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235 questions

There is no statutory regulation of acupuncture, and the only registrations which a practitioner has to have relate to the various pieces of skin piercing legislation which apply across the UK. These set standards of hygience and safe practice with which a practitioner must comply.

In most of England, Wales and Northern Ireland the Local Government Miscellaneous Provisions Act 1982 amended by the Local Government Act 2003 applies to all acupuncturists except those who are also doctors or dentists. A practitioner pays one-off fee for every practice which they set up. All authorities inspect premises on registration, and many conduct regular inspections.

 

In Greater London, the London Local Authorities Act 1991 applies, and everyone must pay an annual licence unless they are a statutorily regulated practitioner. such as a doct, physio or nurse, or unless they belong to an exempt body by virtue of meeting strict organisational criteria. The BAcC is an exempt body.

 

In Scotland skin piercing regulations introduced in 2006 under the Civic Government Act 1982 mean that all acupuncturists except statutorily regulated healthcare practitioners must pay an annual licence.

 

Although there have been recommendations from three working groups to regulate acupuncture by statute, the Secretary of State's latest statement in February 2011 congratulated the acupuncture profession on its robust self-regulation and announced that there were no imminent plans to regulate the profession further.

Q. I had a shoulder replacement (just the ball of the joint) done one year ago. It has remained extremely painful, and I am unable to move my upper arm more than 30 degrees without pain. My surgeon says that I fall into the 5% of cases where there is no clear cause that can be rectified, and that I should consider having a full shoulder replacement. However I am reluctant to do this as there is a 30% chance of it failing within 10 years, and then there is very little they can do, as the bone around the socket will be too weak to take a further replacement. I am 62 and hope to have at least 20 year's active life ahead of me, if not more. Otherwise, I am healthy and fit.

Would acupuncture help with pain relief in this instance?

 

 

A. We have to be a little cautious about answers to questions about pain per se rather than named conditions in which pain is present. As you are probably aware healthcare professionals of all persuasions are governed by strict rules of what counts as good evidence in advertisng and marketing, and there is no specific evidence on which we could base an unqualified positive answer. However, much of the research into acupuncture in the early days was about its capacity to reduce pain, and the results, both on humans and animals, meant that it has continued to remain a worthy focus of attention for at least forty years.

 

From an eastern medical perspective pain and inflammation are usually described in terms of blockage or stagnation of energy, and the practitioner's task is simply to try to move the energy with needles and in some cases moxibustion to try to improve the flow. There are certainly a number of protocols used to free frozen shoulders which may have an impact on what you are dealing with, but in general the strategy is often the same as that used by western professionals in conventional healthcare, breaking the cycle of restriction, inflammation and pain which perpetuates itself. In your specific case there may also be issues with the way that the muscles are functioning around the new joint; the shoulder joint is much more heavily dependent on an exact balance of muscle than the more pronounced ball and socket of the hip, and it often takes an extended period of exercise and physiotherapy to regain full movement.

 

In Chinese medicine each case is regarded as unique, and a practitioner will always want to see the overall picture before making any projections about how effective treatment may be. Your best course of action would be to consult a BAcC member local to you to let them take a look at the problem to see whether in your case there is something which acupuncture might do. We are sure that if they feel that acupuncture would not be the best option they will have other positive suggestions about other forms of treatment that may be of benefit to you.

 

What counts as a good outcome may need to be carefully defined. For most people the outcome is fairly clear - 'I want the pain gone' - but in some cases it is a case of pain management, and the judgement has to be whether the extent and sustainability of relief after treatment warrants the time and expense. Regular reviews of what is happening are essential to ensure that everyone is clear about and happy with continuing treatment.

Post-herpetic neuralgia is a highly unpleasant condition. Acupuncture has been used for a number of neuralgias, for some of which we have prepared factsheets on our website, but the factsheet for post-herpetic neuralgia is still in preparation. There are some encouraging signs from recent research, as in this Italian study of severe pain during the zoster attack

 

 

http://ukpmc.ac.uk/articles/PMC3125389//reload=0;jsessionid=Hmmss672XQCZjw7C1cgg.4

 

but no conclusive evidence accepted in the West as yet on which we could base a firm recommendation.

