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134 questions

Q: I have been receiving acupuncture for a number of years for primarily a kidney condition but also for eye puffiness (associated with kidney conditions). On  my last visit I had a reaction to the treatment, resulting in a severe black eye. I have not been able to go out for 7days so far and it looks like it will not heal for probably another 7-10 days, it was that bad. Do I have any recourse about this? I paid for the treatment but have cancelled any further appointments. How do I check that the acupuncturist was qualified or up-to-date with training regarding facial acupuncture? 

A: We are sorry to hear of your experience. Black eyes, while rare, are a possible side effect of using acupuncture points close to the eye. The best advice to give to a patient when needling them is to ask them to apply pressure where the needle has been inserted. This is more comfortable than having it done to you, and can help to stop or mitigate any minor bruising which can occur in the area. As we have always understood it the muscular structure around the eye and skin tone are not as effective as elsewhere in the body at providing a defensive reaction from the body to minimise bleeding.

As far as competence is concerned, although there is a minor specialism developing in the area of facial or cosmetic acupuncture, the majority of points used are the same as might be used by any properly trained acupuncturist, and we would normally expect that practitioners would be maintaining currency by frequent use, i.e. we would not make it a specific requirement for re-training except in the rare event that someone was reported to us for being incompetent. These are such basic skills that it is hard to imagine anyone not being up to speed.

That said, where someone is using treatments based on additional training in facial acupuncture there may be a number of needling techniques which are an extension of what most of us would do, and if the problem arose as a consequence of this, then there may be a question mark about how well practised the person was in using the technique, and what their level of training was.

Most practitioners belong to professionals bodies which all have publicly available complaints procedures for people who are dissatisfied with either the conduct or performance of a practitioner. In the case of performance it would be necessary to argue that the problem arose from negligence or incompetence before it could be pursued. If the problem has occurred simply as an unexpected but possible adverse effect of treatment, then the only ethical issue involved would be whether you had been properly informed of the possibility that this might happen and had given appropriate consent after so knowing.

Even here, the professional insurance that all practitioners hold would allow for redress if something untoward happened. That is why we all have appropriate cover. If you feel that you have suffered detriment you are free to make an insurance claim against the practitioner. The best way to do this is to write to the practitioner directly who will forward the letter to their insurer. The insurer will then inevitably ask the practitioner to leave further correspondence to them.

Q: I have been receiving acupuncture for a number of years for primarily a kidney condition but also for eye puffiness (associated with kidney conditions). On  my last visit I had a reaction to the treatment, resulting in a severe black eye. I have not been able to go out for 7days so far and it looks like it will not heal for probably another 7-10 days, it was that bad. Do I have any recourse about this? I paid for the treatment but have cancelled any further appointments. How do I check that the acupuncturist was qualified or up-to-date with training regarding facial acupuncture? 

A: We are sorry to hear of your experience. Black eyes, while rare, are a possible side effect of using acupuncture points close to the eye. The best advice to give to a patient when needling them is to ask them to apply pressure where the needle has been inserted. This is more comfortable than having it done to you, and can help to stop or mitigate any minor bruising which can occur in the area. As we have always understood it the muscular structure around the eye and skin tone are not as effective as elsewhere in the body at providing a defensive reaction from the body to minimise bleeding.

As far as competence is concerned, although there is a minor specialism developing in the area of facial or cosmetic acupuncture, the majority of points used are the same as might be used by any properly trained acupuncturist, and we would normally expect that practitioners would be maintaining currency by frequent use, i.e. we would not make it a specific requirement for re-training except in the rare event that someone was reported to us for being incompetent. These are such basic skills that it is hard to imagine anyone not being up to speed.

That said, where someone is using treatments based on additional training in facial acupuncture there may be a number of needling techniques which are an extension of what most of us would do, and if the problem arose as a consequence of this, then there may be a question mark about how well practised the person was in using the technique, and what their level of training was.

Most practitioners belong to professionals bodies which all have publicly available complaints procedures for people who are dissatisfied with either the conduct or performance of a practitioner. In the case of performance it would be necessary to argue that the problem arose from negligence or incompetence before it could be pursued. If the problem has occurred simply as an unexpected but possible adverse effect of treatment, then the only ethical issue involved would be whether you had been properly informed of the possibility that this might happen and had given appropriate consent after so knowing.

Even here, the professional insurance that all practitioners hold would allow for redress if something untoward happened. That is why we all have appropriate cover. If you feel that you have suffered detriment you are free to make an insurance claim against the practitioner. The best way to do this is to write to the practitioner directly who will forward the letter to their insurer. The insurer will then inevitably ask the practitioner to leave further correspondence to them.

Q:  I had acupuncture 2 days ago and since i have had pains on my left side mainly over lower ribs but coming down to waist. My skin in that area is hypersensitive and it hurts when my clothes brush against it. No needles were used here however. I had cupping and needles to my lower abdomen and I think some needles in feet and 1 in each wrist. Have spoken to acupuncturist who has no answers. Anyone else know when it will stop or what I can do!?

