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Ask an expert - neuro and psycho logical

222 questions

Q: I have PTSD. I know acupuncture would not treat this, but could it help with the anxiety and sleep problems I have?

A: Strangely enough there is a small but growing amount of evidence that acupuncture treatment can be effective for PTSD. We found this 2013 systematic review

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580897/

which looks at all the evidence from all the existing studies, and makes some encouraging noises. The conclusions to nearly all reviews of this kind are that larger and better designed studies are needed, but what evidence there is is quite positive.

There is no doubt that acupuncture treatment has been used for some of the component parts of PTSD, notably stress and anxiety, as well as with sleep problems. We have a number of factsheets on our website

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

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

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

which gather the evidence together, and we have answered a great many questions on all three which you can find rather easily through typing any into the 'site search' option on our home page.

What we invariably say in nearly every case, though, is that it is important to visit a local BAcC member for an informal chat to get a view about whether treatment can help your specific problems. PTSD can manifest for all sorts of reasons, and all of us will have treated patients over the years who have been badly affected by accidents, injuries and family traumas. There are ways of interpreting some of these through the diagnostic categories of Chinese medicine which can offer direct treatment options of specific energetic changes, not just an easing of symptoms over time. Each case is unique, though, and needs to be addressed as such.

Talking to a local BAcC member (and most of us don't charge for a short chat with a prospective patient) can often give the practitioner a better idea than we can offer here of whether treatment may work, and has the added advantage that you can meet them and see where they work before committing to treatment. The nature of PTSD is that when someone tries to address the issues involved, as invariably happens during the course of treatment, the patient needs to be able to trust the practitioner as someone they can do business with. If that rapport exists it can really help things along, as much as the converse is true. It is probably better to chat to two or three people to see where the best 'fit' is than to just go to the first or nearest. We are not counsellors, but we do listen intently, and for someone to feel that they can talk openly about their problems their often needs to be a good level of basic rapport.


A:  A great deal depends on the cause and extent of the nerve damage.

There is a very small amount of evidence for nerve regeneration in animals after the use of acupuncture treatment, but nothing of which we are aware from work on human beings. There will be stories on the internet of people who were diagnosed with nerve damage and who have recovered movement and sensation, but there may not always be attributable to the treatment. In general, once a nerve has been damaged with consequent loss of function or sensation, that's that.

However, there are occasions when something which causes nerve damage doesn't but does affect the flow of energy in the body in a way which reflects nerve damage. This is most common in cases of scarring where after a major operation people can often report 'dead' patches on a limb or reduced movement. Like any flow once something has been interrupted it will continue to be interrupted until something is done to reconnect it, and most of us have had the experience of treating someone as simply as a kind of 'joining  the dots' across scar tissue and seeing some quite extraordinary changes.

However, without a great deal more information to go on it would be remiss of us to start guessing at long distance. The best advice is to visit a BAcC member local to you so that they can see exactly what is going on and offer a more professional view based on what they observe. Most are happy to do this with prospective patients when we are not sure whether acupuncture is a good option, and most of us don't charge for this. This also gives you a chance to see where someone works and a chance to see whether they are someone you feel comfortable with before committing yourself to treatment

Q:  Scalp acupuncture for a child with cerebral palsy.  I need a practitioner in UK with experience.in scalp acupuncture..

A:  Scalp acupuncture is a fairly recent development, rather similar to ear acupuncture which was first introduced by Nogier in the 1950s. The main proponent of scalp acupuncture was a Japanese practitioner called Yamamoto, and there are a number of UK practitioners who use his techniques. More recently we have seen training courses run by Suzanne Robidoux who is explaining and promulgating the systems developed by a Chinese practitioner called Dr Feng.

In both these cases, however, the training is at postgraduate level, and there are no agreed standards for what counts as a 'scalp acupuncturist', and therefore no way that we could begin to recognise whom we could recommend. All that we can say is that if you use a search engine like google and type in 'scalp acupuncture' and your city or town, you may find someone who has trained in one of these systems.

There are a number of case reports like this one

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833473/


which offer considerable encouragement, although we have to say that case studies stand a long way down the chain of evidence because there are so many confounding factors which might skew the results. That said, we are aware of considerable excitement amongst our members at the possibility that scalp acupuncture may offer a treatment for a number of intractable conditions like Parkinsons disease. 

