Q: I had an acupuncture session to help with my lower back pain and when the needles were inserted into my lower back my bum area I had a spasm in my leg. I also had pain in the other side where the other needle was all the rest seems to be fine. When I spoke to the practitioner he said this was normal as he had use larger Needles. It has now been over two weeks and I’m still suffering from pain at the side of the needle insertion and also from shooting pains and pins and needles especially in the side where the spasm occurred. Please help me is this normal as I have used acupuncture as treatment for my ME and migratory arthritis previously and have never experienced this.
A: We would hesitate to use the word 'normal' for anything which a patient might experience which is unpleasant, but adverse effects can happen after treatment. The vast majority are transient and have disappeared within 24 - 48 hours, but some can linger a little longer.
If this does persist, however, then it would be wise to make an appointment to see your GP just to ensure that everything is OK. The chances of something serious having happened are quite remote; acupuncture remains one of the safest modalities in use. It may be worth eliminating other possibilities, though, and a visit to the GP will undoubtedly provide reassurance that this is nothing more than a transient adverse event.
I don't suspect any malpractice, but was wondering if this is normal and should I be concerned with anything? Would this mild pain go away on its own? I'm concerned if it could be something more serious like a blood clot, damaged nerve or a damaged tendon as a result of the acupuncture.
A: We think that the advice your practitioner gave you is correct, and that while this seems to have taken a little longer than similar bruising to resolve it will eventually dissipate. It may well be that while the visible evidence of bruising has gone there may still be some deeper bruising which has consolidated and which is impinging a local nerve. This would mean that any weightbearing would be likely to generate a reaction.
However, just because serious adverse events are very rare does not mean that they do not happen, and so if the problem persists more than two or three weeks that may well be a good reason to have further investigations. We think it highly unlikely that there has been any permanent damage to nerves because if the practitioner had hit a nerve on the foot you would have known all about it. A blood clot sounds dramatic, but that is all that deep bruising is and it isn't likely to travel from the area. Tendon or ligament damage is possible, but our experience has been that if there are reports of tendon damage the point where they are caused is painful at the moment of insertion. In short, if the problem didn't resolve quietly over the next few days we would be puzzled!
You can discount bits of needle. The standard of needle manufacture has improve dramatically in the last twenty years, and the fact that all needles are now used only once and then thrown away in the sharps box means that broken needles are almost unheard of. The principle cause of what even then was a rare event was the constant autoclaving to sterilise a used needle which made the steel brittle. As we said, now a thing of the past.
What you report is a little unusual but not unknown. We have come across patients who have been treated for several sessions and only then shown a reaction to needles. Sometimes there is an obvious cause - change of needles, slightly deeper insertion in muscular areas - but most often it is an unpredictable reaction. The only concern would be if the blister/bite like bumps were a potential source of infection if they became open, or if they increased in severity. At this point a practitioner might just refer on to a GP for an onward referral to a dermatologist. In the vast majority of cases, however, this tends to be a short-lived phenomenon.
The other issue to consider is whether the reaction is not a physical one but a sign of some kind of energetic release. It is very much a part of Chinese medicine theory that some of the physical problems which affect the body are the result of pathogens entering the body or pathogens which have built up in the superficial tissues because of blockage or excess. When treatment 'bites' this can sometimes cause the skin and superficial tissue to become quite reactive, as well as in some cases generating rashes and areas of heat. If this is a treatment reaction it will be short-lived; the majority of what we call adverse events are transient and minor.
The best thing to do is to ask your practitioner if there has been any change of equipment or style from the first to the second session, and if so revert to the former. If not, then it is simply a matter of keeping an eye on the small bumps to ensure that they recede as swiftly as they came. We have come across patients in whom this is a benign and continuing reaction to treatment, and as long as it is managed with common sense there won't be a problem.
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