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Styles of needling in acupuncture

Q:  I had my first acupuncture session last week for shoulder impingement as physio does not appear to be working. However, I had no problem with the needles going in but the physio then kept tapping it which really hurt. I only let him do it for approx 5 mins and then asked him to remove the needles. Should the needles be tapped in this way? I always thought that once the needles were in position they should be left to work.

A: There are many different styles of needling, some of which one can feel a little more than others. In traditional acupuncture the range is from Chinese style treatment, which can often involve quite vigorous manipulation of the needle, to Japanese style, which is much gentler and often sees needles being inserted with minimal 'action'. The kind of acupuncture done by the majority of physios is western medical acupuncture, and this is based on different principles. The technique can be a little more assertive, and because the theories are often based on creating local effects, there can be some quite significant pressure or 'action' applied to the needle.

Whatever the style, however, if the patient is not happy with what is going on they have every right to say so and to ask that the treatment be delivered in a more acceptable way. The tapping of needles is not a requirement, and if it is painful, and the patient requests it, it should stop. If the practitioner says they cannot do it any other way, or refuses to change, then the patient should simply terminate that part of the session. Since for physios acupuncture is seen as one of many tools, he should be able to find other methods for achieving his objectives. If he carried on after you had said that you weren't happy, that would mean he was treating without your consent, which is a serious business.

However, let's not get adversarial about it! The majority of problems like this rest on the need for better communication, and the understanding by the patient that they have a larger element of control in what goes on than they believe. If you explain the problem to your physio we are sure that he will take the appropriate steps to make your future treatments more comfortable.

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