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Q:,  Why did I have the big lumps on my body (arm, belly and stomach) after acupuncture? It is hurting now and also was bleeding after needles were removed. The most concern is the lumps.

A:  There are a number of occasions, usually quite rare, where the needles can cause a reaction because of the nature of the constituents, like the nickel found in the steel in some needles or the silicone coating with which some needles are treated tor smoother insertion. If there is a reaction at every point treated then it might suggest that it is a reaction to something generic rather than a freak coincidence of a similar reaction at every point. Most people with nickel allergies are usually well aware that they have them from wearing jewellery made from something other than gold or silver, but silicone is a much rarer compound in daily life and that might be a cause.

However, we are a little concerned when you say you were bleeding after the needles were removed. Although there can be a tiny drop of blood after a needle is removed, it is rare for this to involve every single needle insertion unless the practitioner is using needles that are too large, or the practitioner is manipulating the needles more vigorously than the patient can take, or the patient is not reacting normally to needling. Examples of this latter factor would be the skin being less elastic than it should be or the blood not clotting as quickly as it should.

in the case of the first two possibilities it is a matter of talking to the practitioner about changing the needles for a finer gauge or using less vigorous techniques. It might also involve him checking whether there is a coating on the needle which might be affecting you. If neither of these appears to be the case, then it might be worthwhile getting yourself checked by your GP. Wed do occasionally find that acupuncture treatment, which is invasive after all, can reveal problems which are not directly related to the treatment.

Having said all of that some people are simply very reactive to anything which pierces the skin, and if this is the case by the time you read this the lumps may well have gone down. If they recur after the next treatment then it might be worth asking yourself whether the short term inconvenience is worth the results you get from treatment.

Without seeing the exact nature of the lumps, though, (how large, what colour, etc)  it is difficult to be more specific, and we hope that spelling out all of the possibilities has not been too alarming.

Q:  I recently came across a case where a patient who had had a TIA 5 years previous to acupuncture had another during the treatment. Are you aware of any evidence/cases where this has happened. I wonder if it was pure coincidence.

A:  We are sorry to say that we are not aware of this particular case. We have long been aware of Soma Glick's treatment of a patient having a TIA/stroke while it was happening

http://somadevi.com/wp-content/uploads/2009/04/tis.pdf

but we have not come across the case to which you are referring.

We strongly suspect that the occurrence is a coincidence. From all of the data which has been collected over the last forty years there is no evidence of a TIA arising during or immediately after acupuncture treatment. Three major studies

http://www.who.int/bulletin/volumes/88/12/10-076737/en/

http://www.hindawi.com/journals/ecam/2013/581203/

 http://aim.bmj.com/content/22/3/122which have collected data from dozens of other reviews and have never reported such an event, not are we aware through our own records of any patient of our own members or those of other associations being affected.

There may be some aspects of having treatment which could, in theory, if the patient was anxious, have triggered the repetition of an existing condition, but that would still be highly unusual.

Our belief is that with well over 4 million treatments being administered in the UK alone each year the statistical possibility of a serious health problem unrelated to the treatment itself has increased dramatically, and this is probably what has happened here.

However, we would be very grateful for further details of the case to which you refer in case there is something which would prompt further investigation.


 

Q:  I have had 5 sessions of acupuncture to help with pain for a trapped nerve in my neck. However on the last session 10 days ago the needle in my hand really hurt. It still hurts now sometimes I cannot clench my fist as it sends a shock down my little finger. If I move a nail over my hand in the place where the needle was it sends a shock down my finger too.  Is this normal or do I need to seek medical advice?

A:  The greater majority of adverse events like these are minor and transient. What can happen on occasion is that the needles can cause slight bruising beneath the skin and as this consolidates and hardens it can aggravate the nerves and blood vessels travelling in that area. If the needle was used on the point which we suspect it was, there is not a great deal of tissue in that area and a small lump of any description may continue to be painful for as long as it takes to dissolve, which can be as much as one or two weeks. 

 

The discomfort should decrease in severity, but if it carries on into the second week with no relenting, then it would be wise to see your GP in case there has been any damage to a nerve. We suspect that this is unlikely, because hitting a nerve, as any experienced practitioner will tell you, is not a pleasant experience for anyone, patient and practitioner alike - the effect is usually immediate and unmistakeable.

 

The other theoretical possibility is that the tip of the needle has broken off and is lodged under the skin. We say theoretical because there have been no reported cases in the BAcC of broken needles since 1999 and earlier when the use of single use disposable needles became mandatory.This was because of the vCJD/BSE crisis when it became clear that autoclaving did not kill the prion, a protein responsible for the transmission of the disease. Autoclaving, which was the most common means of sterilising needles along with all other medical equipment, tended to make the steel in needles brittle if done too often. In reality, needles were too blunt to use after two or three uses for there to be enough cycles of sterilisation to weaken their structure, but in theory it could have happened. In theory the same could happen from faulty manufacture, and if the pain did continue beyond two or three weeks an X-ray may be useful as an eliminatory procedure.

