This is a page of common questions and their answers. If you wish to ask me anything else please email me at steve@steve-woodley.co.uk and I will get back to you as soon as I can.
Acupuncture
Herbs
Other Methods
General Questions
Acupuncture
Q: How do I know if acupuncture can help me?
A: The BAcC has provides an
A-Z of conditions with references to the scientific research on each one to help people decide if acupuncture may be a suitable route for them. As a rule, acupuncture can be seen as the art of stimulating the body with needles, electricity or heat, releasing endorphins and oxytocin, which can help with symptoms of pain and give a feeling of relaxation or well-being assisting you to cope.
However, this can be utilised in several different ways. Treating disease is only one branch of Chinese medicine. Traditionally it was split into three tiers which can be described as:
- Treating Disease (Zhibing 治病), considered the lowest form of medicine.
- Nurturing Life (Yangsheng 養生), improving health to avoid disease and considered a superior form of medicine.
- Transcendent Practices (Chengxian 成仙 "becoming immortal", Dushi 度世 "to spend the world" or Guodu 過度 "cross the limits"), spiritual in nature, aimed at improving your relationship with yourself and the universe.
Whatever stage of life you are at - in good health, seeking alleviation from symptoms, or learning to accept the hand that fate has dealt - one of these modes of treatment can be appropriate.
Q: What can I expect from a treatment?
A: Your first treatment will involve taking a full case history. This may also involve some special tests or examinations to help us identify any particular structures involved or a discussion of personal life issues that may be affecting the problem.
Once I have an idea of the area to treat I may palpate to assess any areas that feel abnormal and use acupuncture, manual techniques or ancillary therapies to initiate the change we want. At the end I may prescribe some exercises and suggest lifestyle changes to help you manage better at home.
Typically a session is comprised of approximately 20 minutes of consultation and examination which may include preliminary massage and palpation, 20 minutes of deeper treatment with acupuncture or manual techniques and 10 minutes of take home advice and getting ready to leave. In the last 10 minutes I clean up, write up and get ready for the next appointment.
A first session may spend longer on consultation while treatment is aimed at assessing how you respond in order to tailor your next session to your needs. Subsequent sessions usually involve a catch up with how the things are progressing and either a repeat or a modification of the original treatment to accommodate any new developments, fine tune what we did before, or try a change of style to find a method that works better.
Q: How often will I need to receive treatment?
A: This varies according to the condition and person being treated. I often compare acupuncture to being somewhere between physiotherapy and psychotherapy where you may need intensive treatment initially until the natural course of the illness has resolved or some skills to manage at home have been taught. Then sessions can vary depending on what we wish to achieve. Occasional sessions to check for developments are recommended but if there is a change in the pattern, a time of crisis or we feel able to push for a further improvement then some some additional sessions should be scheduled to develop a new program.
There is not necessarily an upper limit. Just like how a professional sportsman will have their own private coaches, therapists and physios to tend to their changing needs daily, so too did Chinese nobles have private physicians who modified their treatments and advice daily according to their client's needs. For average working folk that is not possible so its important that we develop an agreement regarding frequency and what we can achieve in that time.
Q: What should I do before I arrive?
A: Before you arrive I recommend making the following preparations:
- Make sure you have eaten something that day but avoid a heavy meal in the hour before arriving
- Avoid alcohol or recreational drugs
- Bring a list of any medication you are taking, investigations, allergies or other relevant information
- If you may require any urgent medication make sure you bring some and we know where it is
- Wear loose fitting clothing that can be easily moved or removed if necessary
- Try to arrange some time after the session to maximise the benefits
Q: Where will you need to reach? / Will I have to remove my clothes?
A: For hygiene reasons it is not possible to needle through clothing so the areas I need to reach must be available. The exact areas depend on the issue but as a general rule I will need access to the lower arms and legs, around the affected area and sometimes the back. I advise people to wear loose clothing that is easy to move or roll up or take off where necessary.
Q: How will I feel after treatment?
A: Usually relaxed and calm. Some people can feel a little drowsy or light headed and if this is the case it is not recommended to drive or do anything that puts you at risk immediately afterwards.
Some occasional side-effects of acupuncture may include some soreness or bruising around the needling sites but these are quite rare and go away quickly. After
tui na some people feel a little sore in the muscles that have been manipulated but resolves quickly.
Occasionally after the initial treatment a condition can flare up as the body enters a "healing crisis" and adjusts to the new balance but this is often seen as a good sign that the body is attempting to address the problem.
Q: Is acupuncture safe?
A: All members of the British Acupuncture Council (BAcC) observe a Code of Safe Practice which lays down stringent standards of hygiene and sterilisation for needles and other equipment. All needles come in pre-sterilised blister packs which are disposed of immediately after use. These procedures have been approved by the Department of Health as providing protection against the transmission of infectious diseases.
