Find an acupuncturist...

Ask an expert - about acupuncture - side effects

134 questions

Q: I'm a physiotherapist and  recently frequented an eletropuncture three-day course. When we were practicing some points (specifically the 3R - third point from the meridian kidney) my colleague put the needle a little above the point and touched/hitted the tibial posterior nerve. I immediatly felt sharp pain in the plantar side of the calcaneous.  After that "incident" and until today I have little to no pain on walking, but when I stretch the entire posterior chain or only the sciatic nerve (with dorsal flexion) I have that sharp strong pain. I talked with the person responsible for the course and she told me that in a matter of days the pain will be gone. What is your opinion?

The person running your course is very probably correct; the vast majority of transient adverse events disappear within a matter of a few days. Exceptions to this are rare, and when they happen it is often because of small bruises forming beneath the skin which cause nerve impingement when the body is moved in particular directions. This is quite common where there are natural channels in the body, like the ankle or wrist, where there is a higher concentration of blood vessels and nerves travelling in narrow compartments.

We are not clear from your e-mail whether the needle being used to practise was wired up to the EA device or not. If it was a practice run the chances are that it wasn't but we do occasionally hear of patients whose treatment involved EA delivered at higher levels than they can tolerate, and this can occasionally cause longer term irritation of the nerves. The warning signs are very clear, however, and unless a practitioner spins the dials carelessly it is unusual for someone to go from no-pain to pain that quickly.

Our recommendation is, as we're sure you're doing as a qualified professional, to keep an eye on how things go and try to estimate whether there is a qualitative change in the symptom over time. If, however, it still persists after a week, we would probably advise you to visit your GP and possibly line up an appointment with a neurologist. The GP is more than likely to say 'wait and see' after only a week, but it can be helpful to have marked the spot.

Injuries which happen on training courses are often a source of confusion. There are usually disclaimers in place where people on the course use each other as testing apparatus, but that does not mean that a person on the course signs away their right to redress if the damage causes detriment, as they say in the insurance world. The course and the person running it should be properly insured, and if there are consequences which impact on your health and work, it would be entirely legitimate to make a claim.

Q: An acupuncturist put a needle in my neck and then suddenly pulled it out and stopped the session. When I asked why he said my body suddenly went really cold, but wouldn't explain any further. Since then I've had increased pain in my neck and I haven't been back to him, but I wonder if you could tell me what might have occurred at that time? I would really appreciate having a clearer understanding of what that could me (my body suddenly going cold) and if this is a common problem in acupuncture or something associated with a doctor who perhaps is less qualified than they should be?

>A:  We are sorry to hear of your experience of acupuncture treatment. While not impossible for this to happen it is relatively rare in our experience. 

We would probably classify this kind of reaction as 'needle shock.' This is not caused by any specific interference with or damage to a part of the body but happens in people who are quite sensitive to being needled. We would describe this as  an energetic reaction, whereas conventional medical professionals would tend to describe this as a neurological one, but essentially a rapid temperature change/loss is sometimes a precursor to someone fainting, and a responsible practitioner will simply stop the treatment at that point. They may put the patient in the recovery position, but in any event will often make them lie down for a moment until they feel better. In your case, you had not felt any reaction, and it was the practitioner's experience of cold which meant that they drew the acupuncture session to a close, so restorative action may not have been required.

We don't think that the level of training that your doctor has is a factor. One significant difference between medical acupuncture and traditional acupuncture, though, is that western acupuncture has no concept of energy, and is often based on an understanding of trigger points, blockages in the body of muscle, or on a neurological mechanism which causes a healing response. This does mean that the technique can often be applied a little more vigorously than we would expect our members to do, and this can sometimes trigger a reaction such as you have had. If this was a traditional acupuncturist, they would simply reduce the number of needles they used, insert them less deeply and use less manipulation of the needle. However, since these are not usually factors within medical acupuncture, the practitioner has taken the wise precaution of stopping.

