Ask an expert - neuro and psycho logical

222 questions

Q: In the last year I have been diagnosed with an inherited condition called spino cerebellum atrophy 6 (SCA6). One of the symptoms is nystagmus which sometimes means reading is difficult. Could acupuncture or acupressure help with either condition? If so, is there a practitioner in West London who might specialise in such conditions?

A:  We are always a little wary about answering questions about hereditary conditions, especially ones like yours where the condition is genetic and where there are few recorded instances of reversal of the symptoms, although several accounts of supportive treatments which reduce the rate of deterioration.

 The reason that we are cautious is that from a Chinese medicine perspective, where there was and is no concept of genes but often a very strong sense of patterns of energy being passed down from generation to generation, there are occasions when a hereditary pattern like migraine or asthma can be addressed successfully when the energetic 'glitch' is treated. However, our practical experience is that where the conditions are genetic and inherited, rather than energetic dispositions to certain problems, there is less chance of success. You can find a number of Chinese studies of the treatment of cerebellar ataxia which make very encouraging noises, but these are mainly stroke or accident related occurrences which have a more obvious and potentially treatable cause.

 Having said all that, there is no doubt that many of the symptoms of conditions like SCA6 can be successfully mapped onto the diagnostic categories of Chinese medicine, and it may be possible to help reduce the severity of some of the effects of the condition. A great deal depends on the causal pathway. There are occasions when the symptom is not a directly caused problem but the consequence of an earlier part of the 'chain' being disrupted. If this is so, then treatment may be worth considering, even if only for the fact that the general well-being associated with the use of traditional acupuncture may make someone's attitude and response to their condition improve.

 We think the best thing to do, given that we are not in a position to assess the Chinese medicine diagnostic patterns or the symptom presentation that you have, is for you to visit a BAcC member local to you for a brief informal assessment of what may be possible. Most of us are happy to give up a small amount of time without charge to assess whether treatment would be worthwhile, and this gives the patient a chance to meet the practitioner and see where they work before committing to treatment. There are no specialists in this particular field, or indeed in very few fields with the exception of paediatrics and obstetrics. Chinese medicine is by its very nature generalist, and all of our members are equally well qualified to treat the greater majority of patients who come to their clinics. 

 The one thing we would say, though, is to try to set measurable outcomes if you do decide to have treatment and to ensure that progress is reviewed regularly. It is quite easy to run up a large number of treatments without realising one has done so, and if there has been no real progress this can be a cause of some frustration. Better, in our view, to keep a careful eye on progress, or lack of it, and make decisions about carrying on on a clear basis.

Can you advise if it is necessary to have a specialist for depression to treat with accupuncture. 

There is no need to seek out a specialist to treat depression with acupuncture. We are all generalists who treat people rather than conditions, and the huge strength of Chinese medicine is that it looks at the unique and individual presentation of every patient. It would not be unusual for twenty people with the same named condition to be treated in twenty entirely different ways. The practitioner will work to find out exactly what 'depression' means for someone - it's a name that covers a huge range of possible disturbances of the system - and then look at why these problems have arisen in these individuals.

 

There has been a fair bit of research into the use of acupuncture to treat depression, as our factsheet shows

 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html

 

but by far the most interesting result was a study recently conducted by one of our leading researcher/practitioners

 

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001518

 

which showed some very positive outcomes. Hugh has also written several follow-up articles looking at the data he and his colleagues collected, but these are a little on the scholarly side.

 

Most of us have treated people with depression as a primary referral because friends, family and colleagues who have come for a problem like backache or headache have found that acupuncture has helped depression too, and have referred on friends for whom depression is the main issue. The only time any of us might be cautious in taking on a case would be if someone's depression was linked to a serious psychiatric illness. Here we do recognise that there are special skills which might be needed, but there are very few patients in this category who present for treatment.

 

Sadly we can't recommend individual practitioners - we have no criteria to go for one over another - but also it follows from what we have said is that we think all of our members are suitably qualified to address the problem you have. If you use the postcode search facility on our home page you will find a number of people who are geographically closest, and most are willing to give up a little time, often without charge, to discuss whether acupuncture treatment is the best option for you. This also has the advantage that you can meet them and see where they work before committing to treatment. 

Q:  I can't sleep I am not falling asleep till about four in the morning.   I don't feel tired.  I have tried everything it's getting me down.  I can't go on like this.  I wonder if you can help me please.

A:  There is no doubt that acupuncture has a good track record for helping with insomnia. While the studies are not really sufficient in quantity to make substantive claims such as there have been, as you can see from our factsheet

 http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1283-insomnia.html

 are very encouraging.

 The real strength of traditional acupuncture, however, is not in treating conditions as much as it is in treating the people with the conditions. Although a dozen people with insomnia may present for treatment with exactly the same kind of insomnia, it would be not unusual if each was treated differently. The failure to get to sleep is a sign that the system is out of balance, but the causes can be quite different. The art and skill of the practitioner lies in finding out exactly why this distressing symptom occurs in you.

