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134 questions

Q: I had accupuncture in my left foot after which my right leg felt very cold and tingling -  is this normal?

A:This is not a normal response to treatment, and although we could provide a possible explanation we would be very surprised if the treatment and this sensation are connected.

Essentially, traditional acupuncture treats the system as a whole, whatever the symptoms or conditions which the patients comes in with. Because it is an enclosed system in which all the pathways interconnect there is always a possibility that dealing with blockages or even simply improving the overall flow will cause an increase in the energy supply to areas which could deal with a weaker flow but not with something stronger. This can be diagnostically very significant, and a practitioner can often uncover other
areas of blockage as the system starts to work better.

Generally, though, cold and tingling sensations arise where the energy is lacking, and it would be most unusual for this to be the case after a treatment. However, without knowing exactly what the practitioner did and why it is difficult to comment. What we can say with certainty is that the practitioner, if there are a BAcC member, will not only be the best person to offer advice but will be delighted to discuss with you what may have happened.

The other thing to bear in mind is that the symptom may have nothing to do with the acupuncture treatment and may have arisen for some other reason. This is not a sneaky way of avoiding responsibility, but a genuine concern. We have sometimes seen situations develop where the argument kicks in about whether the treatment caused the problem or not while the problem itself goes untreated. What you are experiencing is not a normal state of affairs, and if it persists for more than 48 hours after treatment you can say with some certainty that it has not been caused by it. In this case we would always recommend that a patient visits their GP to start to establish what is happening.

In all cases, however, the practitioner is usually the best resource at your disposal, and nearly all of our members are very happy to guide patients through the options for other forms of care and attention if a problem arises which they are not able to treat or consider would be better treated by other forms of conventional or complementary medicine.

Q:  I  have been a long term headache sufferer. My GP advised acupuncture. I have had one session. I believe there was a needle in both temple areas, my forehead and
2 needles in my should/neck area. About 1 hour after treatment I had a sensation in my fingertips (right hand only) which over the last week  went to my whole hand, right ear, scalp of my head and partially my right foot. I have spoken with the GP about this, who has said it's nothing to worry about. I am not sure this is normal. The sensation is like the remainder of pins and needles. Once the blood has come back to the area, that remainder numbness feeling.  Also a friend of mine believes the strength in my right hand is not as good as it was.

A:  This is certainly a very powerful reaction to treatment, and our first question would really be whether the treatment was administered by a traditional acupuncturist or by a doctor. This may seem strange, but there are two or three distinct and different ways of approaching acupuncture treatment with different techniques, and what you are experiencing might or  can be interpreted in a couple of different ways.

From a traditional acupuncture point of view the body is a system of energy, called 'qi' whose rhythms, flow and balance determine the state of someone's health. Where there is excess, deficiency or blockage, there will be pain or discomfort and the skill of the acupuncturist lies in moving the energy to promote balance and reduce symptoms. This can have one or two direct consequences. Quite often in the area where the needles have been applied there can be a dull, aching sensation which the Chinese call 'deqi' and which for a Chinese practitioner is a requirement of good treatment. This tends to be localised and relatively short lived. There can also be an effect from unblocking energy which can travel through the channel system and generate strange sensations across the whole of the body in very clearly identified channel pathways. This is much less common, but not unknown - unblocking something in one part of the body can occasionally reveal a blockage elsewhere which then generates new symptoms.

The important thing to say, though, is that a traditional acupuncturist will be using needles at such a superficial level that there is very little likelihood of physical damage which has secondary consequences. The practice of Chinese medicine is over 2000 years old, and over this time the safe insertion of needles has been refined to the extent that injuries are rare. The other style of treatment, often called western medical acupuncture and used by doctors and physios, is a much more formula based
treatment relying on different theories. The needling is often based on releasing knots in the muscles or having local neurophysiological effects to reduce or remove long-term discomfort. This can be a great deal more vigorous than the methods used by traditional acupuncturists, and it is just possible that there has been some local bruising in the neck which has caused a mild nerve impingement. This will go away as soon as the bruising subsides.

However, we are not sure that we agree that it is nothing to worry about, especially since the sensation is across such diverse areas. We are always careful to ensure that in cases like this there symptoms are coming from an entirely different problem, but because they emerged at the time of acupuncture treatment are assumed to be a result of it. This has to be addressed carefully because at some levels it sounds like a 'not my fault' statement, but we have seen a number of occasions where people have become
mildly obsessed with proving it was the acupuncture which caused the problem but have not dealt with the problem itself.

 If it seems unusual, then it is unusual, and you should be going back to the practitioner who applied the needles to discuss the matter with them and to get their advice. They will know where they have needled and what physical consequences there may be from where they went. If it seems unlikely to be an effect of the treatment, then you may need a referral to a neurologist to determine exactly what is happening.