The increased pain in the neck may be connected with the acupuncture session, but without knowing the timescales involved, i.e. how long it is since the treatment and how soon after the treatment the pain increased, we cannot say. It is highly unlikely to be a sign of physical damage, although there may be some internal bruising which can happen after treatment. We are assuming that you were having treatment for neck pain, and it is not uncommon for this to be affected by all manner of movements, thus making it very difficult to work out exactly what causes it to become worse.

The bottom line for us, though, is that if a patient has a problem after a session, then the first and most necessary port of call is the practitioner who undertook the treatment. They know exactly what they did, where the needles were inserted, and so on, and are best placed to comment of what has happened. If the practitioner does not give a satisfactory answer, the next step is to contact any professional body to which they belong, or in the case of a doctor the practice manager of the practice where they work to find out where to make a complaint. Hopefully, however, it will not come to this, and the practitioner will be able to reassure you about what has happened.   

Q:  My sister has a long standing back injury, she fell on a concrete surface and injured her lower back in 1997. She has been in tremendous pain over the years, chiropractors, physios, pain killers the lot. Recently someone advised acupuncture, and we all recommended she go. After this length of time she'd try anything for relief. The acupuncturist told her she needed at least 6 sessions, then they could decide further. My sister managed 3 sessions. All 3 were very painful, and the pain lasted for days mostly at the points where the needles were inserted, mostly her left shoulder. After the last session, she was very dizzy, lightheaded, started experiencing blackouts and fainting, unable to stand, unable to get up and down stairs we took her into hospital because she'd hurt herself when she fainted. Her MRI is clear, 2nd one also clear. All results clear. They are now focussing on getting her mobile, saying its like her brain has forgotten the function of her legs and that is  why she isn't walking. My sister has a 5 year  and has now been in hospital a week. Any advice  would be greatly appreciated.

A:   This is certainly a very strange outcome after acupuncture treatment. Generally speaking, acupuncture is an extremely safe treatment, and such few adverse effects as there are tend to be short-term and transient. Of course, one can never rule out a causal connection, but at this stage what really matters is finding a solution to your sister's problems.

The practitioner has certainly taken an approach we favour, which is to set a target of four to six sessions and then review progress. The placing of needles in the shoulder is something on which we could not comment without detailed access to the notes. Chinese medicine treats the person as much as it treats the condition, so needles are inserted where they need to be for achieving balance across the whole system, and this may be far away from the site of the problem. Even symptomatic treatments can be a long way from the problem; a standard first-aid point for frozen shoulder is on the shin.

What would interest us most is the fact that the treatment itself was painful. We are assuming that your sister made her feelings known to the practitioner about how painful it was. In this situation a responsible and caring practitioner will inevitably look to use even shallower needle insertion with less 'action' on the needle (less needle rotation), and in some cases to move to other areas of the body where the patient experiences less pain. We find quite often that with backs in spasm treating directly in the area of the pain can appear to aggravate the sensations, and we often work at a distance, making use of the channel connections to affect the painful area.

On the assumption that the practitioner did respond positively to your sister's distress, it may simply be that acupuncture is not the best treatment for your sister. We have come across a handful of patients in our time who are too sensitive for needles and for whom treatment is a form of torture, even when they are committed to it and really want it to work. If this is the case, it may also rule out some of the hands-on therapies which may also feel highly uncomfortable.

We still believe that acupuncture may have a role to play in helping your sister, although we would not be surprised if she decided that this was a bad option. If she does go ahead, it will be important to establish with the practitioner that the treatment has to be extremely gentle and involve as few needles as possible. If the practitioner will not agree to this, find another practitioner. Other than that, we wonder whether cranial osteopathy might offer a possibility. This is an extremely gentle form of treatment with profound effects, and a growing number of osteopaths now offer this as their primary technique. If the problem may be more neurological, and on the assumption there is no actual physical damage to her system, there may be some mileage in looking at hypnotherapy as an option. This is a highly problematic area, though; there is no statutory regulation of hypnotherapy, and the range of training levels for people to be able to call themselves hypnotherapists is vast. At one end you have degree level practitioners, especially those using Ericksonian hypnotherapy in which this expert has great faith, and there are weekend trained 'look into my eyes' people whose standards may not be as good. However, where learned patterns are forgotten, this is something to bear in mind.

