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Neuropathic pain in hands and fingers

Q: Since breaking an elbow in late 2009, followed by a frozen shoulder in early 2010, I have suffered chronic neuropathic pain in my hand and fingers.
 
I have see a pain management specialist and after various investigations, it has been concluded that the only problem is nerve irritation at the C6/C7 level - assumed to be related to posture and tight scalenes. I have undertaken a wide number of injections, pulsed radio frequency and taken both Pregabalin and Duloxetine. None of the injections or PRF helped; I couldn't tolerate Pregabalin and Duloxetine was only of limited help so I stopped taking it. Physiotherapy helps to some extent (primarily focuses on trigger points) and I have been taking clinical pilates sessions to help with posture. Capsaicin applied topically to my hand gave some relief.

 Since it is now nearly 4 years that the problem has been ongoing, I am becoming somewhat despondent. Is there any evidence that acupuncture might help resolve the problem or at least offer some pain relief?  If so, could you recommend an acupuncturist in London.

A:  When someone has tried, or been treated with, as many of the standard treatment options as you have and without lasting effect, we would be reluctant to make encouraging noises about the value fo acupuncture treatment where all else has failed. However, it is perfectly true to say that acupuncture in Chinese medicine is premised on an entirely different theoretical basis, and symptoms such as neuropathic pain are understood as disruptions in the flow of energy, or 'qi' as it is called in Chinese medicine. The skill and art of the practitioner lies in determining whether this disruption in the flow arises as a consequence of a local blockage or weakness in the flow, or whether it is the tip of a much larger iceberg, and is local evidence of a systemic problem. When there has been local damage, especially where there has been a broken bone, it is not uncommon to find that from a Chinese medicien perspective there has been a local restriction which, until unblocked as best possible, will continue to generate symptoms 'downstream.'
 
We do have a factsheet on neuropathic pain
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/neuropathic-pain.html
 
but this does not really address the issue with which you are dealing. Our best advice to you, because of the very specific nature of the problems you have, is to visit a BAcC member local to you and let them have a look at the problems. Nothing can replace a face to face assessment in cases like yours, and we are confident that you will be given an honest view of how beneficial acupuncture treatment may be. If you were to present in our clinic we would also have in mind that cranial osteopathy might well have something to offer. The kinds of subtle disruption to the flow of energy which injuries can cause is often treated well by this form of intervention.
 
As for personal recommendations, we don't make them because there is no need to. All of our members are equally well equipped to deal with any patient who visits them, whether this involves treatment or  referrals on to other forms of treatment if they judge the problems to be best treated in other ways.
 
We hope that after your long journey so far that you find something which helps to bring the symptom under control.  

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