 

However, post-herpetic pain has been around as long as mankind, and the diagnostic systems of Chinese medicine have been used for many centuries to make sense of the way that the pain presents. Treatment is often a complex mixture of treatment local to the area of pain and more systemic treatment to correct the imbalances from which the treatment stems.

 

Whichever system of medicine is used to treat post-herpetic neuralogia a practitioner will always be understandably cautious about the outcome. This is one of a number of conditions which can prove intractable to treatment, and while it is fair to say that a central question for an acupuncture practitioner is how much change and how sustainable, for conditions like these there is often a period of short term relief which is not progressive, i.e. treatment will achieve the same result but not necessarily extend that period of relief. We expect our members to be alert to this kind of situation and to comunicate clearly with patients about their findings. After all, even a short period of relief may be something which a patient is prepared to accept, but it is important that this becomes the clear understanding of what is happening.

 

One of the great strengths of Chinese medicine, though, is that it treats the person, not the disease, and since from this perspective everyone is unique, as is their disease pattern, there will be cases where more progress may be possible. Seeking advice from a BAcC member in a brief face to face chat may be the best way to establish the extent to which acupuncture may be able to help your specific case.

Q. i have had a slight (chronic) discomefort in my bum whilstdriving for the past 3-4 years.started playing squash again after a couple of years off, first 5-6 games fine, last one agonising. pain in the bone i sit on. internet says ISCHIAL TUBEROSITY which is 99% correct.would accupuncture be any good?

 

 

A. The first thing a medical practitioner of any persuasion would have to do would be to establish exactly what was causing the pain you are experiencing. The fact that it has come on after a renewed burst of heavy exercise would normally point in the direction of some kind of muscular strain or tear, or inflammation of a tendon or ligament. Spending a long time sitting in a fixed position with the pressure of the ischial tuberosity on an inflamed area would certainly be capable of generating some fairly intense pain. However, pain can be referred in all sorts of ways, and the sciatic nerve might have been affected higher up in the lower back with the pain manifesting in the buttock.

 

A BAcC member will generally spend a good deal of time trying to elicit what type of pain it is, where it is felt, what makes it feel better or worse, and so on, both to get a sense of the western pathology which this most likely represents and to inform the treatment strategy which they will adopt from a Chinese medicine perspective. BAcC members are required to work closely with orthodox healthcare professionals and with other complementary therapists, and if in the practitioner's point of view there is something which needs to be investigated further by X-ray or something which manipulation may help to correct quickly, you may be referred to a doctor or osteopath. If not, the practitioner will give you an honest assessment of whether he or she thinks they can help you.

 

There is a growing body of evidence for the use of acupuncture for pain, for sciatic pain in particular and for musculo-skeletal conditions, although most of this research originates in China and is regarded as methodologically unsound at the moment. Our factsheets on the BAcC homepage under 'research' and 'factsheets' will give you a detailed breakdown of the current evidence and its index of reliability. In this particular case, if you decide to go ahead with treatment, it is probable that you may be asked to stop playing squash for a while to give the problem a chance to recover

Q. Hi,I have nerve damage to my Greater Auricular Nerve and Cranial nerve 5, after surgery to remove a whartins tumour on my right Parotid gland, I cannot take any appropriate medication due to bad side affects, can Acupuncture help me to relieve the pain.

 

 

A. Generally speaking, where pain arises from nerves damaged by surgery there are no straight answers about how successful acupuncture may be. In the treatment of phantom limb pain, for example, there are a number of studies such as

 

http://aim.bmj.com/content/22/2/93.abstract

 

which seem to indicate that needling the opposite limb can make a great difference to the pain experienced. You describe damage rather than complete cutting, and that may be far less amenable to treatment.

 

From a Chinese medicine perspective the areas which are painful are understood within a framework of flows and patterns of energy across the body, and there is some possibility that a practitioner might be able to make sense of what you are feeling, and where, within this context. If so, there may be some possibility of reducing the amount of pain that you experience.

 

The best course of action, since each case is unique and different, is to visit a BAcC member local to you for an informal asessment of whether in your particular case there is a something which they feel they might be able to help. It might also be worth discussing with them what side effects you suffer when taking medications. Occasionally people use acupuncture for the nausea which some drugs induce, and the evidence for this us is now widely accepted in the west.

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