Lower Back Pain Clinic – Thursday 6th March

This year Acupuncture Awareness Week (AAW) runs from March 3rd – 8th. The focus nationwide is on back pain and support comes from the dancer Camilla on BBC’s ‘Strictly’ – she uses acupuncture for her own back pain.
NICE have recently recommended that acupuncture be made available on the NHS for chronic lower back pain, however it is still currently difficult to obtain a referral for NHS acupuncture in Norfolk.
To celebrate AAW 2014 I am running a special pain clinic for lower back pain on Thursday 6th March. This is suitable for people who would like to try acupuncture before committing to a full course of acupuncture or speaking to their GP about options on the NHS.

  • Cost – £10 per acupuncture session
  • Must be suffering with lower back pain – in the small of the back, sacrum, coccyx and buttocks.
  • Must be aged between 18-79.
  • Must not have had any other form of physical treatment (physiotherapy / osteopathy for example) 48 hours prior to acupuncture

Please book your slot by calling clinic reception on 01603 665173. Clinic runs from The Complementary Health Care Clinic, 34 Exchange St, NR2 1AX.

Acupuncture and Bells Palsy

Acupuncture is a great choice for patients with Bells Palsy –  I recommend acupuncture once or twice a week to speed up recovery. My patients tell me they feel an improvement within several hours of the acupuncture session, which then plateaus until the next session and then so on. Often we massage the neck and shoulders of Bells Palsy sufferers.  This is because in acupuncture the meridians that nourish the face pass through the back and sides of the neck so we like to start by getting the blood moving here first. Acupuncturists have a special set of ultra fine needles kept for delicate areas like the face, and these are inserted into the affected facial muscles and slowly turned. On an unaffected person this will hardly be noticeable but often with Bells Palsy the patient will feel the needles as prickly warmth spreading across the face.

Bells Palsy is often classified as ‘Wind-cold invasion’. In Chinese medicine they often describe what they see! ‘Wind’ means it is created from something outside the body (like a virus or environmental factor) but was strong enough to break through the body’s natural defenses. Acupuncture therefore aims to strengthen the person so they can push the invasion back out again. For this reason we also advise plenty of rest and avoidance of both coffee and alcohol until the facial muscles return to normal. ‘Cold’ in Chinese medicine is constrictive and blocks movement, so again the acupuncturist tries to balance this out by creating warmth and movement in the facial muscles to get them moving again. Difficult as it may be to slow down in the modern world – if Bells Palsy strikes, taking a couple of weeks out is simply the best thing you can do for yourself to speed up recovery.

It is worth noting that that most cases of Bells Palsy are self limiting – and many people first start to notice an improvement within 2-3 weeks from the start. NICE are clear that most people will make a full recovery in 9 months –  this is a general figure based on patients and not the therapies involved. So we have two groups – The first being those who do naturally make a full recovery and perhaps for them the real question should be ‘is there anything that can speed up my recovery time?’ The second group is those who do not make a full recovery and so the question is ‘can acupuncture help Bells Palsy 9 months on?’  A third question would be ‘is there anything I can do early on to minimise my chance of having long term problems?’  A review of various Bells Palsy treatments including acupuncture, physiotherapy, and medication is provided by The Cochran Database, where it is shown that the use of corticosteriods early on can lead to better outcomes long term – however using the corticosteriods more than 72 hours after onset appears to have to no significant benefit. A separate recent study compared the type of acupuncture used in Bells Palsy and found that those who received strong needling sensations in the face (compared to those who did not) were more likely to experience long term recovery.


Post Herpetic Neuralgia

2012 has seen a stream of patients in the Norwich clinic suffering with Post Herpetic Neuralgia (PHN). After an attack of shingles / chicken pox (involving the herpes virus), the nerve involved can remain incredibly sensitive and continue to elicit pain for months. Many cases of PHN are self limiting and can be helped with conventional medications such as anti-depressants and opiates. However if the drugs don’t work – there is little else recommended. A small percentage (3%) of cases will continue with severe discomfort and as many as 40% are estimated to struggled to some degree or another long term.