 Of course, as you well know, the problem becomes a spiral of descent into despair. Less sleep means that people become more anxious, less able to concentrate, and this can all make the problem far worse. The treatment can also help with these sorts of aspects. Invariable we find that there are often life conditions or emotional states which precede the onset of the problem, and these too form a part of the diagnostic process.

 The best advice, especially for someone suffering as you are, is to visit a BAcC member local to you for a brief face to face assessment of what is going on. The advice will be much more precise than we can give here, and most members are happy to see someone without a small amount of time without charge to establish whether acupuncture is the best option. This also gives you a chance to meet them and see where they work before committing to treatment.
 

 We have to be honest and say that there is no recorded evidence that we can find to support a claim that acupuncture can treat cortico basal degeneration.

 The diagnosis of the condition itself is not that easy, with most determinations being made post mortem and the condition most often diagnosed by recognising what it is not. It has  a number of similarities with Parkinsons Disease, and is often treated with the same class of drugs, but there is not a great deal of conclusive evidence for acupuncture successfully treating that either. What we tend to say to most patients who come to us with degenerative conditions is that the best we may be able to achieve is to slow down the rate of degeneration. As one rather inspired patient said many years ago, 'I think I'm getting worse slower'.

 Of course, the ancient Chinese would have had no idea about the specifics of conditions like this. Indeed they didn't entirely associate consciousness and cognitive function with the brain. What they would have done is to make sense of the symptoms of a condition within the framework of functional understanding which they had, and to treat accordingly. This can sometimes generate some unexpected results; not all of the problems which someone may develop may be primary issues to do with the main diagnosis, and may resolve to a good degree. One of the problems with having a 'headline' condition is that nearly every new symptom is attributed to it, and this may well not be the case.

 We are always very careful to counsel patients with problems like this about having unrealistic expectations of what may be possible. Once that has been taken on board, though, we do find that many patients derive a great many benefits from acupuncture treatment. In its oldest form, for example, Chinese medicine was about simply balancing up the system in the expectation that a system in balance could correct itself, and the main focus of treatment in ancient times was keeping people well, not getting them better after they became ill which was said to be like 'digging a well when you were already thirsty or forging a spear after the battle has started.'

 The best advice is always to pop in to see a BAcC member for an informal chat to see what they find and to give advice better crafted to your individual needs. Most members are happy to give up a few minutes without charge and this will also give you a chance to meet them and see where they work before committing to treatment.

 

Q:  Over 7 weeks I had acupuncture treatment for chronic insomnia (one session per week). The insomnia has slightly worsened, not improved, and I am awake from 3 am most mornings. I used to get some relief from Valerian, but since the acupuncture Valerian does not work. How long is it before the effects of the acupuncture wear off?

A:  We are sorry to hear that you are experiencing increased problems with the insomnia, but we would be very surprised if the change was down to the acupuncture treatment. Traditional acupuncture, when delivered properly, is all about balancing energies and unblocking areas of stuck energy. The most that usually happens after a session is that there can be a 24-72 window during which the energetic changes can cause mild and transient reactions like a slight headache or lightheadness, and in the case of musculo-skeletal problems a slight worsening of the symptoms. After this the body tends to stay in its adjusted state unless someone is doing something which causes it to revert, like working far too hard or eating erratically.

In this very limited case, where the treatment is given against a backdrop of poor lifestyle (not that we are suggesting that you have) it might be possible for a treatment to 'wear off' but if this were to be the case then the practitioner would be particularly concerned to adjust the treatment to avoid a kind of boom-slump cycle. The practitioner might also be interested in the fact that you are awake from 3.00am. Odd as it might sound, there are a number of diagnostic patterns where this would be a significant and which might just have been made more apparent by an overall boost in the body's energies. Over the longer term, however, the pattern would revert, so it would be surprising to find that a course of treatment had caused long term adverse effects.

We are interested to read from your supplementary question that it was a drop-in session at which you had the treatment. We are not quite sure what this means. We have a number of members who operate in multi-bed settings which offer treatment at reduced rates for people who could not otherwise afford it, but we are aware that there are other settings where people offer acupuncture, often ear acupuncture, on a walk-in basis. If it is the former this would still be traditional acupuncture. If it was the latter then it might be slightly more formulaic, and there is no doubt that for some people the repeated use of a formula which was not suited to the patient might exacerbate a problem. The best person to ask would be the practitioner who offered the treatment. If it has been done in a traditional way and crafted to your individual needs, the feedback will make sense and perhaps point to ways forward. If it is/was a formula treatment, then it might simply be better to avoid further sessions, as you have.

There is no doubt that acupuncture can benefit in treating insomnia, as our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1283-insomnia.html

and you may still find that seeking advice from one of our members working locally to you is a good option if the treatment that you had was offered by someone who did not belong to our body. Most members are happy to offer a brief chat without charge to assess whether someone may be able to benefit from traditional acupuncture.

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