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I have been suffering from intense heel pain in both feet now for 6 years.

Q. I have been suffering from intense heel pain in both feet now for 6 years. I've been through years of physio/insoles/MRI/surgery etc in attempts to find the cause. Research now leads me to consider peripheral neuropathy. 15 years ago I suffered an almost terminating attack of Guillain-Barré Syndrome and I wonder whether this may be involved. I live on Hampshire/Surrey border. Could I get some recommendations for expert acupucture in this area, specialising in Peripheral Neuropathy.

A. The first thing to say is that there are only a couple of areas where we take specialism seriously - paediatrics and obstetrics - and where are are eventually likely to recognise expert training. Chinese medicine is by its very nature generalist because we treat people with conditions, not the condition itself. In that sense we are all qualified to treat everything, although we have to be very careful how we say this because treat implies cure, and treating people with, for example, cancer is not about curing so much as maximising the body's balance. It's an easy misunderstanding to foster.

That said, many problems present locally against a backdrop of systemic weakness, so some protocols emerge which can be applied within the overall context which we would primarily treat. We have been asked about peripheral neuropathy on a number of occasions, and a typical answer has been

There is some evidence that acupuncture may be helpful in the treatment of neuropathy, as our factsheet

shows 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.
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 achievement 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.

From a conventional/western perspective it is quite possible that the Guillain Barre episode has resulted in nerve damage, and to that extent there may be a limit to what is achievable. We do come across cases, though, where the disruption in the flow of energy as we see it produces a pain which is assumed to arise from a broader condition someone has. Once people get a disease label it seems quite common to refer everything back to it. This is why we always recommend in cases like yours that a chat with a local BAcC member is always worthwhile. It is sometimes possible to see signs of blockage which would encourage the view that treatment may help.

We always have to be realistic, though, and after 15 years of unrelenting pain it would be a long shot for acupuncture to do the trick quickly. This does leave you open to the possibility of running up a large bill in the attempt which achieves nothing significant, so if you do decide after talking to someone to go ahead we would recommend that you try to find as objective as possible an outcome measure of progress and agree regular review periods before you start.

Good luck!

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