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Ask an expert - muscles and bones - back / spine

66 questions

Q:  I have an exposed nerve in my lower back due to wear in my lower spine. I have been told I need a spinal steroid injection which I dont want. Could acupuncture give me any relief?

 

A:  Spinal steroid injections can be helpful for some groups of patients while offering limited benefit to others. As this study shows
 
http://www.ncbi.nlm.nih.gov/pubmed/15363419
 
there is no doubt that it can help, but a great deal depends on the extent of the deterioration and where its exact location is.
 
Acupuncture treatment can have some very positive benefits for lower back pain and for sciatica, as our factsheets show please click here

and please click here

and as we are sure you are aware it is now amongst the recommended treatments in the NICE guidelines for lower back pain. However, there are limits to what any form of treatment can achieve in the face of extreme deterioration of a spinal joint, and you would almost certainly need to be assessed face to face by a practitioner for them to be able to give you an informed professional view on whether they could help you.
 
It is important to be aware, however, that Chinese medicine as a system operates on an entirely different basis from conventional medicine, using concepts such as 'qi', a description of the energy of the body, and of flow of energy around the body. The practitioner will want to know not simply where things hurt now, but how the whole system is working and why the back has deteriorated in the way it has, along with what other symptoms you nay have. All of this information will help them to build up a comprehensive picture of your system and give you the best possible advice on the advisability of acupuncture treatment.   
 

Q:  I have a c6 c7 herniated disc I would like to try acupuncture but am a little anxious. Horrible symptoms, dizziness, possible trigeminal nerve injury too, plus sciatica all on my left side. Do you think it would help?

 

A:  This question is a great deal more complex than it may appear. A great deal depends on what diagnosis has already taken place and what treatment options have been explored. Many orthorpaedic surgeons, as well as manipulative therapists such as osteopaths and chiropractors, are reluctant to take any action which the body may experience as 'aggressive', and as a consequence most of the treatment options are about management rather than resolution.
 
To address your first comment, there is almost certainly no reason to feel anxious about treatment as far as physical damage or worsening of symptoms is concerned. Not only does acupuncture have a very good safety record, with very few significant adverse events reported in the UK over the last 20 years, but a properly trained and qualified practitioner will never needle anywhere close to a problem area if there is a risk that in doing so they will make things worse or cause physical damage.
 
One of the great strengths of Chinese medicine is that it understands the body, mind and spirit as a dynamic system of energy whose movement and balance ensure that we remain in good health. When this balance is compromised by injury or wear and tear there are often ways of encouraging flow through the affected area, often working at a considerable distance from where the problem manifests, which can help to restore proper flow. The Chinese took the very simple but effective view that where flow was good, symptoms would resolve. Sciatica, which is often generated by problems with disc herniation in the lumbar spine, is, as our factsheet shows, please click here
 
a very similar problem which appears to be helped considerably by treatment.
 
The idea of maintaining good flow is also critical to dealing with local problems, such as some of those which you have, where a flow has been disrupted. It is quite common for simple needling in the area to be used to great effect. We can reassure, though, that there is no likelihood of anyone using deep needling techniques in the immediate area of the herniation.
 
We recommend, both to ensure that treatment is a good option and to be reassured about the whole process, that you contact a BAcC member local to you and seek a brief face to face assessment of whether acupuncture is the best way forward. We are sure that they will give you honest and impartial advice

Q:  Hi I have had back pain for nearly 5 years, after I had flu injection, that night I could not walk. I was sent to A E by my doctor. There I was given a pill and left to sleep. I was  sent home  in a wheel chair. My doctor requested  a MRI. I had a small trapped nerve for which I now take more and more pills. I have had pain treatment which gave me 3-4 week free. this was nice, I was given  a tens machine. On using this I had a pain down my spine to my feet.  I  collapsed  it was like cramp. The doctor sent me to A E for a DVT and after 1 week of treatment it was not. It  was a nerve problem. The last 8 weeks have been hard and the pain is worse. I am on a morphine based tablet with another bunch.  The  last MRI showed no damage to lower spine l-5 l-4 l-3.   Is there any chance that acupuncture, could help me this time

 

A:  Generally speaking the advice which we give to people suffering from back pain is straightforward. As our factsheet shows please click here
 

there is a considerable volume of research suggesting that acupuncture can help with chronic low back pain, such that NICE now make it one of the recommended options for treatment.
 
