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Is there eviden to support acupuncture for hereditary neuropathy?

Q: Is  there any evidence to support the use of acupuncture for the treatment of hereditary neuropathy with pressure palsy either as a preventative measure or during an episode?

A:If by evidence you mean appropriately conducted trials, the answer is no, at least as far as we know in the West. Research into acupuncture is not as commonplace as we would wish for a number of reasons, and when trials are conducted they tend to be for conditions where a substantial number of individuals can be gathered with exactly the same symptoms. HNPP is not very common. It is possible that there have been some research in China, but the vast majority of papers are not translated, and are often methodologically unacceptable in the west, working as they do from the assumption that acupuncture works and often more concerned with what works better, rather than checking whether it works.

That said, the two systems of medicine, conventional and Chinese, are based on entirely different conceptual bases, and the framework of Chinese medicine, based on the understanding of all phenomena as embodiments of energy (called 'qi'), can occasionally offer ways of interpreting and treating symptoms where conventional medicine has no answers. Advanced as Chinese understanding was in ancient times, it had none of the sophisticated interpretation of neurological disturbances which we have but looked at them through the framework of energy flow as a failure of local flow often predicated upon weaknesses in the flow of the whole system. Using needles to restore flow could help to reverse the deficiencies and blockages from which symptoms developed.

However, one has to be realistic with hereditary genetic conditions. Chinese medicine also has its concepts of genetic inheritance in the energy which is transmitted from parents to child in its creation, and while all energy is technically mutable, our experience is that inherited patterns are often quite difficult to treat and just as resistant to change as genetic conditions as understood in the West. Never say 'never', though. Our experience is equally that an although an imbalance may have been handed down from parent to child this does not that it becomes more greatly untreatable.

We would not want to generate false hope or expectation, though. As we said in an answer to a question about peripheral neuropathy:

Q: Is there any evidence that acupuncture can help with peripheral neuropathy?

A: 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 achevement 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.

This remains the best advice we can give you. A practitioner may see something in your state of balance which is a basis for treating the system as a whole with some expectation of change, however limited. The question may well be how much change and how sustainable. If it managed to quell the worst symptoms during an attack, which based on evidence for acupuncture and pain relief may be possible, then treatment may be very worthwhile.

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