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An interesting and unusual question! Battlefield acupuncture is  not really within the usual scope of traditional acupuncture, and derives mainly from the work of Richard Niemtzow and his colleagues in the last two decades. This 'expert' recalls seeing one of his first major presentations of the technique at a BAcC conference in the early 2000s, and there was no mention of any specific cautions over and above the safe and hygienic methods we all use anyway when inserting needles.

The best steer we can find is from advice given to people who have had body piercings. These are much larger and if there was a risk then this would be massively amplified by a more substantial piece of metal. The only real caution we could find was that it would be better to avoid using a sunbed in the first two or three weeks after a piercing has been inserted in order not to aggravate the wound. We strongly suspect that this would be the best advice we could offer.

Of course, the person who will be best equipped to field this question will be the practitioner who inserted the needles. On the assumption that they have trained in the technique rather than self-taught by the use of books and videos, it is highly likely that they will have been alerted to possible risks like this. However, we have also searched the adverse events databases and haven't found any reports to suggest that there is a risk from using a sunbed after acupuncture. 

 

 

 

There is very little risk associated with the treatment of low back pain in pregnancy. In this journal article from Acupuncture in Medicine

http://aim.bmj.com/content/acupmed/21/1-2/36.full.pdf

the house journal of the British Medical Acupuncture Society, the author makes it quite clear that low back pain in pregnancy is one of the more frequent problems addressed by acupuncture in pregnancy, alongside morning sickness and migraine. He also spells out the key risk factors, namely using some of a series of 'forbidden' points, especially during the first trimester. No properly qualified practitioner would ever use these points anyway, but it has to be said that there are very few western practitioners who needle points as vigorously as the Chinese for whom these proscriptions applied.

The treatment of back pain generally is one of the better proven uses of acupuncture (by the rather inappropriate research measures which are in the ascendant in the west). Research into the use of acupuncture for back pain in pregnancy is limited, but that which exists is largely positive. 

Although we have not yet finalised our work on specialist practice, we are looking at recognising postgraduate qualifications in obstetric acupuncture. If you are looking for a practitioner it may well be using a google search under acupuncture and pregnancy alongside your home area to identify someone who has had specialist training. There are some advantages from visiting someone who spends more time than the average practitioner treating pregnant women. We are all generalists, but there are times when a more in depth knowledge of a field of expertise is valuable.

Trigger point therapy itself is a slightly more western approach to acupuncture with slightly different diagnostic principles. In practice the needles tend to get inserted in the same place but for different reasons, but if trigger point needling is what you specifically want then you may have to check out the registers of the medical acupuncturists (BMAS and AACP) who use this technique as a stock intervention. However, we are confident that the use of traditional acupuncture would prove equally as effective, and potentially more so insofar as it looks at the performance of the whole system, not simply the presenting symptom. 

 

You will not be surprised to hear that we have been asked this question before, although not for some time. Our last answer over a year ago said:

We have to be honest and say that there is not a great deal of evidence for the effective treatment of Morton's neuroma with acupuncture. We published an answer through this same section three years ago to a question from a patient who was convinced, and with some justification, that treatment with one of our colleagues has been wholly responsible for a complete improvement in his condition. 

We have to say, though, that our clinical experience runs counter to this, which is why the very upbeat tone of webpages like that of this American practitioner

http://acuroots.com/mortons-neuroma-treatment-plan-with-acupuncture-and-tui-na/

(informative as it is) raises a wry smile. If only... Having said that, what he describes in the formation of the tissues which cause the condition is something with which we deal elsewhere on the body, and in theory there is no reason why treatment should not be able to reduce some of the discomfort. However, we would be very surprised if this could be done without the aid of orthotics which reduce some of the pressure on the affected areas while any treatment beds in.

Each case is unique and different, however, and the only real solution is to seek face to face advice from a BAcC member who can look at exactly how the problem manifests in you, and more importantly, can see the overall context in which it is occurring. One of the great strengths of Chinese medicine is that it looks at the whole system, not simply at a symptom which is regarded as merely a warning sign. Thousands of people with identical foot structures to you will walk thousands of miles without getting neuromas, and there may be systemic problems which have predisposed this to happen.

The other recommendation we would make, and we are sure that you have done this already, is to find a good chiropodist or podiatrist who can work alongside any other treatments you try to help to maintain improvements. Working in partnership with other health professionals for problems like yours can often be extremely powerful

This still represents the best that we can say. We have looked at the research databases to see whether any further case studies have appeared, but the cupboard is remarkably bare. Our earlier advice, to visit a local BAcC member for an informal assessment of what may be possible, is still likely to be your best option. We are confident that you will get an honest opinion before committing to treatment.

