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Ask an expert - neuro and psycho logical

219 questions

Q:  When I had acupuncture for my permanent headache for the first time it was amazing and completely cured it for about 4 hours.
After that, however,  (17 visits) it never did anything. Other treatments have not even come close to that first time with acupuncture.
I have tried tablets,osteopathy, chiropractor, and many other treatments but none have come close to the first time with acupuncture.
Can you advise me on what if anything that signifies/ or acupuncture to relieve vagal nerve pressure.

A: This is not a frequent occurrence but most practitioners will be able to tell stories of similar outcome. This particular expert remembers treating a patient who had been hospitalised with neuropathy and was taking pethidine and other serious medications. After one session the pains disappeared, but then returned gradually over the next week, and were never amenable to any more change. There  is no agreed explanation for why this should occur. We suspect that the novelty of the intervention combined with the hope and expectation of the patient and practitioner can be a very powerful healing force but one which cannot be sustained. However this happens, it is clear that seventeen sessions is more than enough to establish that the treatment is not likely to work.

We have looked at the available research on vagal nerve stimulation and/or control, and by far the greater proportion involves the use of auricular acupuncture. This is a relatively modern development, as this rather dense but interesting study shows

and there are several others which seem to point to this form of treatment as an option. We think that your best bet may be to contact a practitioner who specialises in this form of treatment. Most of these are gathered on the register of the Complementary and Natural Healthcare Council (CNHC), a voluntary register which is accredited by the Professional Standards Authority and which subsumed the old Acupuncture Microsystems Group. There are thousands of practitioners who use the five point protocols for detox and addiction, but a smaller number who undergo extensive training in this modality. The CNHC register is where you will find most of them.

We wish you all the best. Cold comfort it may be but the fact that the condition could change at all does open the possibility that there may be something which will be able to effect the same sort of change on a more sustainable basis.


A:  As our fact sheets show

there are growing bodies of evidence suggesting that acupuncture is a beneficial treatment for all the things from which you suffer. The evidence, while good, is not quite to the standard which means we could say unequivocally that you would benefit, but this is as much a comment on the kind of research which is demanded rather than the quality of the results themselves. Randomised double blind control trials are good for pill testing but not so effective with treatments with many variables, like acupuncture.

The great strength of Chinese medicine, however, is not that it treats this or that condition, but that it treats the person. This is why twenty people with headaches may be treated twenty different ways. Clearly some points will have a direct effect, but treatment is not the equivalent of an aspirin, and the practitioner will be at pains to discover why this symptom appears in you and not in someone experiencing similar external stresses. The best treatment always combines treating the symptoms within the context of their overall pattern, and the pattern is the primary factor. Indeed, in ancient times some of the older systems used to treat the people without necessarily taking any notice of individual symptoms, in the simple but effective belief that a system in balance took care of its own problems.

The best advice we can offer is that you visit a BAcC member local to you, and see if they are prepared to give up a little time without charge to discuss whether your specific presentation. Anxiety and depression are rather broad labels which cover a huge range of possibilities, and sometimes we have to say to patients that what they are dealing with requires more of a talking therapy approach than we can offer. Given that it is rare for mental and emotional issues to arise without accompanying physical changes, even where these do now generate symptoms, a practitioner of Chinese medicine may well be able to see overall patterns which give them confidence that they may be able to help.

It can be a real challenge, however, to set meaningful targets for change - some days you may feel good, other days not so. Diaries and written commentaries are often a feature of seeing whether things really have changed; we all tend to forget good days last week if today started badly.

We have seen a number of articles published in the popular press in the last few years which show that acupuncture treatment for these types of problem appears to have worked, and in theory there is no reason why it shouldn't work for you too. We hope that it may.

Q:  Does acupuncture help to cure insomnia? I have been suffering from insomnia for many years. may be over 20 years. I have been taking over the counter remedies, such as Valerian,  hop and magnesium. 

A:  There is no doubt that acupuncture has been used with some success in treating imsomnia. As we wrote in a reply two years ago:

As our BAcC factsheet shows

there is some encouraging evidence which suggests that acupuncture has a role to play in helping people to deal with longstanding sleep problems. Indeed, the issue is a very topical one; we are just about to launch Acupuncture Awareness Week and Toyah Wilcox has lent her support to the venture because she found acupuncture to be a very effective solution to a sleep problem which she had had for many years. Her story can be found here:

From a Chinese medicine perspective there are a number of well established patterns which explain why the mind refuses to close down at night even though the person is physically exhausted. A skilled practitioner will want to know not simply about the sleeping patterns but about everything else to do with daily functioning, and it is highly probable that there will be other signs and symptoms which will show or confirm what is out of balance and needs to be corrected and harmonised.

Delightful as Toyah Wilcox's account is, though, her response to treatment was exceptional. One of the real problems with sleeplessness is that the body gets used to patterns or habits, and it can sometimes take a while for the system to realise that change is possible. We have found patients who couldn't sleep until 2.00am desperately hanging on till 2.00am even though they were now properly exhausted and ready for sleep 'because that's my bedtime'. Many people know this experience well from trying to go to bed at 9.00pm ready for a journey at 4.00am and finding it really hard to do. So, helping someone back to a good sleep routine can often be a challenge but there are success stories.

As we often remind people, though, Chinese medicine works from an entirely different paradigm. Insomnia doesn't have a single specified treatment, and each person who cannot sleep does so in a way that is unique to them. The best advice will always be that given after a brief face-to face assessment by a BAcC member local to you, who can have a quick look at the overall diagnostic picture and offer you a candid assessment of how acupuncture may be able to help you.