However, it seems as though something else has happened in your case, and the question which a practitioner would have to resolve would be how much the flu injection was causally connected to the sudden escalation of your problem, and if not, what else might have been going on which could have caused the pain and restriction of movement to have increased so much. Back pain is used as a generic term in both eastern and western medicine to cover an enormous variety of specific causes and types of pain. Just as the conventional doctors have tried to elicit by elimination what is causing your continuing problems a practitioner of Chinese medicine would want to try to establish how to classify your symptoms within the diagnostic patterns of Chinese medicine, and then make sense of how some of the interventions appear to have made things worse.
 
Your case has such specific factors that it is difficult to give unequivocal advice, but based on the recognised role of acupuncture in the treatment of low back pain we can say with confidence that it would be worth your while visiting a BAcC member local to you for them to be able to give you face to face assessment of whether they think that acupuncture will benefit you. Of concern, though, will be your reaction to TENS. Although these machines are much more vigorous than acupuncture treatment they often use similar areas of the body for treatment, and the practitioner will want to check whether your system has become hyper-sensitive to some forms of treatment, which can happen when pain becomes constant and debilitating.
     
 
 

Q:  I have low back pain mainly on both sides but the right is much worse on the buttock and toes down to both the outside of my upper and loser legs and my feet feel very tight and and burnign.  I have had 6 acupuncture sessions so far can I expectr better results by having more acupuncture. 

 

A:  It is very difficult to give you an accurate answer. So much depends on how long you have had the pain, what physical damage there may have been to cause the initial onset of the pain, and what other treatments may have been tried.
 
All that we can advise is that you discuss with your practitioner what progress they believe has been made, what their own estimate of the prognosis is, and what review periods they think are essential to ensure that you do not have treatment which is not having any useful or sustained effect. We have to be realistic in our work and emphasise that not all problems respond to treatment, and in some cases where the problems do respond the effect does not last. In cases such as these the practitioner may well have other suggestions or recommendations about other forms of treatment which may be better suited to the problem or the person.  
 

Q:  I am straggling with joint pain specially in my knees, back, coccyx and right shoulder... will you treat me.
 How much will it cost me?

 

A:  As we have said on occasion to other enquirers the BAcC does not deal directly with patients on behalf of its members, so you will need to use the 'find a practitioner' function on our website please click here

 

or ring the office to be sent a list of our members working in your area. We are sure that they will be only too happy to give you the benefit of face to face advice of whether they think that acupuncture will be of benefit.
 
In the London area, a treatment session of 45 minutes to one hour usually costs around £40-£50, with the first consultation at which detailed notes are made and examinations undertaken a little more, perhaps £50-£60 for an hour to an hour and a half. Outside London the prices can be a little lower by about £10, but most practitioners in the BAcC are self-employed and able to negotiate personal rates if need be.
 
There are a number of ways in which joint pains across the whole body are understood in western medicine, and a Chinese medicine practitioner is highly likely to want to have ensured that there is no serious underlying western pathology. If this is the case, as it is likely to be, the acupuncturist will be looking at the kinds of pains which you have, when they present, whether they are better for heat or cold, and so on, to make a diagnosis which will enable them to try to help you. There are a number of ways in which Chinese medicine looks at systemic problems such as these, and if your condition falls into a recognised pattern there is some hope that treatment will be beneficial. Even if the pattern is not straightforward, Chinese medicine was initially premised on establishing balance across the system in the simple belief that a system in balance corrected symptoms, where they appeared. 

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