Minor adverse effects such as soreness around the needle site, bruising or minor bleeding may happen but serious side effects from professional acupuncture are few. When practised correctly acupuncture is one of the safest therapies to receive since it involves almost no forceful motions or heavy pressure.
Q: Does acupuncture hurt?
A: The aim of acupuncture is to relieve pain, not cause it!
As a form of nervous stimulation some sensations are desirable, described in Chinese literature as
deqi, and usually experienced as a numbness, heaviness, aching, dragging, pulling or distending feeling that may radiate some distance from the point. Most people find these sensations interesting but everyone has different tolerance of stimulation and if they are uncomfortable or producing a sharp pain then you should tell your acupuncturist who can reposition the needle.
Q: How does acupuncture work?
A: Acupuncture has been controversial in Western medicine for so long that we actually know more about it than we do some drugs but while many theories have been presented few are universally accepted. What we do know is that when the strange needle sensations known as
de qi are achieved the signal travels along the nerves releasing endogenous opioids that block pain signals and oxytocin that produces sensations of well-being. It may also have many psychological mechanisms that are not very well understood.
I often explain to people that acupuncture can be seen to have developed from two main areas of Chinese culture: massage and meditation. On one hand there is the musculoskeletal style that is like massage but instead of using pressure on painful spots we use a needle. The second type is like meditation but where certain points we want someone to focus on are stimulated. There is considerable scope for creativity and cross-over for both of these modes of treatment as well as with other modes of Chinese medicine.
For a summary of all the modern theories of acupuncture's mechanisms, I have written an article
here.
Q: Where does acupuncture come from?
A: People have been manipulating their bodies for longer than written records tell with the earliest evidence being a
5, 300 year old frozen mummy with evidence of acupuncture points and tools. It most likely evolved out of massage, with practitioners developing tools to work deeper until they broke the skin. These early practices were more like bloodletting and lancing of boils with the use of heat to cauterise open wounds following soon after. The Chinese concept of
Qi, a subtle agent of change, which early observers realised could be manipulated without necessarily leaking blood refined the system into one of stimulating the nervous system to affect change. While the European methods of bloodletting died out when the true nature of blood was understood, the Chinese method of using needles to stimulate points without drawing blood continues to be relevant today. Due to the complexity of the nervous system, the traditional methods of selecting points discovered by generations of acupuncture physicians is still being used for its practicality, sophistication and adaptability.
For those interested in reading more
this page has a more complete (although still brief) history of acupuncture and Chinese medicine.
Q: What is the difference between the various professional bodies?
A: Acupuncture and herbal medicine are not state regulated professions so there are many different bodies regulating its practice. Here is a quick guide to the main organisations.
I am a member of:
Other bodies regulating acupuncture include:
Q: I have heard about different styles of acupuncture: medical acupuncture, TCM, five elements, etc. What is the difference?
A: Many different schools of acupuncture have existed throughout history and there are still many around today. Each one has their own strengths and weaknesses.
this page summarises each styles with a brief explanation of its strengths and weaknesses.
Q: What style do you practice?
A: I was initially trained in TCM acupuncture but have expanded upon this with training in
tui na, a solid reading of modern theories and research, contemplation upon classical sources and some creative touches of my own based on my own background in martial arts, anthropology and body art.
For more information on my influences and interests you can see my
interests page.
Herbs
Q: How do I prepare the herbs?
A: An instruction sheet will be provided with your herbs but they are traditionally boiled in a saucepan for 20-30 minutes to make a strong tea. The liquid from one boil can keep in the fridge for 2-3 days and in the freezer for longer. Dehydrated granules are also possible to be ordered by post. In some instances I may prepare the herbs into ointments, capsules or wines in which case I will advise on a case by case basis.
Q: How often do I need to take herbs?
A: The usual dosage is twice per day.
Q: How long will I need to take herbs?
A: This depends entirely on the condition being treated. Like any medicine it should be taken until the illness passes meaning simple problems may take a few weeks and chronic conditions may require long term treatment plans.
Q: Does herbal medicine always taste bad?
A: Chinese herbal formulas are very unlikely to win any cookery contests. Their ingredients are selected for their effects and not necessarily for their pleasant tastes which can mean some of them are quite bitter or sour. Unsurprisingly a lot of them taste quite "woody" or "leafy". Not all of them are bad though and after a time many people can find their tastes adjusting or expanding to appreciate a different range.
Q: Is herbal medicine the same as homeopathy?
A: Most definitely not! Homeopathy is the administration of medicines that have been so diluted there is no active ingredient still present. Herbal medicine is using plants for medical purposes and many of the plants have known active compounds. Although Chinese medicine values mild treatments to preserve health placing herbs on a continuum with food therapy, it also contains stronger substances which contain active ingredients for clearing symptoms. Some of these such as
artemesinin for malaria and
ephedrine as a decongestent have been extracted and made into modern drugs while others are currently in research.
Other Methods
Q: What is tui na?
