Feelings of anxiety after acupuncture treatment

Q:  I have had two treatments for mild anxiety which included needles and burning of moxi around my ankles.Prior to the treatments my anxiety had been reduced thanks to counselling and reading books that made me understand the cause etc.After the first treatment it returned that night and led to a woolly headed and dizzy feeling and heart palpitations.These lasted for a few days and then subsided.After my second treatment the feeling returned (again during the night following) although this time I  worked out the cause so have not felt anxious.I am annoyed that the accupuncturist did not warn me of these side effects and am concerend as to whether they are normal .Please let me know if these are normal side effects as so far I have paid £100 for nothing but a whole load of additional anxiety.

A:  It is not unusual when someone has treatment for the first time that in the first few sessions there can occasionally be a rebound effect where the symptoms can be more pronounced. This is much more likely with musculo-skeletal problems like back and neck pain, and we routinely advise patients that things are very likely to get a little worse before they get better. We tend to speak of 48 hours of disruption, and while there is no conclusive explanation of why this happens, there are several theories about re-arranging of the structure which are plausible. Certainly osteopaths and chiropractors tend to offer the same kinds of advice.

When it comes to problems like anxiety or depression this is more of a professional judgement call. One of the terrible things about anxiety states, as you probably know well, is that they tend to feed off themselves, so that the first hint of anxiety causes fresh anxiety and a vicious spiral can kick in. If you tell a patient with anxiety that things may get a little worse it is almost a guarantee that things will get worse, and given the circularity of the problem this can sometimes precipitate a sharp attack. Our experience is that for the small number of people who, when not alerted, have a panic attack are far outweighed by the numbers who find the treatment very relaxing and find immediate benefits with a reduction of their anxiety levels.

We cannot speak for why your practitioner did not alert you, but it is quite probable that he or she felt that your situation was not such as to warrant a warning. Your feedback is essential, however. If someone has a very powerful reaction to treatment, then there may be aspects of the treatment which can be adjusted to reduce the chances of the same thing happening again. Some people are highly sensitive to treatment, and have very marked reactions which can be quite unpleasant. It can sometimes simply be a matter of reducing the number of needles or of using less manipulation to make the side effects more tolerable or even disappear.

As for whether the situation is normal. We are always reluctant to say ‘normal’ because this implies that it happens on a very regular basis. ‘Not unknown’ is a better way of putting it, but what we can say is that when people react strongly it does suggest that the treatment may well have a beneficial effect. Had you had two sessions with no reaction at all it might have been more puzzling. We suspect that further sessions from now on will start to generate positive benefits. There is certainly a growing body of evidence that acupuncture can help with anxiety states, and the BAcC has been working with Anxiety UK on some research into the positive benefits of treatment.

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