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Ask an expert - about acupuncture - does it hurt?

12 questions

Q: Does acupuncture hurt? A friend of mine has just had acupuncture and described it as 30 minutes of the worst pain of her life.


A:  Acupuncture rarely 'hurts'. The most that people experience is a dull ache around the base of the inserted needle, or a slight tingling feeling when the needle is inserted. Points at the extremities, like toe or finger ends, can sometimes be a little sharp, but the sensation is usually brief.
If someone experiences real pain it suggests one of three things: the needle has been inserted into a nerve and has been left causing discomfort; the practitioner is incompetent; or the patient is extremely sensitive. If it is the latter acupuncture treatment is not for them. There are a few prospective patients who find the experience genuinely uncomfortable, and we advise them to try acupressure or shiatsu. If the needle has caught a  nerve it is unlikely to be a repeatable experience. If the practitioner is incompetent, that might be the cause, although in modern times the use of guide tubes with needles means that it is very difficult to put a needle into without the requisite sensitivity.
In fact, acupuncture is one of the most relaxing treatments you can get.
We are sorry that your friend has had such an unhappy experience of acupuncture but are confident that this is unlikely to be the case should you decide to have treatment yourself. 


Q:   Does acupuncture for plantar fasciitis hurt. I have been told that it will, as the idea is to put needles close to the bone to create a flamatory response. Is this all true.

A:  Acupuncture performed using the techniques of Chinese medicine is not usually painful. There are a couple of recognised responses - a localised tingling sensation or a dull ache, called 'deqi' - about which most practitioners will forewarn the patient. Occasionally there can be a slightly sharper sensation, especially with acupuncture points where there is relatively little covering of flesh, i.e. near the nails, etc.
However, the theory of Chinese medicine involves the movement of energy, or 'qi' as it is called, and while a few practitioners in the BAcC employ quite vigorous techniques, the majority are trying to achieve subtle changes and use very gentle needle insertion. Treating a condition like plantar fasciitis would involve a mixture of local treatment and distal treatment to encourage energy flow through the affected area and to stabilise the balance of the whole system to ensure that once treated it stayed treated.
Western medical acupuncture, which we believe is what you are describing, has a different understanding of what the acupuncture is doing, expressed usually in terms of neurophysiological effects or inflammatory responses. If you believe that the healing which takes place can be enhanced or even kick-started by an inflammatory response, then it makes sense to needle quite deeply to encourage the best responses. This may not be everybody's cup of tea, but then, plantar fasciitis is an extremely uncomfortable condition and the trade-off, a few minutes of increased discomfort against a longer term relief, is often worth it. 


Q: I had acupuncture at my physio appointment yesterday it hurt like hell and had to ask him to remove the needles as it felt like i had been hit hard on my knee only two needles were used is this normal to feel this kind of pain


A: The sensations usually experienced from acupuncture treatment are not what one would class as 'pain'. Many people feel a slight dull ache around the needle, a little like a bruised feeling, which tends to stop with the treatment, and some people feel a small tingling or electrical sensation. Occasionally a point will cause a sharper sensation, but this is usually very short lived.
It is not fair for us to comment on the style of treatment of an individual, but our general experience is that physios who use acupuncture tend to use slightly heavier gauges of needle, i.e. thicker, and use points on the basis of a different underlying theory which often requires a slightly heavier technique. For some people this is too intense, and can actually be unpleasant. We can't also rule out the possibility that the practitioner has inserted the needles incorrectly or too deeply, but this would normally leave a residual pain after the needles had been removed.
As a general rule, though, acupuncture should not be painful  

Q:   My doctor offered me acupuncture, I had a terrible reaction to just a few seconds of it, and had to stop, I tried reiki and the same happened, could you explain why this is ? I am a great believer in alternative remedies.


A: There is no doubt that there are a few people who are extremely sensitive to treatment aimed at the energetics of the body. Most practitioners have a least two or three patients for whom acupuncture may not be the best choice of treatment and who use acupressure or moxibustion as the treatment of choice.
However, without knowing exactly what style of acupuncture your doctor uses, the underlying theory of western medical acupuncture often involves trigger points and the use of some fairly direct treatments which some people find a little painful. It is possible that a practitioner using acupuncture on the basis of Chinese medical theory may be a little gentler. There would certainly be no harm in speaking to a BAcC member local to you and asking their advice face to face for them to assess whether this would be a problem with what they do.
We can't really comment on the reiki other than to that once again it may be the individual whose own 'powers' are a little stronger than average. There appears to be no doubt that some people have a natural healing ability, and reactions to what they do may not be totally down to the technique of reiki which, as we understand it, is considered by many to be very gentle.
If acupuncture is too painful, for whatever reason, acupressure, moxibustion and tui na, a form of massage which uses the same energetic theory, are likely to be helpful for the very reason that they might well take advantage of your sensitivity to energetic treatment in a positive way. 

Q. Last week I had acupuncture to treat neck and shoulder injuries caused by a fall in December and I could not believe how painful, both during and for 24 hours after the treatment it was. Is this normal? I recieved the treatment in an NHS hospital by a senior physiotherapist. My next appointment is tomorrow and I am dreading it.


A. One of the principal reasons for differences in technique between professional acupuncturists and medical professionals using acupuncture lies in the underlying theory on which the practice is based. The traditional acupuncturist is primarily concerned with the energies of the body, the term 'qi' which the Chinese use to describe all aspects of physical existence, and treatment can often be very subtle and gentle. The medical acupuncturist, however, is more often working on the basis of muscular and neurophysiological approaches. This can often involve the use of what are called 'trigger points', knots in the muscle tissue, and needling these can often be quite painful. The more physically based treatment often calls for a broader gauge of needle than BAcC members generally use, and it's something of a simple truth that the thicker the needle, the more likely it is to cause discomfort.



A great many physiotherapists have added some of the Chinese medical approaches to their repertoire and are equally subtle in their approach, so we would not want to generalise too much on the basis of a single report. It may be as simple as the fact that this person's technique is not that good, or equally that you are one of a small group of people who are extremely sensitive to acupuncture treatment and have to weigh the benefits of treatment against the discomfort of the needles.


All healthcare professionals can only work with the patient's consent, though, and if there is any aspect of a treatment which you do not like you are within your rights to withhold consent. Any practitioner that continues to use a modality after consent has been withdrawn immediately puts themselves on the wrong side of their professional code of conduct.

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