On balance we think that the sensations will reduce and resolve, but we would rather people sought help and reassurance earlier rather than later in the remote case that there is something which needs following up quickly.

Q:  I had my third treatment last night with a traditional and experienced practitioner. Last night she treated an ankle injury and blocked sinuses. She used a needle in my left ankle, 2 on my elbows and one in my left ear. She had also spent some time doing Chinese and Thai massage. Immediately I got up I had terrible cramping in my left rib, below my breast. This has continued all nightand is still there this morning. Previously I have had an issue with intercostal muscle strain.   I am wondering if the treatment last night released something? I still have shooting pain but otherwise feel fine.

A:  This is certainly unusual as a possible consequence of acupuncture treatment. We usually, although quite rarely, receive questions about problems which arise in the area directly where the needles have been inserted. For a rather unpleasant problem to emerge some way away from the needling site, there are really only two options:

1) the one you have mentioned, that there has been some sort of release of a previous muscle strain. We think that this is probably unlikely; in our experience it would be most unusual for a muscle strain to be re-visited as a consequence of treatment. This is much more common with symptoms like headache or digestive disorders where it is tied to a sense that something is being cleared from within. Most muscle strains are not related to pathogenic factors trapped inside, and where we do see them they are more often to do with the body returning to its proper structure and muscles which have been tightened to accommodate the change now get forced to stretch again.

2) it is a contingent result that just happened to fall immediately after a treatment. This does happen sometimes. With over 3 million treatments a year given by our members, there are going to be a small number of cases where a symptom emerges just after a treatment randomly.

However, it is undoubtedly an unpleasant symptom and we would strongly advise you to see your GP if it carries on for more than another two days. While it is very probably a strained muscle, something which occasionally be brought on during sleep, especially if the body is exposed to cold draughts, there are a number of other conditions which present in this way which might need to be followed up promptly, and your GP will not worry about double-checking just in case.

We are sorry to hear of your experience, and hope that this feedback helps. We are always a little uneasy when we say that a problem is unlikely to have been caused by treatment because we are aware that some therapists use this as their stock response to any suggestion of culpability. Our concern is your health and well-being, and if we think something is not a result of treatment we want to ensure that a patient gets the appropriate treatment as soon as possible. You could actually do a lot worse than popping in to see your practitioner and asking her advice. She may well have some very useful suggestions about the best course of action, and if it is a muscle strain, some practical tips for helping you to recover. Intercostal strains are a nuisance, as we know you already know; it is very difficult to guard them from body movement and even any deeper breathing.


Q: I had acupuncture done to my left hip and I'm in a lot of pain is that normal and  what can I do to ease the pain?

A:  We would need to know a great deal more about the exact nature of the pain, and crucially why you first sought treatment, before we could offer precise comments. It would also be helpful to know how long after treatment the problem started.

There are a number of possibilities. On occasion when patients present with structural problems or problems which arise from a structural fault, such as low back pain or sciatica, then there can be a chance that in the process of the body re-discovering its proper shape there can be a number of aches and pains to do with the muscles and tendons having to adjust. In common with osteopaths and chiropractors, we often advise people that the next 24-48 hours might be a little more uncomfortable, after which they should see improvements.

If the initial problems was in the hip itself, then there are a number of points which are used in the area which can be inserted quite deeply and with perfect safety. It is always a possibility that there has been some bruising fairly deeply under the skin, and this may well cause some local nerve impingement which, because the bruising is deep, would show no surface signs.

in both of these cases we would expect the discomfort to pass relatively quickly, although we have come across cases of deep bruising where the effects have lasted longer. 

The best course of action is to raise the matter with your practitioner. He or she will know exactly what they have done and been trying to achieve, and can probably set your mind at rest. There is no obvious reason to start seeking medical advice at this point unless the pain is very severe or there is an accompanying loss of free movement. If it does carry on for longer than either you or the practitioner think reasonable, then a visit to the GP would be a sensible option.

As far as short term measures are concerned, proprietary pain killers are probably the first line of attack. In most cases these will buy time while the underlying problem rights itself. If the pain is too strong to be touched by proprietary over the counter drugs, then the visit to the GP for advice and stronger treatment may be brought forward.

Your practitioner may, of course, uncover energetic reasons why you have pain and be able to address these with needles, although understandably someone who believes a pain has been caused by treatment may be unwilling to have further treatment to deal with it.

