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14 questions

Q:  Can you have have the needles inserted and manipulated and feel nothing, this has happened with 3 needles in my back.? I could feel the other 9

A:  This is perfectly possible. The combination of the pressure of the guide tube through which the needle is inserted and the pencil-point tip of many needles can mean that there is no discernible feeling when a needle is inserted and manipulated. It is also important to bear in mind that the back is not the most sensitive area of the body, and the special cells which detect feeling are often more widely spaced than elsewhere on the body.
There are a number of different styles of acupuncture, and the range of possible sensation is considerable. Modern practice in China is to elicit a very specific response to the needling, called 'deqi', which is a rather dull aching sensation, like the beginnings of a bruise. By contrast, modern Japanese techniques are often so subtle that there is no sensation at all, and we have heard stories of Japanese practitioners apologising if a patient makes any noise when the needle is inserted. The same applies to the needle insertion itself. Japanese needles are pencil-tip shape, in contrast to the slightly rounded end of the Chinese needle, and even at 0.2 of a mm, there is a tangible difference as these needles are inserted, with the Chinese varieties more likely to be felt as they break the skin. The sensation is usually not very great or very long-lasting, however, and if a sharp pain continues after the needle has been inserted it is as well to let the practitioner know so that they can make it more comfortable.
In any event if you cannot feel a needle either being inserted or in place when you can feel others it is as well to let the practitioner know. None of us is infallible, and the literally pinpoint accuracy needed is not always achieved. It can also be good feedback to the practitioner about the energetic sensitivity of the area, rather akin to the famous Sherlock Holmes 'dog that did not bark.' If there is a reaction in some places and not others this may be evidence of a poor flow of energy, or 'qi', in the area which may have diagnostic significance.   

Q:  i had my first acupuncture session and the therapist put the needles through my clothes is this the proper practice?   The needles went into my buttock and leg.

A:  The short answer is 'no'.
This question was raised a very long time ago when a member queried whether it was acceptable to needle through by thin fabric when treating patients whose religious or ciltural sensitivities made it impossible for them to uncover areas of the body which the practitioner felt needed to be needled. The categorical advice was not to do this. Either the practitioner must find other ways of treating the problems through the use of available points, which can often be done, or the patient must be referred on to a practitioner in front of whom the removal of some clothing is acceptable.
The possibilities for infection or the accidental contamination of the puncture site with foreign bodies are so obvious that the prohibition is self-evident, i.e. one would never expect to have to gather evidence to support it.
If your practitioner has done this with you it is fair to assume that this is a standard practice, and it is important that they cease and desist immediately. If he or she belongs to a professional association, it would be a good idea to approach them with this information. Even if you chose not to make a formal complaint we are confident that they would instruct the member not to do this again on pain of removal from the Register if they failed to comply. If this person is a BAcC member, you need to contact our Ethics Secretary on 0208 735 1205 for further advice. If the practitioner does not appear to belong to a professional body then a word with the Local Authority Environmental Health Department is merited. 
We should reassure you by saying that the chances of an infection are remote, but even though they are remote, the treatment is nowhere near as safe as that undertaken with proper preparation and precautions.

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.

Q:  How good is Chinese accupunture for healing


A:  A good question, but almost unanswerable in a short paragraph!
Acupuncture is simply a system of medicine which helps the body to return to normal function. How good it is depends on how complex the problems which beset the patient, how long the problem(s) have been troubling them, how clear the diagnosis of their problems is, and how competent the practitioner is. There is a growing body of evidence of acupuncture's efficacy for a number of named conditions, but the strength of the system lies in the fact that it has existed for two and half thousand years and continues to be a treatment of choice for many millions of people across the globe.

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