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Q: I have had a cough now for about 7 months. I've been to the doctor several times, have taken antibiotics and had blood tests and xrays - nothing showed up.

A:  We are assuming that you have had all of the investigations which are available. The one you have not mentioned, and which is another quite frequent cause of a persistent cough, is a hiatus hernia or other stomach-related problem which leads to acid reflux. This can also be a cause of a persistent cough, along with a post-nasal drip and asthma.
 
If none of these has been identified as a cause, or even if they have, there may be some merit in looking at acupuncture treatment. There is not a great deal of evidence for the treatment of coughing, but this is mainly a reflection of the many different causes of coughing and the difficulties of designing a trial which generates meaningful results. Persisitent coughing has certainly be a symptom recognised within traditional Chinese medicine, and if it appears alongside other symptoms and alongside the diagnostic evidence which a trained practitioner will find using Chinese medicine techniques, there are a number of clearly defined syndromes which offer treatment protocols to address the underlying patterns.
 
Even where there is no recognised syndrome, it is important to remember that in its earliest forms Chinese medicine was asymptomatic, i.e it treated the patient as a whole based on the diagnostic evidence and not necessarily with regard to what they reported. In this way the treatment could truly be said to be unique. The underlying premise was symptoms only appear when the system as a whole is out of balance, and because of the internal patterns of energy flow, a symptom may not necessarily arise where the actual problem lies. The skill and art of the practitioner is to go to the root of the problem and once this is treated, there should be an improvement in the symptoms.
 
We would recommend that you get the stomach checked first, however, to see if this is the cause because this may offer rapid treatment solutions in conventional medicine. However, we still believe it would be worth your while talking to a BAcC member local to you to see if they feel they could offer you help, because most of the conventional solutions suppress the symptoms rather than clear them, and if there is an option which aims for a restoration of normal function this may be worth trying.  
 
 

We were asked this question once in relation to xerostomia induced by radiotherapy, and our answer was, taken from our factsheet on palliative care and further supplemented:

Dry mouth (xerostomia)

A systematic review found possible benefits with acupuncture for radiotherapy-induced xerostomia (O’Sullivan 2010). Not all the inter-group differences were significant but this is typical in trials comparing acupuncture with sham acupuncture, for the latter is commonly viewed as being an active treatment itself, not a placebo, and hence may underestimate the effects of the therapy (Lundeberg 2011; Sherman 2009; Paterson 2005).The RCTs to date are few in number and small in size. Although they have produced encouraging results, and are supported by observational studies (for example, Meidell 2009), larger trials are required to achieve more robust evidence. Acupuncture may also help with xerostomia dysphagia (swallowing difficulty) in late-stage palliative care (Filshie 2003).

 there is some evidence for the value of acupuncture treatment for dry mouth after radiotherapy, and the two studies below certainly seem very positive.
 
http://www.ncbi.nlm.nih.gov/pubmed/23104718
 
http://www.ncbi.nlm.nih.gov/pubmed/22072272
 
Clearly there is a considerable difference between the kinds of functional disturbances caused by disruption of the balance of the body's energies through normal wear and tear and the kinds of damaged brought on by injury or accident. This does mean that it is more difficult to predict whether acupuncture treatment might be of benefit. Treatment of the kind used in the studies tends to be localised or precisely targeted, and this can mean that it does not really conform to the patterns of treatment which a Chinese medicine practitioner would employ. In broad terms, however, acupuncture treatment is aimed at putting the whole system back in balance with the underlying belief that a body in balance tends to deal with symptoms itsef, and on this basis it may well be worth talking to a BAcC member local to you to see if a combination of systemic and local treatment may, in their view, be of benefit. Most BAcC members are more than happy to give up a little time without charge to give a face to face assessment of whether treatment would help.
 

There is a chance, of course, that the xerostomia which you are asking about is not related to cancer treatment. From a Chinese medicine perspective this makes no difference. The understanding of the dhe nechanics of the disruption of the physiology of salivation from within the Chinese medicine paradigm will be the same whatever the cause, although the cause, again seen from this perspective, may have a considerable impact on the treatment. By this we mean that radiotherapy might be seen as a cause of great heat and dryness within the system as a whole or locally, and this would almost certainly feed into the treatment strategy.
 