We always advise caution, though: if something is really effective its use tends to proliferate very quickly. We have seen a number of claims for the treatment of degenerative eye conditions, for example, in two clinics in USA and India but nowhere else. That said, this 'expert' had a go at being treated by someone who had just undertaken some training, and it was a remarkably powerful effect which, given some of the traditional points used, is not entirely a surprise.

It is best to be wary of unrealistic expectations, therefore, and the best way to address this is by having clear and measurable outcomes, and by setting clear review dates after each group of four or five sessions to see if there is or has been sustainable change. 

 

 

Q:  I have suffered from pudendal neuralgia for 2 years. I would like to know if acunpuncture can be used to treat this condition? Also, details of practices that can treat this condition. I live in Newcastle-upon-Tyne

A:  Pudendal nerve problems can be a source of immense discomfort and can often lead to severe depression, especially if entrapment of the nerve not only causes the neuralgia but also affects functions in the lower abdomen.

We would first want to ask a great many questions about what brought the problem on, or if there was no obvious cause what was happening at the time of onset. We would also probably want to know whether the onset was sudden or gradual, whether you had found anything which seemed to relieve the problem, and what tended to exacerbate it. These questions would be standard fare for any doctor, but the underlying theory of Chinese medicine can often make sense of symptoms and how they present within an entirely different framework.

The bottom line, though, is that quite often pudendal nerve problems result from physical changes in the lower spine or in the internal musculature, and these can often be difficult to reverse. Occasionally there is a level of entrapment brought on by a hobby like cycling or working for long hours in a fixed position, but these are easily identified and easily remedied. The majority of cases are more treatment resistant, and it would be unfair to give you unrealistic expectations of what was possible. We have trawled through the research databases and found very few studies which even look at the problem, let alone indicate that it might be amenable to treatment.

However we must not sell ourselves short! Acupuncture treatment is often the last resort for intractable problems, and occasionally generates results in the most unexpected cases. If a practitioner can make sense of the presentation you have from a Chinese medicine perspective then there may be some cause for hope that the symptom can be reduced in severity or even removed. The best way to establish this would be to see a BAcC member local to you for a chat and brief face to face assessment.  The only caution we ever offer is that where we are not sure whether treatment will work it makes sense to try to find measurable outcomes and to review progress regularly, and certainly after the first four or five sessions. If there has been no change of any kind then it may be wise to call it a day early rather than run up a large bill going nowhere.

As generalists all of our members are capable of treating this problem, and using the postcode search facility on our home page www.acupuncture.org.uk will generate a list of members geographically closest to you. 

 

Q:  My GP is referring me for acupuncture for my neck.  I have a partial fear of needles and a low pain threshold . I am suffering with bad headaches and my gp thinks it's coming from my neck.

A: The GP may well be correct; a considerable number of headaches arise from problems in the neck, often to do with gradual changes in the vertebrae which can impinge nerves and affect blood flow. There is quite a great deal that acupuncture for both problems, as our factsheets show:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/4076-neck-pain.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/1581-headache.html

Obviously we have to qualify these kinds of sheet with the statement that traditional acupuncture treats the person, not the condition, so we treat a person with a headache, not just a headache. This can make a profound difference to the treatment. Twenty different patients with the same presenting symptom might be treated in twenty entirely different ways as the practitioner sought to balance their own specific patterns of energy. This is one reason why we believe that acupuncture can be more successful than some conventional treatment because it is tailored to the unique needs of the patient.

As far as needles are concerned, there is no reason to fear them. The majority of members use needles which are 0.18mm ot 0.25mm and usually only an inch long, of which the top 3mm-5mm is actually inserted. The use of guide tubes helps even more, the pressure of the tube deadening most of the sensation in the area. Most of us have treated people who are needle phobic, and the simple expedient of showing someone what is going on, perhaps on an area where they can see what's happening, and talking through the process is usually more than effective. There are very few cases where the needling itself has stopped people having treatment, and most of us know how to start as gently as possible in order to keep people happy!

The best thing to do is to visit a local BAcC member for a pre-commitment chat to be reassured about them, where they work and what needles look like. You will also get the benefit of a straightforward assessment of how well acupuncture may be able to help you.

 

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