 

 

 

 

We are often asked whether adverse reactions are normal, and our usual response is 'not normal, but not unknown'. It is not unusual early in a  course of treatment for someone to experience a slight worsening of their original symptoms (we aren't sure what you presenting problem is/was) or even the expulsion of pathogens which can cause the body to feel a little sore. Pathogens in the Chinese medicine sense can cover a  wide range of what the Chinese called 'invasions' like colds and viral conditions which can lurk around until they are expelled. Occasionally people do feel flu-like symptoms out of nowhere. It is unusual to find this happening on the third session rather than the first or second time, but there are no rules. The aches should subside within 49-72 hours.

Of course, the possibility which we have to factor in is that this is a new condition which has nothing to do with the treatment. With over 4 million sessions a year there are bond to be odd times when something comes up just after a session which has nothing to do with the treatment. it is always best to bear this in mind if the problem continues for more than a few days. Acupuncture very rarely causes long term adverse effects except on the rare occasions when a needle pierces something it shouldn't, so if a potential side-effect doesn't subside after about four days then it is worth seeking medical advice.

Hopefully by the time you receive this the aches and soreness will have subsided. 

 

We are really sorry to hear of your wife's problems. It must be extremely hard for all of you.

First, let us say that acupuncture and herbal medicine are two distinct and separate disciplines, although in China they are usually learned together. For historical reasons in the UK there were already existing traditions of acupuncture and western herbal medicine, and the two eastern modalities developed separately. So, if you go to an acupuncturist the chances are that they will not be using Chinese herbs as well. If they are you can be assured that they are very well trained, and are particularly careful when someone is already taking medications which have a serious impact on their functioning. Herbalists will know what the potential interactions of the medications are, and will make sure that nothing they do will interfere with your wife's treatment.

Acupuncture itself is extremely unlikely to cause any problems for your wife. The main source of adverse effects from treatment, other than minor transient ones, is from insertion of the needles themselves, not from the energetics of what is going on. There are no case reports of which we are aware which suggest that acupuncture treatment can do anything other than good when treating people with serious mental health issues.

 As far as the treatment itself is concerned, we were asked a question about schizophrenia a while ago, and although this is a very different problem the response we gave captures some of what we would like to say. We responded:

We have to say that although the World Health Organisation's list of treatable conditions does include schizophrenia as a condition for which some evidence of efficacy exists, the overall position is that there is nowhere enough evidence to suggest that acupuncture would be able to deliver a solution to this problem.

However, when we talk about evidence in this context, we are talking about the kind of randomised control trials beloved of drug testing regimes, which are not the most suitable way of testing a complex multivariate process like traditional acupuncture. Is there a history of acupuncture and herbal medicine for serious mental disorder? Well, the answer would be a qualified yes. There are a number of presentations for groups of symptoms which could well be characterised as psychosis which are recognised syndromes in Chinese medicine with clear treatment protocols. This is even more the case with Tibetan medicine which uniquely in Far Eastern medicine has a very complex and enduring tradition of using herbal medicines to treat a number of what we regard as sectionable mental disorders. However, this tradition has barely travelled to the West, and few practitioners have the necessary skills to offer solutions.

The major issue would be to locate someone with the requisite skills and experience. Although we have few recognised specialisms in traditional acupuncture we have been developing areas like paediatrics, obstetrics and mental health issues where we believe the special nature of the client group may require additional skills which we would recognise as expert practice. Although in theory, as generalists we should all be able to help any patient we take the view that serious mental disease needs some familiarity with the field and some experience of how to work with people in extremely distressed states. Not everyone has this experience or skill, and it would not help your wife is someone is out of their depth. With that caveat it may be possible to locate someone through our searchable database who is skilled in this area and willing to have a try. The chances are that anyone working in an area will know which of their colleagues is most likely to be able to help,

We think that there is still some wisdom in these words, and our advice is pretty much always to visit a local BAcC member for a brief informal assessment of what might be possible. These situations are so very complex that it is nigh on impossible to give a definitive view at arm's length. We always feel confident that we can help everyone to a degree, but when a situation is quite fraught it is always best to make sure that a patient gets the help they need, even if that means referring them to other forms of treatment.

 

 

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