying patterns.
 
Good Chinese medicine aims to understand the appearance of symptoms in disturbances of the function of Organs (capitalised because an Organ is seen a complex collection of functions which embrace some of the physical ones we understand in the West but many which affect mental and emotional factors), and the practitioner uses their art and skill to determine what the driving force behind the complex pattern of disharmony is. In some cases this will show direct connections with the symptom, in others only a complex pattern in which the symptom is a weakness exaggerated by problems elsewhere.
 
The long and short of it is that the best advice you are likely to get for the treatment of a condition such as this will come from a brief face to face assessment from a BAcC member local to you. It is probably true to say that the best you might achieve is a reduction in the rate of deterioration or a stable but not deteriorating state, but at this remove we cannot really say. If you did decide to have treatment it would be very useful to establish markers by which any change can be monitored, and also review periods to make sure that the treatment is being regularly assessed for outcome and value.
 
As far as practitioners are concerned, we do not recognise fields of specialism. From our perspective our members as generalists are all equally well equipped in Chinese medicine to deal with the full range of problems which people bring to their clinics. We have one or two fields like obstetrics and paediatrics where we are shortly to recognise standards of expert practice, but we do not have short term plans for other specialties. There are one or two members who focus their work on people with eye problems, an while we cannot give specific recommendations, it is a simple matter to track them down through google. 
 
 
  

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