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Q. Energy has been a problem for most of my 69 years. I read that acupuncture may help. My GP only uses acupuncture on muscles, & cannot help. My Question is: Does an acupuncturist attend extra training to learn about energy? Are you aware of those who qualify in this acupuncture speciality? Many thanks.


A. We have to be a little careful with our terms here. Traditional Chinese Medicine has a clear understanding of the body, mind and spirit as different forms of 'qi', a word which is very difficult to translate, but which if often described as 'energy', or 'vital life force'. This is seen as the base material of everything, and through its different forms and their inter-relationships, described by using terms such as yin and yang, a complex understanding of the person on all levels is derived. Similar terms such as 'prana' and 'ki' are found in Inidan and Japanese thought. Acupuncture treatment is aimed at improving the flow of qi, removing blockages and sorting out relatuve excesses and deficiencies.



However, this is not quite the same as the 'energy' which people talk about when they say that they 'have no energy'. It's very true that feeling an utter lack of energy can be understood as a a problem with the qi, but that doesn't necessarily mean that it is something which a Chinese medicine practitioner can automatically sort out. What it does often mean, however, is that the paradigm of Chinese medicine is sometimes able to make sense of someone's symptoms and lifestyle in a way which is wholly unlike the way that western medicine views the person. The sense of feeling depleted and lacking the energy to do things is described in several of the syndromes and patterns recognised in Chinese medicine. Your best course of action is to seek out a BAcC member local to you and ask their advice on whether your specific and particular patterns are amenable to treatment.

Adverse events arising from acupuncture treatment are quite rare. Safety surveys published in the BMJ a few years ago showed a likelihood of less than 1 in 10,000 of an adverse reaction to treatment. However, that does not mean they never happen.



In the first instance you should go back to the practitioner whom you are seeing to let them take a look at the problem. If the practitioner is a BAcC member he or she will be sufficiently trained in western medicine to recognise whether this is a temporary transient reaction or one which requires referral to a doctor. It will be useful to establish whether the part of the body where the inflamed spots are was in contact with any soaps, creams or lotions which might have penetrated the skin barrier. Since all the needles used by BAcC members are pre-sterilised, used once and then disposed of, the only way that a puncture point could become infected or inflamed would be from the needle carrying something from the skin surface into the dermis, or the puncture points not 'sealing' immediately after the treatment and something on the skin surface passing the outer payer of defence.


As a general point inflammation does not necessarily mean infection, and there are a small percentage of patients whose skin can react to needles in this way. This reaction is more often than not transient.

Q. I have had an on going hip and leg problem since the summer. I am now seeing a local physiotherapist who on my last visit suggested acupuncture, as the needle first went in to my buttock my leg went numb for a second or so, I just wondered if this is a normal response or should I avoid acupuncture with him in the future?


A. People can experience a range of sensations when they are needled. People frequently describe a dull, aching numbness where the needle has been inserted, and in China this is seen as a necessary component of successful treatment. Other patients report a mild tingling sensation.



The sensation is most often local to where the needle was inserted. In some cases people can report that the sensation 'travels', and the pathway usually follows the channels or meridians which are described in Chinese medicine for the flow of energy. Some Chinese practitioners use a quite vigorous form of needling to create this effect in what they term 'propagated needle sensation', often used to treat a problem from a distance and often where someone wants to help an affected limb.


It is possible, therefore, that your physiotherapist has, consciously or not, achieved this sensation in using needles which, if they are being inserted in the buttock, are likely to be longer and more substantial than the needles that practitioners customarily use. The other possibility is that the needles have been used at a depth which has got close to the sciatic nerve, and the sensation arises from the proximity to the nerve. It won't have been a direct hit on the nerve, which you would have experienced as an electric shock.


The important point is that the reaction lasted only a second or two. Unusual as it is, this may still be worth putting up with if the improvements you get from the acupuncture outweigh this slight disbenefit. If, however, you find this disconcerting, you can simply ask the physio not to use needles again.

A great deal depends on the relationship between the various symptoms you have and the Arnold-Chiari Malformation Type I which you have. If the symptoms are arising directly from the malformation it is highly likely that acupuncture might have minimal effect other than perhaps to reduce their severity. As you will see from the factsheets of evidence here for vertigo and headaches, there is a gathering body of evidence that acupuncture may be of value.



Tinnitus is a different matter. Although the factsheet here offers a small hope the reality is that tinnitus can be one of the most intractable problems to address, with many people investing huge amounts of time and money to no avail and then experiencing a total loss of symptom for no apparent reason.

Given the specific nature of the malformation you have, however, if you did decide to have acupuncture treatment your practitioner would benefit greatly from talking to your consultant(s) to detemine how much of your symptom pattern derived directly from the physical fault, and how much might simply be contingent. This would enable them to give a much clearer answer to how much they think they might be able to help you.

Q. I have three "issues" (!) that I think acupuncture may help to overcome: addiction to micotine, generalised anxiey and also I am trying to become "more fertile", after a bad miscarriage 6 years' ago. Obviously, smoking isn't helping on either the pregnancy or anxiety front. Can you tell me whether acupucture is particulrly successful re. stopping smoking?


A. The evidence for acupuncture helping people to stop smoking, either traditional acupuncture or ear acupuncture, is not that great. This was certainly the case when the BMA researched conditions for which acupuncture was effective over a decade ago, and nothing new in the field of acupuncture research has been published since to change that view.



However, research for areas such as nicotine addiction or stress tends to employ a model of treatment which is rarely similar to the ways in which a traditional acupuncturist normally works. The use of formula points, the same ones applied time and time again, does not square with traditional treatment which is developmental and evolutionary - the results from a session help the practitioner to refine the diagnosis and inform amendments to how they treat the patient on the next visit. This is all premised on a system of Chinese medicine which aims to balance energies in the body in the simple belief that a system in balance tends to see a reduction in the symptoms which arise from underlying disharmony. Various forms of addiction, anxiety states and system failures are seen as the alarm bells of disease, and treatment is aimed at correcting the underlying patterns.


It is often worthwhile talking directly and in person to a practitioner to get a sense of whether your own individual case is something which they believe they might be able to help. Using our 'find a practitioner' search on the website or your local Yellow Pages should identify a number of BAcC members working in your area.

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