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Q. I have been having chiropractic treatment on my neck (no cracking manipulation) and back for 6 months. For the last 3 months have also been having some acupunture (at the same appointments). My neck problem has always effected my right side. However in the last few sessions my chiropractor has said my left (neck/shoulder) was a little tight. He treat this also with acupunture. After my last session, i developed a large bruise in the area (I rarely bruise), and a strong sharp pain in my left shoulder blade, plus a horibble gripping like pain around the spine area between the shoulders. It has now been 2 weeks since this last session. I am still experiencing sharp 'needle like' pains in my shoulder muscles and back ache. Is this normal? i've not had it before. Any aches in the past have normally gone after a couple of days.

A. We think that it is highly unlikely that there has been any serious damage; serious adverse events after acupuncture treatment are extremely rare. However, in cases like this where physical therapists use needles as an adjunct to their work we often advise people just to check in with their doctors. This is not intended to be disrespectful to these practitioners but we do find that many of the osteopaths, chiropractors and physios who undertake short course training use slightly more vigorous techniques than we might. This can on occasion cause some fairly deep bruising which can take a number of weeks to disperse, and during this period it can cause a number of unusual pains as nerves which traverse the area are impinged. If, of course, your practitioner is a fully trained acupuncture practitioner we offer our apologies for any intimation that he or she is only 'short course trained', and can only say that these things can sometimes happen, however much experience someone has.

Basically, though, any treatment which causes pain lasting longer than a few days is worth investigating, and very often this can establish causation. It is not uncommon for practitioners and patients to get involved in arguments about what caused what when the problem gets left untreated, so for our own members we always recommend that they send patients to GPs for a check. Accidents are rare but they do happen, and it is always better not to be too categorical.

We can reassure you, however, that there is extremely unlikely to be any part of a needle inside the body causing some of these sensations. The use of single use disposable needles has rendered needle breakage almost unknown, so although pains can sometimes feel like pieces of needle left in situ they aren't. In the bad old days when needles were sterilised and re-used it could make the steel brittle and able to fracture, but since 1999 we are unaware of anyone still sterilising and re-using needles.

We do hope that this problem resolves itself relatively soon.

Q. Can acuputure related to fertility cause boils???

A. A great deal depends on where the boil or boils are situated. If they have come up at the exact spot where the needles have been applied, this would be worthy of further investigation. Adverse events like infection from needling are very rare, and only happen in countries where hygienic procedure is poor. If someone follows the simple safety procedures and uses single use disposable needles, then infection is almost impossible. The only reason might be that the person had something like an oil on the skin which the needling had pushed into deeper dermal layers. This is the reason that our members are instructed never to apply massage oils and then needle unless they have properly cleansed the site.

If the boils have come up somewhere else, then it is highly improbable that the acupuncture treatment has been responsible. Systemic infections arising from acupuncture are unheard of in the UK. It might just be possible to make a case in Chinese medicine for the release of pathogens to cause something like boils but not boils themselves which are very clearly an infection.

The best advice that we can give is that you see your GP, if you haven't already done so, and seek treatment with antibiotics. There are a number of varieties of swelling and inflammation like this and it is important to establish as soon as possible exactly what is going on.

It might also be worthwhile checking in with the practitioner to alert them to what has happened. We record things like this in our notes so that there is a clear audit trail and so that we can just check whether there is a possibility, however remote, that the treatment might have been involved.

Q. Can acupuncture get fluid off your feet and ankle

A. We are assuming that you have already sought appropriate medical advice about the swelling in your feet and ankles. Although in the vast majority of cases this is a relatively benign symptom it can in one or two cases be the first sign of something more serious and these conditions need to be eliminated before you proceed.

As far as the swelling itself is concerned this is not a 20th century phenomenon, and the Chinese were just as susceptible to these kinds of problems 2000 years ago. Chinese medicine has a different way of looking at the physiology of the body, and especially at the way the Organs of the body work. Because everything is understood as the balance and movement of energy, the Organs are responsible for functional aspects of the flow which extend far beyond what we see an organ doing in the west. The poor distribution of fluid in the body, especially the pooling of fluids in the lower parts, points immediately to a weakness in a specific part of the system as the most likely cause.

