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Ask an expert - muscles and bones - back / spine

66 questions

A: There is no reason not to undertake treatment as soon as possible after an injury to the lower back or the manifestation of a lower back problem. In Chinese hospitals it is routine practice to use courses of acupuncture daily as soon as possible to ensure that the blockages and after-effects of the initial problem do not consolidate into a longer-term chronic problem which becomes all the more difficult to shift.
 
We are not quite clear from your question what the extent of your problem is and what treatment you may already be having or have had for it. We are confident, however, that if you visit a BAcC member local to you for advice and potentially for treatment they will ensure that there is nothing in your unique circumstances which would make the use of acupuncture inadvisable. Factors which they might take into account would be any surgery you may have had and any advice from you GP or consultant. If they had any doubt about proceeding they would almost certainly, with your permission obviously, contact your GP to ensure that there was no contra-indication to the use of acupuncture.
 
We suspect that this would be unlikely, however. Many members see a large number of patients with lower back and disc problems, and acupuncture is even recommended in the NICE guidelines for the treatment of chronic back pain.
 

Q: I had a back pain about 2 years,I am still going to a physiotherapits. Before I visited the physiotherspist nobody knew about the problem.  They simply said  it was a mechanical problem in my back.  I want to know  is there any way to sort out or find out what the problem is  through any MRI/CT SCA etc. Is there any treatment for the so called mechanical problem?

 

A:  It is very difficult for us to comment on this. Our expertise is not sufficient to comment authoritatively on the management of your case. Our understanding, though, is that if there is a mechanical problem some form of X-ray, MRI or CT scan should be able to identify it, although it has been our experience of taking on 'last resort' patients that there is sometimes presumed to be a mechanical problem even though the evidence for the problem is not that clear.
 
What we do find on occasion is that there are sometimes links between visible problems and the pains which people experience which may not always be directly causal. Many people over the age of 50, for example, have some deterioration of the lower spine through wear and tear which shows up on an X-ray, but not everyone with back pain in this group suffers it because of the wear and tear, although it is often assumed to be the case.
 
Acupuncture has been shown to be effective for low back pain, as our fact sheet shows, please click here
 
and you may find that if the treatment route you are currently following does not resolve the problem, you might benefit from seeking the advise of a BAcC member local to you to see if they feel that they could help your problem.
 
The one observation we would make is that sometimes we treat people who have pains for which they want to know the exact cause is, and after the treatment has resolved the problem neither the practitioner nor the patient is any the wiser of what the specific problem was from a western point of view. This can seem quite odd, but Chinese medicine is based on an entirely different way of looking at the body and its problems, and the overlap with western medicine is not always exact.

As we said in an earlier answer to the same question

Please click here
 
a great deal depends on what is causing the trapped nerve. In many cases this is a result of muscular spasm, and the kind of acupuncture which all practitioners - traditional, doctors and physiotherapists - use may well be able to help by releasing the muscles which are causing the entrapment. In many cases this will resolve the problem. In some, however, if there is a deeper underlying cause which is causing the spasms, then the traditional acupuncturist may be at a slight advantage in being able to treat the system as a whole. However, a doctor would say, with some justification, that many of these system-wide causes are equally amenable to treatment by western methods too.
 
It is also possible that the trapped nerve may result from structural problems. Although traditional acupuncture, with its emphasis on function and its belief that if everything functions properly then even structure will come back into place, may help, you may find that an osteopath or chiropractor may be the first and best option by working directly on structure and clicking bones back into place. In practice we often find a greta deal of cross-referral; osteopaths put people back into shape and often refer them to acupuncture practitioners to stimulate the muscles to hold them there.
 
We would advise you to seek guidance first, either from your doctor or from an osteopath, about whether there is a structural problem and proceed from there. If it is a muscular problem creating spasms which are causing the problem we are confident that acupuncture may well be able to offer you some relief.
 

A:  I am 8 weeks pregnant and have a lumbar facet sprain causing inflammation in my lower left back. a physio friend (who doesn't know i'm pregnant) suggested acupuncture to help relieve some of the tension and inflammation but my chiropractor suggested acupuncture may not be 100% safe in the first trimester.would it be 100% safe for the type of acupuncture i would require?

 

Q: Backache and lower back pain, together with nausea and morning sickness, are among the most common reasons for women to seek help from acupuncture treatment in early pregnancy. There are well-established protocols for treating all of these without any risk to the foetus, and all properly qualified practitioners are aware of the acupuncture points which it is best to avoid during the first trimester. Even this may be an over-cautious approach; not only are there no recorded instances of acupuncture causing adverse effects in this way, but it is also unlikely that anyone practising in the UK uses needle techniques with sufficiently strong stimulation to risk any adverse effects.
 
There is an interesting case study published by a medical colleague which details the treatment of low back pain, and he makes the point in a more formal fashion.
 
http://aim.bmj.com/content/21/1-2/42.full.pdf
 
Worth a read, if a little technical. There are also dozens of practitioner websites which discuss the use of acupuncture for low back pain in early pregnancy.
 
It is always worth discussing with your practitioner, if you decide to go ahead with treatment, any fears or concerns you may have. We are sure that they will set your mind at rest.
 

Q: I have suffered from back pain and sciatica for a few years now. 2 weeks ago I had partial removal of the lower disc as it was causing compression of the sciatic nerve. The numbness in my leg and foot remains, and could remain for years.   Could acupuncture help relieve these symptoms, as it is nerve damage?

 

A:  We are often asked about regeneration of nerve tissue, and our usual response is that this would be beyond anything we would claim for acupuncture treatment. Nerve damage in the area where you have it is often the slowest to recover and if the damage is fairly high up the nerve repair can sometimes be very limited.
 
This is one of the situations, however, where we tread with caution because the theories of Chinese medicine, based on over two thousand years of practice, work from the same symptoms reported by the patient but do so within a theoretical framework which is entirely different. The underlying concepts of Chinese medicine, the flow of energy called 'qi' and the ying/yang logic of its inter-relationship and flow, is very alien to the western ear, but the reality is that a patient with symptoms such as you have would have consulted their practitioner a thousand years ago and that practitioner would have tried to make sense of the symptom in terms of the flow of qi. Western medicine depends on exact causality, and is very effective for it. However, just as every back pain may not necessarily derive from arthritis of the lower back, even when it is visible on Xray, so the experience of numbness may not be solely due to the nerve damage and may reflect energetic changes which acupuncture might be able to influence.
 
We tread with caution as we said, however, because we are fully aware that our detractors would love to see us make claims for something which in Western medical terms would be regarded as impossible, confirming their view that we offer false hope to people with real problems. Our response is that symptoms are rarely as clear-cut as they are presented unless there is physical evidence in the form of a missing part or complete severing of a part which means that there is no doubt. While the possibility remains that the symptom may be  addressed by other means, we would not tell our members not to offer treatment.
 
Our advice to you is to visit a BAcC member local to you and discuss your case with them face to face. This will allow them to make an assessment based on what they can see, and offer you a clear view of how treatable your problem may be.
 

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