A:
Tui na (literally "pushing and pulling") is a term applied hand-on manual therapies practised throughout China. It involves locating areas of tension, stiffness or pain and releasing them through a variety of massage techniques, movements and pressure. It is possible to use this instead of acupuncture or in combination during a treatment.
I have prepared a page with
more of information on Tui na if you wish to find out more.
Q: What is electro-acupuncture?
 | A: Electro-acupuncture, sometimes called P.E.N.S. (Percutaneous Electrical Nerve Stimulation), is where a mild electric current is pulsed through the needles as a means of stimulation.
I have prepared a page with more information on electro-acupuncture if you wish to know more. |
Q: What is moxibustion?
 |
A: Moxibustion is when the herb Artemisia vulgaris, Mugwort or Moxa (from Japanese Mogusa), is burned on or near an acupuncture point to activate it using heat like an early version of a heat lamp.
The use of heat to treat acupuncture points is so common that the Chinese word for acupuncture, zhenjiu, actually means "needle / moxa" therapy.
I have prepared a page with more information on moxibustion if you wish to know more. |
Q: What are cupping, gua sha and "seven star / plum blossom" needles?
A: These are three ancillary techniques that are usually included under the term acupuncture.
| Cupping uses suction to pull the skin up, like a reverse massage. |
| Gua sha is a kind of instrument assisted massage using horn or stone tools to scrape the skin. |
| Plum Blossom Needling a means of stimulating the skin with many tiny needles on a small hammer or roller. |
I have prepared a page with
more information on cupping, Gua sha and Plum Blossom needling if you wish to know more.
General Questions
Q: Should I tell my doctor?
A: You do not have to tell your doctor but if you are receiving treatment from them then it is highly recommended that you inform them of your plans to receive acupuncture or take Chinese herbs, especially if you intend to use Chinese medicine to help you reduce or stop taking medication. It is important that your doctor be consulted regarding any change in prescription and I cannot advise on how to do this. You should always tell your practitioner if you are on any prescription medication as it may affect your response to treatment and you should
never stop taking prescription medication without professional guidance.
Q: How does traditional Chinese medicine fit into modern science and medicine?
A: Chinese medicine was developed using observation and clinical experience that has accumulated over thousands of years.
This may be referred as a traditional science although it predates the development of the scientific method by millenia. In recent times a lot of interest in Chinese medicine, both from Chinese and western scientists, has enabled some of it to be tested or have theories about its mechanisms speculated. The scientific method never proves a hypothesis, only disproves false ones and refines its theories based on current evidence. Based on this I follow a four tier system of evidence based practice:
- Strong evidence of effectiveness and are often incorporated into regular healthcare: e.g. acupuncture for migraines as recommended by NICE, or for myofascial pain relief as frequently practised by doctors and physiotherapists, or the use of certain herbs whose efficacy and mechanisms are are quite well understood.
- Good reason why they should help but conclusive evidence may be lacking, e.g. acupuncture for conditions where evidence is mixed or herbal formulas whose constituents should help a certain condition but which have not yet been trialled, or conversely where efficacy may have been demonstrated but mechanisms are unclear or debatable.
- Traditional usage indicates they are effective but specific evidence is lacking: e.g. choosing a specific styles of acupuncture where there is no evidence to suggest one is superior, or traditional uses for herbs that have little or inconclusive research. The best approach for these may be to trial and assess for individual results.
- Known to be unsafe and should be disregarded: e.g. plants such as the aristolochia species which were used in the past but are now known to be harmful and substitutes used or acupuncture techniques that are no longer considered safe.
I find using this four tiered system to decide on a course of action helps us to maintain an evidence base while still finding room for the art, personal style and improvisation that is necessary for traditional practice.
Q: How is my personal data managed?
A: The General Data Protection Regulation law requires that our data management practices are described. This is best explained in several parts:
- What data do you collect?
I am required to take a full history as well as record what we have done in each session. We must also take the contact details of each patient, their registered medical practice and an emergency contact for safety.
- How long is this data stored?
Data is required to be stored for 8 years in case it is questioned. In the case of those under the age of 18 they must be retained until their 25th birthday (8 years after turning 18). After this time it is destroyed.
- How is your data stored?
Primarily this data is stored in paper files that is kept in a locked draw. I prefer to take notes on a computer so recent cases are kept on a encrypted memory drive which is stored securely when not in use. All case notes are recorded using only an identifier number so that medical and personal information are never present in the same document.
- Is my data shared?
No information is used for marketing purposes or forwarded to third parties without your permission.
To comply with GDPR, written consent must be obtained before I send any information relating to your treatment to a third party or across unsecure media including emailing receipts for insurance claims. Case notes may be discussed with colleagues but all identifying information is removed except age, gender and occupation which can be important clinically.
Under the governments Test and Trace scheme for the prevention of Covid-19, personal contact information must be collected and may have to be shared for this purpose. By attending the session the patient agrees to participate in this scheme.
