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Lump under ankle bone after acupuncture treatments

Q:  I have been receiving treatment through the NHS for fibromyalgia and chronic lower back pain. I have had 5 sessions and have had needles inserted into my mid and lower back, buttocks and the backs of my knees. During sessions 2-4 I also had needles to my ankles. Following session 4 I developed an extremely uncomfortable right ankle, with a lump under the ankle bone which is quite evident by feel and very painful to touch. I cannot recall any injury, trip or fall, and at today's session we had to avoid using needles to my ankles. Could this pain and lump be related to the acupuncture I have received so far?

A:  While we could never say for certain that it is, there is no doubt that if a lump or bump appears where someone has placed needles the usual assumption is that it has happened as a consequence of the treatment. Put the other way around, if you had said that the acupuncture definitely caused the problem, we wouldn't be able to say that it didn't.

 The most common form of lump like this is a deep bruise which has resulted from a slightly over-deep or over-vigorous insertion of a needle. This can sometimes show no signs on the surface, but because the ankle is a very narrow and 'crowded' space, it can put pressure on surrounding nerves and blood vessels and be really uncomfortable. There are other possibilities to do with needling in or near joint capsules which can cause similar problems, and in all cases these usually subside within a matter of days. They should certainly be gone within a couple of weeks. The other outside possibility is that there has been an allergic reaction to the needle in this specific place (we have seen one rare case of this) but it would be most unusual to react only in one place and not in equivalent areas on the other limb.

 If the lump is showing no signs of reducing, or the pain and/or discomfort remains the same, then perhaps it would be wise to contact your GP and have the lump assessed. Although there is a strong probability that the treatment is the cause, it is always best to consider the possibility that it is entirely contingent and just happened to appear at the same time. People sometimes get involved in arguing about whether acupuncture caused a problem, or sometimes simply assume that it did, and leave it uninvestigated longer than is beneficial. A lump is a lump, and needs checking.

 We hope, and expect, that it will resolve quite quickly.

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