Acupuncture has a good history of addressing nerve pain in general – Prior to 2011 I had little experience with PHN, this year changed that! From the hips, to the back to the face – I had to learn how to use acupuncture effectively for this condition. The most resistant case was of neuralgia remaining 2 years after the original infection with minimal relief from medication. Using electro-acupuncture and infra red heat, all remaining PHN cleared up after the 4th session – even I was surprised! I found as a rule with successful cases, the first session of acupuncture gives relief for the rest of the day only. The second session usually lasts into the next day, the third extends for several days and by the 4th or 5th we are seeing substantial pain relief. On top of acupuncture, I ask all patients to stop drinking any coffee and sometimes to take a good quality B-vit complex.

Most PHN patients see me twice for one to one appointments before they are moved to the multi-bed acupuncture clinic on Thursdays to continue their sessions at reduced rates. Please ask your GP for a referral letter for further reductions.

The Norwich Community Acupuncture Clinic runs from Norwich city centre at The Complementary Health Care Clinic 01603 665173.

Acupuncture and Back Pain

Back pain is extremely common – about four in five people are affected at some point in their lifetime. If you ever experienced it yourself, you will know just how frustrating it is – limiting your ability to perform the simplest of tasks. It’s no surprise really when we consider just how much work our back does for us. Lifting, turning, bending and walking – our back will be active in all of these.

The fact that humans walk upright puts great pressure on the spine and the muscles that support it. Bones, joints, muscles, ligaments and tendons connect in such a way to allow an amazing combination of flexibility and strength. Our main support structure is the spine with 24 separate vertebrae plus the bones of the sacrum and coccyx. Between the vertebrae are discs that act as shock absorbers and allow us to bend. The spinal cord runs down the centre of each vertebra allowing the nervous system to relay information from the brain to the rest of the body – then back up to the brain. There’s a lot holding us up so to speak – yet back pain is mostly muscular in nature. Muscle pain perpetuates what is known as the pain cycle, a phenomenon of which the back is particularly susceptible. In the pain cycle, pain causes a muscle to spasm, which may distort the discs, joints and nerves of the spine. This spasm leads to further pain, leading to further spasm, which compounds the original problem. If the nerves are irritated enough it may cause pain to radiate down the leg and across the hips.

In young healthy people, back pain is more likely to originate from poor posture, a strain or tear to the muscles and ligaments or a direct trauma to the spine. It’s pretty easy to overstrain the back, which is why nearly everyone at risk in the workplace must go through the motions of demonstrating how to lift with bended knees! In fact in December I managed to injure myself while trying to move a heavy piece of furniture. Despite being a minor incident the whole back tightened up making it impossible to stand straight without pain. It was only with some acupuncture treatment from a colleague, was I able to return to work and the neurofen on standby could return to the back of the cupboard! As we age, degenerative diseases such as arthritis and osteoporosis can begin to cause problems. In Chinese medicine we look to see how people carry pain in their faces, and one of the secondary benefits of pain relief is an overall softening and ease in the facial expressions.

Back pain is one of the commonest reasons that people initially visit an acupuncturist and usually with the support of their GP. Often they find their medication doesn’t fully alleviate their pain or the side effects are intolerable. The good news is that acupuncture has minimal side effects. In fact The National Institute of Clinical Excellence (NICE) and the World Health Organisation (WHO) have both supported the use of acupuncture in lower back pain after evaluating recent trials, yet only a few NHS clinics provide this option and are rare in Norfolk, although the British Acupuncture Council is working hard to increase the number of acupuncturists within the NHS.

So are you wondering how it really works? Traditional acupuncturists see pain as a lack or blockage of energy at the site of pain. A good acupuncturist will ascertain which particular meridians are involved and then place needles along the channel to get the energy moving again. Often the acupuncturist will choose a point at the far end of the meridian to affect the pain in the middle – for example, there is a fantastic point between the nose and upper lip which is used to affect energy in the sacrum. An acupuncturist will also look at the underlying cause of your back pain. Let’s take two people both complaining of lower back pain, but one has osteoarthritis and the other pulled a muscle while gardening. Although both are likely to be needled near the pain, an acupuncturist will choose additional points that influence the bones according to Chinese medicine and different points that nourish the sinews for the gardener. Those who prefer a physiological explanation of acupunctures efficacy can look at the recent research which has identified several possible reactions in the body responsible for pain relief. They include the release of beta-endorphins and a model whereby traditional acupuncture meridians parallel the neurons and synapses of the nervous system.

