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Pain in knees and bruising after acupuncture for whiplash and sprained back?

Q: I had my second session of acupuncture for whiplash & sprained back. Afterwards I had  pain in my knee where no needles were placed and a large painful bruise on my back. Is that something to be expected?

A:  We are sorry to hear of your experience.

There are a number of possibilities for the pain appearing behind your knee. The bruise which you have, which sounds very unpleasant, depending on where it is may be impingeing a nerve in your lower back which is creating the sensation of pain in the knee. This may something like a referred pain, where you feel something as though it were behind the knee but it actually comes from pressure on the nerve higher up.

A second, and perhaps likelier, possibility is that the treatment has caused a re-alignment of the back, putting it back into a better position, and as a consequence muscles which have adjusted into different positions are now being forced back into their natural positions and causing a little strain at the insertions of the tendons. We often warn people having treatment for bad backs and necks that this is a strong possibility, and indeed most osteopaths and chiropractors alert patients with these sorts of presenting problems that the first 48 hours after treatment can be a little rocky.

The third possibility is that this is a reaction in an acupuncture point to the problems which you are experiencing. Some points can become spontaneously tender quite some way from the site of illness or injury by a form of resonance between the points and the areas they cover. In some systems of acupuncture, like Japanese Meridian Therapy, this phenomenon is used diagnostically; where the practitioner can find or the patient reports an area of tenderness on the limbs it can often point to an area of weakness inside the body.

In all cases the reaction should subside quite quickly, probably by the time you have received this response. It is very important, though, that you tell the practitioner exactly what you experience, and also make sure that he or she sees the bruise (we are sure that they will, but just in case....). Bruising is a relatively common side effect of treatment (but still rare), but a large painful bruise is not usual. This is something which would usually start within the session, and pressure applied to the point should minimise the effects. If this comes as a surprise to the practitioner it might be good to monitor other points over the next few sessions to see if you bruise very easily. There are both conventional and Chinese medicine reasons for this.

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