We think that this still remains the best advice we can give. Indeed, the one thing which would concern us is that your sleeplessness has now been going on for over twenty years. As we said in the earlier reply, people get used to certain habits and patterns, and it can be very difficult to unpick these when they have existed fa long time. This can have some extraordinary consequences. Sometimes volunteers are employed by sleep clinics to keep people awake until 4.00am in an attempt to make the three hour sleep pattern end at a normal waking time, and then start trying to move the start time back while keeping the waking time. Insomniacs begging to be allowed to sleep - very strange!

It is always best never to prejudge the situation, though. From our perspective everyone is unique and different, and it could well be that a practitioner can trace patterns in your energy which, when corrected, make your sleeping easier and more refreshing. Let's hope so!


Q:  My husband was diagnosed with parkinsons disease about 2 years ago, but at his last appointment with the neurologist he said it was possible he had PSP.

Over the last 6 months my husbands walking has deteriorated drastically and he has freezing episodes every few steps. His balance is very very poor and he has frequent falls despite walking with various walking aids in the house. He cannot go out on his own any more and it is very difficult for me to take him anywhere on my own.

He does not have much in the way of tremors but sometimes his speech is slurred and he is very very slow in eating and all movements. The right side of his body does not have much strength.

He has been on Madapor for two years but this does not seem to make much of an improvement. He is 83 years of age and his brain is still very sharp. Could you tell me whether acupuncture would help him with his walking as I am now at the end of my tether to know what to do for him.

I am a great believer in complementary medicine and treatments and have tried many things for him. 

A: This is a very difficult question to answer. If the diagnosis is indeed PSP, then there really is not a great deal which treatment might offer. There are a number of studies of the use of acupuncture for the treatment of Parkinsons Disease (PD), most of which showed no statistical bias in the treatment group and those which were slightly more positive tended to be so in only one of the aspects of Parkinsons, like sleep quality or rest. However, the overall picture is not very positive.

From a Chinese medicine perspective the various symptoms associated with Parkinsons are understood in a number of ways as disturbances in the flow of energy, and since the portmanteau of possible symptoms is quite broad, there are occasions when treatment does appear to make a difference, mainly of the 'getting worse slower' kind rather than the 'rapid reversal' kind. One of the problems, however, is that once someone has the disease label of PD or PSP everything which happens to them is filtered through this and seen as a manifestation of the underlying problem. This may well be the case, but there are going to be times when a problem is not directly causally related to the PD itself but arises as a consequence of disturbances caused by functional changes arising from the PD. If so, there is a small but real hope that a specific symptom could be helped.

The important factor is that the practitioner who makes this judgement is experienced enough to determine whether it is worth trying, and having tried whether the results after two or three sessions show any indication that the treatment is having an effect. It is crucial to avoid the triumph of hope over experience when someone ploughs on, often running up a large bill, with no discernible change in the patient. We always believe that in cases like this, if the symptom is likely to respond as a separate issue from the underlying condition then four of five sessions will be more than enough to be sure.

We have to be honest, though, and say that we are not that optimistic that there will be much change, given your husband's age and general state of health. However, nothing ventured, nothing gained, and the use of acupuncture would certainly not make things worse.

There are a number of practitioners in your area, and you can generate a list by simply using the postcode search function on our home page.

Q:  I was diagnosed from an adrenal stress test with stage 4 adrenal then all I could do was lie in bed all day.I took prescribed supplements and after 3 months my energy was much better,as I also have sore kidneys I was advised to try acupuncture.the acupuncturist diagnosed my liver as being the source of my exhaustion.  I agree with this. She has 20 years experience but after 7 treatments,when I was gradually gaining strength a treatment devastated my adrenals and I was thrown back 3 months with my symptoms.It is 3 weeks and I haven't recovered.I feel she was too heavy handed I pointed out how sensitive I am before treatment but this has not been taken into account.  Can you recommend an acupuncturist who has a light touch,who can treat my liver/kidneys? 

A:  We are very sorry to hear of your experience. We have come across a small number of cases like yours where a treatment may well have been a little too powerful for the patient. To be absolutely fair, though, we also have to say that our experience of patients recovering from all sorts of long term chronic problems like adrenal exhaustion or the various ME-related conditions is that they can often have a good run with treatment and then for no discernible reason have setbacks which feel like they are back to square one.

The overall strategy with these sorts of conditions appears to be to treat as gently as possible, and to the extent that this is something that any practitioner can do it is simply a matter of negotiating with the practitioner about what they do. This expert, for example, has a patient who insists on no more than three needles per session at a very superficial level, and our experience of doing more than that has been very educational - she gets blown away by treatment and ends up being disorientated for a week.

The question really is whether you have lost confidence in the practitioner. If so, then the best thing to do is to use our postcode search facility to find a number of BAcC members near to you, and then to visit each of them in turn for a brief face to face chat to explain your predicament. The fact that you have had treatment with someone else is something which they will be duty bound not to discuss with the previous practitioner if you ask them not to, and you should assess whether you have confidence in any of them to keep the treatment as simple as possible. It may well be that you feel that the existing practitioner still has your confidence, and this would obviously be the best route to follow. She will know your energies well, and if it is simply a matter of turning the volume down, then she should be well capable of doing that.

We hope you manage to make some good progress. We are aware that adrenal exhaustion is not always accepted by the orthodox professionals, and this can make for a very uncomfortable situation when someone's genuine inability to work is not backed up by doctors who cannot fit the symptoms into their diagnostic models.

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