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Burning and aching in my knee after acupuncture

Q: I was in a snowmobile accient about 12 years ago. I started having  acupuncture in my knee which has had a screw in it for about 5 months ago. I have it once a month and a couple days later I have the worst burning and aching in that knee. is that normal?

A: We always hesitate to use the word 'normal' in cases like this. It is always possible that acupuncture can trigger a reaction, but the vast majority of these are short term, what we call transient adverse events. When they do occur we try to work out whether there is some aspect of the treatment which we can adjust to prevent their re-occurrence, or simply to understand why they occurred in the first place. This helps us to build up a comprehensive picture of the kinds of adverse events about which we might choose to warn prospective patients.

 The fact that this happens every time is a little unusual, and we would perhaps need to know whether the treatment was manual acupuncture or electroacupuncture. Some practitioners do use EA quite regularly for musculo-skeletal problems, and if this is the case then some for of interaction with the metal in the knee is possible, although still highly unlikely.

 Usually when heat is released from the body in this kind of way we tend to see it as a good thing, and it is just possible that the trauma to the knee has caused internal disruption which is clearing slowly as the needles are applied every time. Our practice is based on an understanding of the body as a system of energy, called 'qi', and if the knee has been extremely badly injured (being pinned suggests it was) then the energetic trauma may have been very considerable. If this is the case then it is possible that inserting needles is allowing this to be released on a regular basis, but if this is so we would expect the effect to reduce with time.

 We think the best thing to do in this case is to discuss the matter with your practitioner. We are intrigued by why this is happening and we would strongly suspect that he or she is too. Acupuncturists are by nature very curious about how things like this arise; our whole tradition is about making sense of disparate or unusual groups of symptoms. If your practitioner is aware of what is happening then we think it very likely that they will be actively trying to understand it and working out how best to refine the treatment to make sure that it gets addressed and doe not recur.

 Of course, the other factor we have to bear in mind is that the damage to your knee has sensitised the area to the metals of the needles. Some contain nickel in the steel, and others are silicon coated for ease of insertion. If the area has been disturbed by the accident it may have become hyper-sensitive to one of these substances. Again, your practitioner would be able to explore this as a possibility and see if the treatment can be adjusted accordingly.