Of course, the one possibility that we haven't mentioned is that the pains are unconnected with the treatment. We always have to say this cautiously because some people take it as an attempt to say 'not my fault' but we do come across a small number of cases each year where problems arise after treatment which were not caused by it, they simply were a case of the timing suggesting a causal relationship which wasn't there. We are always concerned when this happens because the focus tends to turn to whether or not the problem was caused by treatment when the problem itself is left untended. If there is a problem, howsoever caused, the main priority is to get it sorted. Arguments about causality and responsibility can usually wait a while.

,Q: I have had 3 sessions of acupuncture for lower back pain. An MRI showed a herniated disc L4/L5 and I have been trying to find a helpful treatment for 9 months. I saw a couple physiotherapists and the exercises they gave me did help a lot but not fully. Five hours after my second acupuncture session I had a lot of pain in places I've had pain previously, and in new places and pain evoked by movements that previously were painfree. I'm worried  the acupuncture just undid 9 months of work. Also, it hurts when he puts the needles in - it is tolerable and he modified it to be less painful in my third session. However, 15 hours after that 3rd session and I am in pain still. I don't know if I should continue for the 10 recommended sessions. Also he suggested herbal medicine to help the imbalance/ weakness of my kidneys and liver. Please advise!!

A: We can start immediately by saying that it is highly unlikely that the acupuncture has undone any of the progress you have made over the last few months. It remains one of the safest forms of treatment available, even compared to many forms of conventional medicine, and unless someone is poorly trained and sticks a needle in a vital organ, itself extremely rare, there is very little chance that physical damage has been caused.

That said, it is not unusual for people to experience a noticeable reaction to treatment, especially after the first one or two sessions, when musculo-skeletal conditions are the order of the day. This expert always warns patients with neck and back problems that for up to 48 hours after a session there may be some additional discomfort and stiffness, but after that there should be some progress. Opinion is divided about why this should be so, but most of the explanations are plausible. The two most commonly accepted are that the body 'immobilises' itself to allow healing to take place, and that the body has often been in an unstable posture because of the problem the patient has/had, and the discomfort arises from the musculature adapting as the structure rectifies itself. This sort of reaction should not continue after the first few treatments. Osteopaths tend to give the same warnings to patients.

We don't want to make unwarranted assumptions but the recommendation of ten sessions along with herbs does suggest that you may have visit a Chinese practitioner in one of the High Street shops. This is very much the norm in traditional Chinese medicine practised within the Chinese NHS - a course of treatment is defined as ten sessions and usually administered daily. Fine when it's free, but most people in the UK would be stretched to stump up ten fees in ten days. If this is the case, then you may find that the needle technique is a little more vigorous than that practised by someone trained in the West. A prerequisite of good treatment in China is to elicit a dull aching sensation, called 'deqi', at the point where the needle is inserted and the needles are often inserted a little more deeply and manipulated until the patient can feel what is happening. This is often too much for western patients, and many ask the practitioner to tone it down. Many others, it has to be said, exhibit a true British diffidence about complaining and walk away, but a responsible practitioner will always take heed of what a patient reports and asks. If they don't, walk away.

As far as the treatment itself is concerned, a herniated disk will normally self-repair within about three months unless it is a really bad one or the patient overdoes it by straining their back. Keeping moving is now the recommendation from conventional medicine, but don't overdo it. In a previous answer we wrote:

Slipped discs can take a long time to recover, even when using therapies which are known to help. Where the standard treatment in conventional medicine used to involve a great deal of bed rest, continual movement is now the order of the day to help the acumulated tissue to disperse.

There are a number of small studies which underpin documents like this overview

which mentions that there is a weak evidence base for acupuncture. Our own fact sheet on sciatica

mentions a number of studies which show some encouraging results for the kinds of secondary problems which can arise from a slipped disc.

Sight unseen it is very difficult to offer a detailed opinion, but speaking in very general terms, there is often an accident or underlying pattern of weakness which predisposes someone to have a slipped disc, and there are often ways of understanding the disease process from a Chinese medicine point of view which offer treatment possibilities. This can often be the case when someone has reached a plateau in the conventional treatment they are having.

However, it is not uncommon for people to seem to plateau and then for the condition to resolve after 3-6 months, and you may well find that you suddenly begin to make progress again. Acupuncture treatment certainly won't do you any harm, and given that the area where you have been affected will have been quite immobile and 'stagnant' for a few months it is possible that from a Chinese medicine perspective there are significant blockages whose clearance may help to speed up your recovery.

and we believe this is sufficiently encouraging to warrant using acupuncture. Certainly in our clinical practice we have been able to help patients with this problem, and the real question is how much help and how sustainable, rather than works/doesn't work. As long as there are frequent reviews to ensure that a treatment habit with no real progress builds up, it would be worth continuing.

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