The question everybody asks is ‘how many sessions will I need?’ There is no one size fits all answer to this. Unsurprisingly the sooner you seek treatment, the easier it is. When the body has been in pain for a long time, we begin to see compensatory mechanisms appear and this is another layer for your therapist to work through before reaching the original problem. As a rule of thumb most people will detect a positive change by the second or third treatment, though for a few it can take up to eight treatments.

There is a lot you can do outside the clinic to help your back pain. If your physiotherapist has shown you exercises, make sure you do them! The benefits are accumulative and will be noticeable in time so don’t give up. If you are taking anti-inflammatory medication, check your diet is supporting these. Certain substances encourage the inflammatory process in the body and simply must be avoided to both reap the benefits of your medication and perhaps even reduce your dependency on it. The biggest culprits in our daily lives are all the fun naughty treats we allow ourselves; coffee, alcohol, cigarettes and sugar! Losing even small amounts of weight can also take pressure off and increase your mobility. Finally, keep moving! We’re not talking cartwheels but small gentle movements will aid circulation to the sore areas -Tai Chi classes are a popular choice for many as part of their ongoing pain management plan.

If your current method of treatment is failing you, take control and make the necessary changes yourself. Nearly all alternative modes of pain management can be used alongside your existing plan from your doctor. Investigate different therapies and don’t be afraid to try something new! The human body has an amazing capacity to heal and transform itself given the right conditions.

If you are interested in acupuncture treatment please seek out a practitioner with the relevant training. You should expect your acupuncturist to have studied to degree level in acupuncture or the equivalent discipline. Most insurance companies now accept treatment by a certified practitioner so it’s well worth checking your cover.
The Norwich Community Acupuncture Clinic offers reduced rates for pain management acupuncture every Thursday at The Complementary Health Care Clinic, 34 Exchange St, Norwich, Norfolk NR2 1AX. All enquries 01603 665173

Acupuncture and Pain Relief – How does it work?

One of the most common conversations I have in clinic with my patients goes like this –

‘So how does this acupuncture on my knee actually work’
– ‘Well would you like the traditional explanation or the modern medical explanation?’
– ‘Both!’

Well the modern view looks at how acupuncture affects the nervous system. The nerves should react to a needle and give you that dull tingling associated with acupuncture. When stimulated they send a message to the spinal cord causing a release of dynorphin and enkephalin, (opioid peptides like endorphin). These in turn help the release of various neurotransmitters such as dopamine, serotonine and norepinephrine – and it is these that are thought to interfere with the pain pathways and trigger a general endorphin release in the brain. That might explain the mild euphoria some people feel after a strong acupuncture session. We also see a local improvement in circulation round the needles – an increase in blood and therefore oxygen to painful tissues and this in itself can be very beneficial. A natural pain killer is also released called adenosine which will affect the local tissues. There are several other theories and no-one seems to be 100% sure about the exact physiological mechanism, so hopefully further research will clarify the issue. However from my point of view I can understand how the research explains short term pain relief – immediately after needling, but good acupuncture can give you several days of pain relief after each visit. It’s effects appear accumulative and we aim to extend the period of relief with each visit – most of the pain conditions I see resolve to the point they only need acupuncture once of twice a year if at all.

The traditional Chinese model of pain relief through acupuncture is using the system of Qi flowing in meridians. When you look at a map of these meridians it looks similar to a image of major nerves – long strips that cover the body with branches that interlink. When the Qi runs smoothly we feel light and buoyant. When the Qi gets stuck or slow moving we start to feel pain. A dull achy pain would be the Qi struggling to move freely. A sharp acute pain would indicate the Qi was so impeded that it was affecting the blood and fluids nearby. An acupuncturist will look at the site of pain and where it radiates to and decide which meridians are involved. They then will needle along that meridian and any others that have nearby branches – to give the Qi a kick start in moving on – ‘Go on clear off!’ The dull tingling sensation is visualised as the Qi reaching up and grabbing the needle. Some of the meridians are pretty complicated in their trajectory – and it is for this reason that your acupuncturist sometimes needles a point on the body that appears to be unrelated to the site of pain.

Whichever explanation you prefer, as long as it works – that’s the important thing right! Every Thursday I run a community acupuncture clinic at Exchange Street, Norwich, which provides low cost acupuncture for pain relief. It’s still difficult to get acupuncture on the NHS in Norfolk so this is somewhere in the middle. Yes it’s private still, but you are sharing the treatment space with others  – like a ward so the cost is greatly lowered (£15 with GP referral).