That said, it isn't simply a matter of sticking a needle or two in formula points and away you go. in the majority of cases a weakness in one part of the system is a consequence of patterns of imbalance across the whole system, and our belief is that the most important need to be corrected so that the lesser ones will clear. Symptoms are alarm bells, not the problem itself, and although there will be times when a symptom is just what it is and no more, most of the time it requires the skill and expertise of the practitioner to determine how best to unravel the complex patterns.

The best advice that we can give is that you visit a local BAcC member for a brief chat about what may be possible. Most members offer a small amount of time without charge to prospective patients to enable them to make an informed choice about treatment. It will also enable the practitioner to assess whether they need to take care in needling. We try not to needle into heavily swollen areas to reduce the chances of cellulitis and other nasty problems, and this can condition what we are able to do. Working at a distance is just as effective, i.e. needling arms to address problems in legs, and one of our colleagues has led the field in researching the effectiveness of this. It can be quite disconcerting to a patient, though, and a chat before treatment starts may well prepare them for this outcome.

Q. I had a reaction to a treatment, I had bad back so the practitioner bled the back of my knees and I fainted after she had finished. As I fell I hurt my ankle whick I told the practitioner but my hand where one of the needles were has gotten progressively painful, could the fall and the needle in my hand have caused damage. What can I do. This is three weeks post treatment the back, my ankle and my hand still hurt.

A. We are very sorry to hear of your experience. It certainly sounds highly unfortunate on all counts.

As far as the specific damage is concerned, any fall involving the ankle can take a long time to resolve. If you twisted the ankle on falling and pulled the lateral ligaments these can take several weeks to recover. However, when a pain continues like this, it is always best to seek medical advice. Broken ankle bones are not common from a simple fall but they can happen, and if you have chipped or cracked a bone you need to know this so that you can get help by way of bandaging or special boots to enable the bones to heal.

As far as the hand is concerned, it is not clear from your question whether you fainted with the needles still in place or after they have been taken out. If they were out you would need to follow the advice given above and get the hand checked by your doctor. If you were unconscious when you fell it is possible that you have broken a bone or torn a ligament. If the needles were still in place the other possibility is that one of them has been forced a little further than usual into the tissue and caused internal bruising far enough beneath the surface of the skin to be undetectable at the surface. This can take up to three or four weeks to disappear without necessarily showing any external trace.

What we always say in these circumstances is to go to the GP to get the areas checked for actual physical damage. This will almost always reveal what caused it, and in your case the fact that you had a heavy fall may account for the pain you are still experiencing rather than being an adverse effect of the acupuncture treatment itself. However, if the needling of the points behind the knee was a contributory factor in your fall then you may have grounds for pursuing an insurance claim against the practitioner for what has happened. It isn't our job to go around encouraging people to make claims, but we all have professional insurance in case accidents happen, and this may be just such a case.

Q. Would acupuncture be used to lower blood pressure as I have bad sude effects from all medication prescribed and I am at my wits end

A. Although we publish a factsheet on hypertension

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/acupuncture-and-hypertension.html
it does not have a great deal of evidence to suggest that acupuncture is that effective as a stand-alone treatment for high blood pressure. However, two more recent systematic reviews, summaries of all trials, tend to the conclusion which we find in clinical practice, that a combination of medication and acupuncture tends to be the most effective treatment. You can see the reviews here

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514875/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381419/

but they are a little complex!

One of the main reasons that there will usually only be trials of acupuncture and medication against medication alone is that no clinician would be able to leave high BP untreated as a control against which the acupuncture was tested. What we find, though, is that when we use acupuncture treatment alongside medication people are often able, after discussion with their doctor, to begin to reduce the amount or numbers of medications they use. For many people this can mean the difference between debilitating side effects and mild inconvenience. Reductions can only be done in concert with the GP, though; patients changing their own medications can sometimes cause major complications. Our members would never advise anyone to so do.

The best advice that we can give is that you visit a local BAcC member for a brief chat about what may be possible. We treat people, not conditions, and it is highly likely that your high blood pressure sits within a wider context which may make a great difference in how much change you might be able to achieve. The same named condition can be treated in dozens of different ways because each patient is unique, so there is no one set treatment. This can mean a considerable difference in the confidence we feel about effecting change.

Most members are happy to give up a few minutes without charge to prospective patients, and this will enable you to make a properly informed choice about whether to proceed with treatment.

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