As we said above, speaking to a BAcC member local to you who can assess the problem face to face may well be the best option for you before committing to treatment.  

Q:  This may seem like a daft question but anyway  I had 7 teeth removed from my lower jaw and had a bone graft and dental implants on a bridge of 10 teeth. The thing is that I'm having great difficulty getting used to them and my tongue doesn't know where to go. Could acupuncture help in any way?

A: This is one of the more interesting questions we have been asked, if not intriguing!
 
We could, I suppose, make a case that acupuncture treatment is always seen as restoring natural balances, and that as such it might help the tongue to find its 'proper place', but ancient Chinese medicine was not familiar with bone grafts and dental implants, so this might be a bit of a stretch. There are certainly points on the body which were traditionally said to promote the healing of bone, and there is also good evidence for the use of acupuncture treatment to reduce inflammation. However, nothing we can find in the research literature suggests that it might be the answer to your problem.
 
The one thing which does occur to us, however, comes from our use of tongue diagnosis. The system depends on an understanding of changes in the colour, shape, size and coating of the tongue which reflect the changes in the internal Organs. There are a number of relatively common syndromes where the tongue can become quite swollen, many of which reflect a weakening of the Yang energy of the body which people might experience as tiredness or lethargy. It is just possible that your tongue is not so much confused by the additional hardware in your mouth but reflects the fact that you are a bit run down from the surgery. The feeling of a swollen tongue is one that people often experience whenthey are exhausted and can't quite seem to enunciate properly.
 
There would be no harm in asking a BAcC member local to you if they can see anything in your overall energy patterns which might be contributing to this feeling, but we suspect that it will settle down of its own accord eventually, irritating and uncomfortable as it must seem now.  
 

As you can imagine, we have been asked this question on several occasions, and our replies have not been that encouraging. The fact sheet which we have on the website
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/tinnitus.html
 
is quite upbeat about a number of small studies, but our clinical experience is not as good, with tinnitus among the more intractable conditions with which patients present. In a recent answer, to which we can probably not add a great deal more, we said:

A. Tinnitus is one of the more intractable conditions which people seek acupuncture treatment for. Our Tinnitus fact sheet, found at lists a small amount of research which suggests that acupuncture may help, but there have been no significant trials which provide solid evidence. It is also fair to say that many practitioners are very cautious about taking on patients for whom tinnitus is the primary problem. It is quite easy to spend considerable time and money and be no better off than when you started, and the individual case reports in the tinnitus sufferers' magazines often have the same shape.

However, what many practitioners do find when treating people with tinnitus is that while the noise remains largely unchanged their ability to cope with it seems to improve. Evidence for this is largely anecdotal, though, and it would be wise to discuss carefully with any future practitioner whether they think that they might be able to help. In all events we would recommend that frequent and regular reviews of outcomes and progress are essential.

We don't think you can say more than this. There are two or three clearly identifable patterns in Chinese medicine, described as syndromes, where tinnitus is a specific named symptom which frequently appears, and it is possible, if your tinnitus has arisen as a part of the syndrome, that there may be some help which acupuncture treatment may offer. An experienced practitioner should be able to make a very straightforward determination on whether this is the case. Overall, however, there is not a great deal of cause for optimism about getting rid of the unwanted noise.  


 

Q:  My husband has just been diagnosed with unilateral vocal chord paralysis caused by a virus. His voice is vey weak and hoarse and surgery is not an option for at least a year.  Does acupuncture work for this condition?

A: There are a relatively small number of studies which report successed in treating vocal cord paralysis, two examples of which are
 
Please click here:
 
Please click here: 
 
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. 
 

Your husband's situation is not quite so drastic as this case, and there may be some greater hope that treatment may encourage a return of some of the lost function. Acupuncture treatment will certainly not do any harm, and since there are a number of functional disturbances seen from a Chinese medicine perspective which impionge directly on the effective use of the voice, it may be that an experienced practitioner can see a direct intervention which may help. Even in the absence of a direct connection, the underlying premise of Chinese medicine, the treatment of the patient rather than the illnss, may offer some possibility of a speedier recovery.
 
It is best to talk to a BAcC member face to face, though, to get a more accurate assessment of whether acupuncture treatment may be of benefit, and we are confident that you will receive honest and impartial advice.
 


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