We hope that your sister does improve and hope that she is able to try acupuncture again on the basis we have suggested. If not, we hope that the two pointers we have given may be useful.  

Q: I went for accupunture treatment for vertigo and had  8 sessions. I developed pain in my lower abdomen and  pain while urinating.  Could it be a result of accupunture, or just a coincidence?

A:Our first reaction is that this is probably a coincidence, but it never pays to be over-assertive without a great deal of information to go on. Much would depend on where the needles were inserted and what kind of manipulation was applied to them. There are no standard treatments for vertigo, and the phrase we frequently use, that we treat the person not the condition, could mean that the needles were applied anywhere depending on your overall balance.

What we can say with certainty, however, is that adverse events after acupuncture are rare, and where these do happen, the vast majority are minor and transient, i.e. only lasting a day or two at most and generally speaking things like a mild headache or feeling slightly unwell. Longer term problems are extremely unusual, and would have to involve physical damage to body tissues. For this to happen it would probably mean being very conscious of the injury as it happened. UK practitioners all use pre-sterilised one-use disposable needles and are thoroughly trained in safe needling, so the chances of infection from the needling are very small.

Whatever the cause, however, it is important that you seek treatment with your GP promptly. Although these are not in themselves what we would call 'red flag' symptoms requiring urgent medical attention, the pain in the lower abdomen and painful urination suggest a possible infection or mild inflammation. This needs to be checked so that appropriate treatment can be arranged. If there is any suggestion that the treatment may have been responsible this can be followed up later.

Q: I had a session of acupuncture to relieve some pain and inflammation. The acupuncturist I saw used points on my left hand and arm (close to the wrist).  During the treatment I felt a heavy pain moving up and down my arm which was quite uncomfortable.  When I got back home my wrist and hand swelled up and was painful. Today the symptoms remain the same . Should I worry or contact a doctor?

A: The short answer is, 'no, you shouldn't worry' but 'yes, you should see your doctor.'

Without knowing exactly what kind of acupuncture you had (traditional acupuncture according to Chinese Medicine principles or acupuncture from a doctor or physio) it's a little difficult to say with certainty what the heavy sensation was. There is a specific sensation elicited by the use of needles in traditional Chinese acupuncture which is called 'deqi', and which feels like a dull aching sensation which can travel along one of the channels in which the energy, or 'qi', flows. In China this is a sensation which the practitioner works hard to elicit, and many Chinese patients will not regard themselves as having been treated unless they feel this. In the West there is less insistence on making this happen, and often a greater use of Japanese needling techniques which cause little tangible sensation. If deqi occurs it is usually a good sign that the practitioner has managed to get things moving.

However, the wrist and hand swelling up is a little more of concern. The chances that there is an infection are remote. Most practitioners use pre-sterilised one-use disposable needles, and unless by a rare chance something was transferred from the skin surface to deeper tissue, there is unlikely to be an infection,. If there were the hand would be hot as well as swollen and quite clearly inflamed. The more likely possibility is that there has been some local bruising, possibly below the skin surface and not necessarily visible, which has caused some form of obstruction in the flow of blood and lymph tissue. The condition called carpal tunnel syndrome, which involved impingement of the nerves in the wrist near where your needles were inserted, can sometimes generate this as a symptom. In all probability the swelling will go down shortly.

However, with problems like this it is always safer to err on the side of caution, and we would advise you to make an appointment with your doctor as soon as possible for both reassurance and for immediate treatment should it turn out to be more significant. Doctors do not mind being consulted where something is unclear, and nobody benefits from a symptom being allowed to run unchecked for any longer than is necessary.

It may be useful to ask the practitioner exactly what points were used and where. This will certainly help the doctor to be able to diagnose what is happening

Post a question

If you have any questions about acupuncture, browse our archive or ask an expert.

Ask an expert

BAcC Factsheets

Research based factsheets have been prepared for over 60 conditions especially for this website

Browse the facts