However, we suspect that the effect will soon diminish and stop, and hope that this has not put you off further treatment for your neck.

 

 

 

 

 

 

However, we suspect that the effect will soon diminish and stop, and hope that this has not put you off further treatment for your neck.

 

Q:  I recently had my first acupuncture treatment for headaches /stress. During the session, I had what I later learned was a retina hemorrhage (burst vessel) The needle placements were mostly in my legs, hands, and one in the forehead. I have been told that this cannot be related and is conicidental, and was likely caused by exertion due to heavy snow shoveling the day before. I am medically healthy otherwise, and have had a full medical workup. It seems hard to fathom that this could be a coincidence. I'd appreciate your thoughts or if you've ever heard of something like this before.

A:  We have undertaken a thorough search of the adverse event literature, which is itself extensive, and found no similar occurrence reported, although there are two or three reports of physical damage to the eye caused by needling in the immediate vicinity. Our understanding is that retinal haemorrhage usually occurs when a patient is hypertensive or has diabetes, or occasionally from a serious blow to the head, and we are assuming that all of these have been ruled out. Heavy snow shovelling might well be a contributory factor if there was already an underlying tendency for the BP to become raised above average.

Coincidences do happen. With over 2.5 million treatments administered by our members alone, and probably the same number again by medical professionals and members of a few other associations it is statistically likely that there are going to be several cases every year where an unusual symptom pops up shortly after an acupuncture treatment when nothing else has changed. Our usual concern in cases like these is to make sure that the problem is treated before getting into arguments about what caused it, and very often the treatment and surrounding investigations reveal what happened. In the overwhelming majority of these cases it is simply a coincidence.

We have to be honest, though, and say that we could never give a categorical denial . Anything can and occasionally does happen, and for all we know the attempt to move energy may have had this unforeseen outcome. Our feeling, though, is that since treating headaches and stress usually involves directing energies downwards away from the head it would be a very strange energetic effect for the same process to cause what would appear to be a result of excess pressure.

This may be something to discuss in greater depth with your practitioner. If there are signs of an energetic cause these will be obvious, but we can't help thinking that this was probably more likely to do with the hard exercise the day before.

I recently had my second set of acupuncture treatments for ongoing shoulder and neck injury and since my treatment on Monday now Friday my sleep pattern has been ruined.  I am unable to sleep longer than 4 hours, I have a constant headache and I am feeling worse on daily basis.
Can this be a side effect of the treatment?  If so should it still be ongoing four days later as the insomnia at this stage is really starting to get me down.

A:  It is unusual for what we often call transient adverse events to last for more than 48 hours. If things persist after this we tend to check whether there has been any actual physical damage from treatment, which is exceedingly rare, whether the treatment has caused physical changes for the better which have started to cause 'downstream' discomforts as surrounding  tissue adjusts, or whether there has been an energetic change which may need further adjustment. Sometimes clearing a blockage, for example, can reveal further blockages lower down a pathway of energy. We have also come across situations where unravelling a pattern of unbalanced energies has made patients slightly 'hyper' for a few days as they start to function better, but in your case the headaches and feeling worse make this unlikely.

Such is the wide range of possibilities that we suspect the person best placed to advise you is your practitioner. If there has been some energetic shift which is responsible for the insomnia that should be apparent and he or she should be able to do something about it. Even if there is no obvious connection to the existing treatment there are nonetheless treatments for insomnia which may be beneficial.

The one note of concern always is that a change which happens after treatment may be nothing to do with the treatment itself. Our members offer 2.5 million treatments a year and there are going to be occasions when something happens after a treatment which has nothing to do with the treatment. This may sound like an evasion of responsibility but we have seen occasions where people have argued about whether or not a problem has been caused by treatment when the problem has been left untreated, and our first and most important duty is to ensure that someone gets proper treatment. If the headache and insomnia persist and the practitioner can see no obvious reason why they should be there (never been anything like this before, new and different), then you should see your GP to ensure that this is not something which requires conventional treatment.

It is fair to say, though, that treating neck and shoulder problems can sometimes be a rocky road, not least because it can be very difficult to get the appropriate rest and immobility to allow for good healing, and often people find their sleep disturbed as the changes in the area take effect. We hope that this does prove to be a transient effect and that your practitioner can both explain what is happening and also do something to alleviate the problems.

 

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