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.

Most people I see with Bells Palsy are through the low-cost community acupuncture clinic which runs every Thursday. Please ring reception on 01603 665173 or click here for more details.

Painful periods – Dysmennorhoea

Woman of all ages regularly come to see me at the acupuncture clinic for help with pain around menstruation. A small amount of cramping and aching is normal on the first day, but for many the pain is unbearable and disrupts everyday life. Painful periods with no serious underlying causes is known as ‘primary dysmennorhoea’ – there is no obvious medical reason why this happens. Pain that is related to conditions such as endometriosis and fibroids is called ‘secondary dysmennorhoea’. This too responds well, though these conditions deserve a separate article to themselves.

In Chinese medicine, pain is seen as ‘stagnation’, and usually with severe period pain we call it ‘blood stagnation’. The underlying cause of this stagnation can be a combination of many things and the job of your acupuncturist is to work out what these may be. Acupuncture visualizes everything in the body in constant motion, slowly and gently. The pain results when the blood and Qi of the pelvis can’t move in the direction it needs to, instead it sits and creates a blockage like a dam, and as the pressure builds up you feel more and more discomfort.

I really see very good results using acupuncture, diet and lifestyle changes. My top tips for managing primary dysmennorhea are the following;

1. Acupuncture regularly – in the second half of the cycle. I usually ask to see my clients twice before their expected period starts. I needle directly on the lower abdomen and the legs using lots of heat to relax the muscles. Sometimes we also work on the lower back and sacrum too. It really doesn’t hurt. The needles just sit under the skin and once in place, the body responds to them by releasing a whole load of various substances which will aid in general pelvic circulation. You can’t usually feel this happening ( some women will be aware of tingling and warmth or muscles relaxing), but it takes around 20-30 mins which is why you will just be lying there listening to music and daydreaming.

2. Discourage ‘bad prostaglandins’ by reducing all meat and dairy produce –  small amounts can be taken (they must be organic). Prostaglandins are present in all cells of the body and most have a beneficial effect. There are a few that are related to constriction and inflammation and too much of these types will cause an imbalance. Women suffering with severe dysmennorhea are found to have higher levels of two particular types of prostaglandins known as PGF2 and PGE2. The fuel the body needs to make these ‘negative prostaglandins comes from arachidonic acid which is abundant in meat and dairy. So cutting these out will make it harder for the body to produce PGE2.

3. Encourage ‘Good Prostaglandins’ – To tip everything in our favour we need to add certain things into our diet. Lots of the ‘good prostaglandins’ will help the uterus contract beautifully and with ease. Adding in lots of oily fish, nuts, seeds and leafy greens will do this. You also need to have adequate amounts of certain vitamins and minerals in your diet so that your body can create these good prostaglandins. Everything should be present in a varied healthy wholefood diet, but if your diet is compromised you may need to take these as supplements short term to boost your levels.

4.  Pelvic stretches – absolutely essential for getting good circulation going. I have a set of yoga stretches I show to each woman that really get deep into the groin. There are plenty of short videos on You Tube for inspiration too. You want to be doing 10-15 mins every 2 days initially. The 5 days before your period you must do every day. Everyone can find time to do 10 mins – once you are familiar with the stretches you can do them in front of the TV in the evenings. After a few months you will probably not need to do them so often as the overall circulation has improved. The one exercise to avoid if you suffer from painful periods is of course sit-ups.

As with many things in natural and complementary medicine – it is the combination of a few small changes here and there which give dramatic results. In acupuncture we don’t accept that severe pain at menstruation is ‘normal’ and something to be put up with. Working with your body requires time and patience and a genuine desire to get to know yourself. Using the 4 interventions above, I see huge reductions in the monthly pain within 6-10 weeks. If you or someone you know suffers with debilitating cramps – please get in touch with the clinic to see how we can help you.

 

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.

Different styles of Acupuncture in Norwich

Did you know that in Norwich alone there are 4 different styles of acupuncture commonly practiced? How do you choose which one is right for you?

Two of the often used types of acupuncture are ’5 elements’ and ‘TCM’ (Traditional Chinese Medicine). In 5 element acupuncture the influence of our mental and emotional state on our body is paramount, many people who already understand the root of their ailment to be deeply imbedded in their thought processes will be well suited to this style. The feel of the acupuncture session will be gentle, thoughtful and nourishing, also making it a good choice for children.

TCM acupuncture is broad term which includes much of the acupuncture coming out of China in the mid 1900′s. It is often seen as slightly more aggressive than other types of acupuncture – though this ultimately depends on the person performing the treatment. Practitioners use electro-acupuncture and strong needling techniques – making it a good choice for people with pain conditions – back, knee and shoulder for example.

Japanese acupuncture uses ultra thin needles, and there are several variants whereby the needle does not actually penetrate the skin. Great for children and people who experience needle shock.

Medical acupuncture is performed by those who are already registered with another professional healthcare skill – physiotherapists, nurses and osteopaths for example. The British Medical Acupuncture Association runs accredited courses of various lengths. The plus side of this is that you can receive acupuncture from someone who has additional knowledge in relation to their field – giving them a more complete understanding on your condition. The flip side to this is that the actual clinical training time on some of these courses is limited – so don’t be shy to ask your therapist how much time they have spent studying before you sign your consent form. My experience from client feedback is that medical acupuncture tends to hurt!

I practice mainly TCM – though I also studied 5 elements. TCM for me is the most effective way to relieve aches and pains in the physical body and it is what I use when working at Norwich’s Community Acupuncture Clinic – which is exclusively for pain relief.

Every acupuncturist develops their own style – nearly all of us include cupping, moxibustion, gua sha, infra red and electro-acupuncture as standard within our practice, so it is not uncommon to actually receive several ‘therapies’ within your normal acupuncture session. Because we can vary so much individually – don’t be afraid to try again with someone new if your previous acupuncture did not help. It is worth spending a little time considering which type of acupuncture is best suited to you. There is a good story here in The Telegraph that illustrates this point. Finally – whoever you do choose make sure they have done the appropriate amount of training and that they are registered with one of the following organisations.

1. The British Acupuncture Council

2. The British Medical Acupuncture Association

3. The Association of Traditional Chinese Medicine and Acupuncture UK

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).