Ask an expert - general

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Q: I have had sciatica since the birth of my baby 5weeks ago and have not got any better and the pain is almost unbearable despite painkillers. However my physio today gave me acupuncture for the first time and whilst there is still a lot if pain there is some relief at last. She is due to come again in a week but I wonder if a week is a bit long and does acupunture benefit from more regular treatment than weekly at this stage?

 

A:  It is certainly the case that in China, where acupuncture is often provided as an outpatient facility in hospitals, acute conditions are treated daily for five or ten days. Although this is quite difficult to arrange in the UK for reasons of convenience and cost, many practitioners will see someone two or three times a week if the situation warrants it.
 
However, it is important to bear in mind that it is quite common for people to have a day or two where symptoms continue after treatment and even on occasion get a little worse, and it is really only possible to assess how well a treatment has taken after everything has settled. The analogy of the mud at the bottom of the pond is often used. Clearing it can make the water far more polluted for a couple of dats but then the residues settle and you can see what difference there has been.
 
At this early stage it might well be helpful if you could have an additional session, but if you can hang on for another day or so you may well find that the improvement continues enough to be able to hang on till next week. If, however, you get a 24 or 48 hour improvement which then settles back to the levels of pain you experience before you should let your physio know and discuss with him or her what the best course of action is. 

 

Q:  My daughter is suffering from a virus similar to glandular fever, causing tiredness, headaches and aches. Will acupuncture provide her with any benefit?

 

A:  The Chinese had no concept of virus or viral infection, but grouped the symptoms together and understood them as affects of the climate, because extremes of climate or rapid changes of climate induce symptoms similar to those we describe as colds or chills. The vocabulary which describes this, such as 'invasion of wind cold' or 'invasion of damp heat', is very much a part of colloquial Chinese vocabulary and accepted as an explanation for someone's illness.
 
As far as treatment is concerned there are protocols which have been used in China for over two thousand years. However, to our knowledge there has been little systematic research of their efficacy, partly because of the short term nature of the condition and also partly because most acupuncture research is western-medicine based, and there isn't a clear-cut enough named condition to meet the requirements of the randomised control trial.
 
As far as treatment for your daughter is concerned, acupuncture would certainly do no harm. Indeed, many children are treated with acupuncture and respond very well. There are two cautions, however. First, it is very important that acupuncture treatment is not substituted for any western medical or care your daughter is receiving unless it is with the knowledge and consent of her GP. Second, your daughter's age has a bearing on the treatment. A teenager will respond to treatment very much in the same way as an adult, and can be treated very much the same. Younger children tend to be more reactive, and also experience their illness in a slghtly different way. Although we do not yet recognise experts or specialisms in professional acupuncture a growing number of our members undertake postgraduate training in treating children, and it may be advisable to see someone who has had this training. That is not to say that any BAcC member cannot be effective, simply that it may be better if the person who treats your daughter has experience of treating children on a regular basis.
 
The best course of action is to ask a BAcC member local to you if someone has this experience and then seek their advice. We do not maintain a database of people specialising in treating specific groups, but our members are usually very aware of who locally provides this kind of service.    
 

Q:  Is there any evidence that acupuncture can help with peripheral neuropathy and if so is there a distinction between chinese and western acupuncture?

 

A:  There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet shows here
 but this is not yet compelling enough for us make a firm recommendation. If you google for results from the US National Centre for Biotechnology Information, a very useful research resource, as 'ncbi acupuncture peripheral neuropathy' you will find references to a number of studies, some of which seem to show very positive results, others less so. Treating nerve damage with acupuncture, however, suffers from the same limitations as any other therapy. If the damage is already considerable there is less chance of reducing the pain and loss of sensation.

 

Western and Chinese acupuncture operate from entirely different conceptual bases, although in practice many of the acupuncture points they use will be in the same places. Most western acupuncture is based on a neurophysiological understanding of acupuncture, that its effects are caused by stimulation of local and distal nerves. There are other variations on this theme, but in essence the practitioner works with a western medical diagnosis and very often uses needles in and around the affected area. Chinese acupuncture is based on a theory of energy, called 'qi', and its flow and balance in the body. This can often mean that the needles used in conditions like peripheral neuropathy are often local to the problem and seen as a blockage in the flow of qi, but Chinese medicine has an elaborate understanding of the functional nature of the internal organs, understood entirely differently from in the West, and will often look at how the problem may also be a manifestation of a wider functional disturbance in the system. Then, of course, you have the underlying premise of the original Chinese medical systems which were largely asymptomatic, regarding the achevement of overall balance as the primary aim in the belief that this would deal with symptoms wherever they manifested.