A: This sounds very strange. Given that the needles and cupping were not applied in the near vicinity of the problem we can probably rule out what might be termed a 'mechanical' effect of treatment, i.e. a needle being stuck into something which has caused physical damage. That does not rule out the possibility of some form of energetic change, and there are a number of side effects which can be stirred up by treatment in a way which conventional medicine would not recognise. We recognise flows of energy, and where there is flow there can also be blockage. When we unblock a problem area it is not unknown for a second block to emerge 'downstream' as it were which had not been a problem before. While possible, your symptom seems a little too intrusive to reflect that.

One possibility, and we always have to say this with care, is that the problem may have arisen as a complete coincidence. This can, if put wrongly, sound like a way of wriggling out of responsibility, but we are always at pains to say that our experience is that this can happen and the last thing we want to see is an argument about whether or not acupuncture caused the problem while the problem itself goes untreated.

Our advice to you, then, is that you should see your GP as soon as you can. The pain and hypersensitivity, while not what we would call 'red flags' are certainly enough to raise a note of concern, and we would be happier to know that you have followed this up by seeing whether there is a medical problem requiring prompt attention. If by some chance it was brought on by the treatment the likelihood is that the problem will already be diminishing; most adverse events only cause problems for about 48 hours at most. If the pains still remain after that it is worth investigating quickly.

 

Q:  I have started to visit an acupuncturist to help with anxiety & panic attacks. The  first visit she put quite a number of needles in my back & said it was to de-toxify the body,second visit had possibly 4 needles in my foot & leg (I didn,t see any of this as I was lying down) I only slightly felt the ones in my foot but no others & did feel slightly better.However on the 3rd visit she put a needle in the inner side of my left wrist & it was extremely painful & I had to ask her to stop-since then I have pain on moving my little finger & the ring finger that radiates up my hand on both sides to the wrist. I haven't been back & I think it's pointless asking her opinion as if she has done something wrong there is no way she is going to admit it.  This was over 2 weeks ago & the pain is still as bad. Can you advise me what might have happened & will it gradually improve?

A:  We think you may be under-estimating the practitioner a little. None of us like to cause physical damage to a patient, but we all have to accept that it is a potential risk of sticking needles in people, and are all usually happy to ensure that we can give as full as possible explanation of what we think has happened and the best way to treat it, usually with conventional medicine if the damage is physical. We also have the backing of very good professional indemnity insurance which is there to protect both ourselves and the patient if something goes wrong.

What has probably happened here is that there has been a small bruise in the area which has caused a minor impingement of the nerve travelling through the wrist. She may have hit the nerve itself, but in these circumstances the discomfort tends to be much sharper and short-lived. If there has been bruising in the area, then this will continue to cause aggravation until it heals, which could be a matter of weeks. This area of the wrist is very replete with vessels and nerves, and it can prove challenging if there has been an injury.

The pain should be starting to reduce very soon. However, we always advise people to see their GP earlier rather than later with problems like this because if it does continue unchanged for another two or three weeks then it may take some time to get a referral to a neurologist. No-one would criticise you for cancelling an appointment if it improved - there is always a waiting list of happy potential recipients - but you may want to criticise them if you become concerned and then find yourself waiting for a month.

On balance we think the problem will start to subside, and in almost all cases recovery is complete. These instances are rare, however, and we hope that it does not put you off acupuncture for life.

Q: I had 20 minutes acupuncture for nerve pain following shoulder surgery. I was very tired and had a headache later that night which then became a migraine. I also suffer from M.E., Fibromylagia and Chronic fatigue. Is this a normal feeling after treatment? 

A:  We wouldn't go so far as to say 'normal' because adverse reactions after treatment are quite unusual but certainly within the range of possible adverse effects after a treatment. A great deal depends on whether you normally suffer from migraines or have experienced migraines in the past. It is not unusual for someone who has suffered from a symptom in the past to experience a re-visiting of the symptom, often quite a powerful version. The received wisdom is that imbalance tends to work its way from the outside to the inside, and that successful treatment reverses the process. There are other therapies which also use this 'law of cure' where symptoms can sometimes appear in reverse chronological order as they are addressed.

If this is a treatment reaction it is likely to last no more than 24-48 hours before subsiding. If it continues beyond this then it is important to address what may be happening. The fact that you have a background of ME/CFS/PVS suggests that your system is not as settled as one might hope, and in the circumstances it is often a matter of clinical judgement about how much treatment and how strong a treatment one can deliver. This is not a criticism of western medical acupuncture, but because it often uses a different premise for how it works a practitioner will often use what we would regard as a very strong treatment for someone whose energies we might regard as too fragile to be able to deal with. This can sometimes lead to quite strong reactions because form our perspective any treatment affects the whole system. A powerful treatment to help a neck or a shoulder is a powerful treatment full stop, and it may be that it was a little too strong for your constitution.

This is not a problem. If you talk the practitioner before any follow-up session he or she can adjust the strength of the treatment to ensure that it reduces the risk if after effects. The beauty of acupuncture treatment is that it does not have to equate treatment strength with intended effect - you don't have to needle more vigorously for more difficult problems. This is somewhat confounding to a British public brought up on no pain, no gain, and a sense that it has to hurt to be doing any good. The reality is, though, that moving energy is a subtle business, and the treatment outcomes are not direct equivalent to the perceived strength of input.

We hope that describing what happened to your practitioner will not only help to head off repeat episodes but might also inform their diagnosis of what is happening in your system.

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