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