 

The important element in treating peripheral neuropathy is understanding the physiological basis for its appearance in western terms and being realistic about what may be achieved. If this amounts to maintaining the status quo, or even as one very wise patient expressed it 'getting worse slower', then as long as this is the agreed basis for treatment, that is fine. Our members are trained to avoid raising unreal and unreasonable expectations in people with degenerative conditions or permanent physical damage. Talking to a BAcC member local to you face to face may be the best advice if you are considering treatment. They should be able to assess relatively quickly whether acupuncture was a worthwhile option for you.
 
 
 
  

Q:  I'm wondering if acupuncture could solve my problem which is centred around vertigo/dizziness/tinnitus. 30+ years. Recently found I have spondilosis in my neck, which has cast a new light on the condition.

 

A: A great deal depends on the extent of the spondylosis and the extent to which it may be impinging on the nerves in the neck and causing problems. That may limit the prospects for change or improvement. However, the fact that there is a malformation in the neck may not in itself be directly linked to the balance and tinnitus problems you suffer. It is quite common for people with bad backs to have X-rays showing arthritic deterioration of the lower spine and to have a causal connection made between the arthritis and the pain. It may well be, but on the other hand most people over 50 have some arthritis, and it is not a necessary consequence that they have pain, nor that the pain derives directly from the arthritis.
 
Chinese medicine has an entirely different understanding of human physiology from western medicine, based on the flow of energy, called 'qi', and its balance throughout the body. The organs of the body are understood differently too, not simply physical objects doing a physical job but having a number of functional aspects which manifest in mind body and emotions. A skilled practitioner would want to know exactly what kind of tinnitus, what kind of vertigo and what kind of dizziness and then related these as symptoms to their own readings and observations to determine whether there were functional, rather than structural, reasons why you may have experienced these problems for such a long time.
 
They may well conclude that it is the physical structure which causes the problem, in which case treatment may be limited to attempting to reduce some of the spasms and inflammation which invariably accompany spondylosis to reduce the secondary effects. They may refer you onward to an osteopath or chiropractor, whose work focuses on structural matters, to see if anything can be done to free the cervical spine. However, they may also be able to offer some reduction in your symptoms if these are related to functional disturbances. There are an increasing number of reviews and studies, a good example of which is
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136456/
 
which offer encouragement in the potential for acupuncture in the treatment of a range of balance and ear problems.
 
Our best advice, however, is to visit a BAcC member local to you to get a more informed face to face assessment of whether treatment may be of benefit for your specific problems. 
 
 

 

 

 

 

Q:  Do you know of accupuncture being used to treat/ help with the pain of Peyronie's disease. (pain/lumps/curve of penis). As a person I know in SA says it has helped him

 

A: Your question is very specific, i.e. can acupuncture help with the pain caused by Peyronie's disease? Although pain relief is one of the most frequent uses of acupuncture in conventional medicine as well as traditional chinese medicine we have never come across any references to the use of acupuncture for pain relief in Peyronie's. It is no doubt possible that some individuals will find that acupuncture is beneficial, but a great deal will depend on the degree of fibrosis in the penile material and whether the condition is in an acute or chronic phase. There is no doubt that acupuncture cannot do any harm, but if you did decide to see whether this would be of benefit here it would be sensible to have a small and finite number of treatments to determine the extent to which acupuncture relieved the pain and how sustainable the change was.
 
As far as treatment of the condition itself is concerned there is no evidence that acupuncture has been used successfully in more than the odd case to bring about improvements. The major treatments are surgical, and there have been more recent attempts to use ultrasound to break up the plaque. There are also a number of drug treatments in use, and some anecdotal evidence for high doses of vitamin E and some herbal preparations. The evidence remains poor, however.
 
There is a small possibility that needling directly into areas such as this might effect some change, in the same way that acupuncture is occasionally used to help deal with serious scar tissue, but to needle the genitalia would immediately breach the codes of conduct of all professional bodies in the UK of which we are aware. If anyone offers this treatment to you, you would be well advised to exercise considerable caution. 
 

 

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