Can acupuncture help ischia bursitis

Q:  I have been told I have ischial bursitis and I wanted to ask whether this was something that acupuncture could help with?

A: This is one of those conditions where the name is less important than the way that the problem manifests. Ischial bursitis used to be called 'weaver's bottom' because it was quite common in professions where someone had to sit on a hard surface for hours on end, and the bursa between the ischial tuberosity and gluteus medius muscle became quite inflamed.

However, from a Chinese medicine point of view this would be less relevant than asking the patient the full range of questions about the nature of the pain (sharp, dull, spasm, chronic), how it varies throughout the day, how it is affected by heat, cold, pressure, and so on. The system of Chinese medicine is based on a theory of energy called 'qi' and its flow and balance in the body, mind and spirit. If the flow is blocked, or becomes stagnant, or deficient, then the practitioner's task is to reinstate ordinary flow in the belief that a properly flowing system does not generate symptoms. There would also be an important judgement call about whether this was a self-contained symptom, or whether the inflammation in one area was the tip of a much larger iceberg where it was the local manifestation of a systemic problem which might appear elsewhere, or whether a general state of depletion of the system allowed this to develop where a better flowing system might have not been affected.

The difference between the Chinese medicine approach and western medicine is that from the western point of view the naming of the condition means that there will be a number of specific treatments which your GP will offer. In the Chinese medicine system, the symptom, rather than the name it is given, will be interpreted in a number of different ways depending on what is seen to be the driver (cold, stagnation, injury, etc) and also depending on the backdrop against which it has occurred. Although many cases will require similar treatment, at a more profound level the treatment each person receives will be unique to their own needs, and will usually involve restoring the overall balance of the system alongside local treatment of the problem.

We always advise prospective patients to visit a BAcC member local to them for informal advice and a brief face to face assessment before committing to treatment. In your case it is highly likely that you may need a course of exercise to help the process of recovery, and most members know of trusted colleagues in the physiotherapy profession in their area to whom they can make a referral if this proves necessary.

Although we are not great fans of medication, there is always something to be said for a short course of anti-inflammatory medication if the symptom is very painful or interfering with your life. We are not keen on seeing people suffer while the treatment begins to take effect over three to five sessions, and although medications like diclofenac have adverse energetic consequences, these are short-term and are often far outweighed by the relief they bring. They are not a long-term solution, though, and that is what we hope acupuncture may help to provide.

As far as research is concerned, there is not a great deal which addresses the specific problem which you have, but that is more a reflection of the difficulty of pinning a single diagnosis down and finding funding for something for which outcome measures are not that precise, and the difficulty of finding funding at all! However, there is sufficient anecdotal evidence to warrant considering acupuncture treatment as a part of the overall package of treatment, perhaps alongside some exercise and possibly also some adjustments to some of the practical matters like workplace and car seating to provide as muhc relief as possible from the symptoms and to stop their escalation.

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