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134 questions

Q:  I recently had acupuncture and one needle really hurt going in and that point was bleeding, I now have quite a big (black/dark blue) bruise that still really hurts 24 hours after treatment. Is this normal? Should you bleed having acupuncture? The acupuncturist said it was because he had hit a vein and just shrugged it off. But I am now worried about going back for another session.

A:  We are sorry to hear that your experience of acupuncture treatment has not been entirely a happy one. Although acupuncture is a remarkably safe treatment, there are a small number of adverse events which can happen with treatment, and bruising is one of them. Although the needles are extremely fine, they can occasionally hit small blood vessels, and while the practitioner will often notice this as soon as the needle is removed and apply pressure with sterile cotton wool to stop the bleeding and reduce potential bruising, the area can still bruise quite significantly over the next few hours. Bruises can take up to a week or more to disappear, depending on the age and health of the person. We wouldn't go so far as to say 'normal' but it does happen occasionally and our members are aware that it is something to which they need to react appropriately.
 
We do not think you should be at all worried about going back for another session. It is important that you let your practitioner know what has happened for several reasons. It is sometimes diagnostically significant if someone bruises easily, and there are also adjustments which practitioners can make to their technique which can reduce the possibility of further bruising (using even finer needles and gentler needle action, for instance). It does also sound as though you were not entirely reassured by your practitioner's attitude, and it may be worth your while to make this observation to him. We are acupuncturists and very used to what we do and what effects it can have; a patient isn't. It can be quite easy to forget how apprehensive people can still feel about having a treatment which has only recently become more a part of mainstream healthcare practice.
 
We hope that your subsequent treatments are uneventful save for feeling better.
 

Q:  I had an acupuncture session 9 days ago and am still experiencing sharp pain from where she stuck the needles in my foot and hand. It feels like the nerve in my hand has been damaged as I'm now getting shooting pains from my wrist into my thumb. Does this normally happen in acupuncture ? How long before the pain goes ?

 

A: Any form of skin piercing carries an inherent risk that the needle will cause physical damage. While rare when treatment is performed by a properly trained and qualified practitioner it can happen. We publish an internal document called the 'Guide to Safe Practice' for our members in which we provide them with advice and guidance for situations which arise in meeting the requirements of our published Code of Safe Practice. In this we write:
  

 

Pain after needling a point

 

If your patient reports a ‘shooting pain’ into one of their toes or fingers directly after insertion of the needle, it is likely that you may have either touched or come too close to a nerve. Although the pain often appears to travel along a meridian, the sensation is different from the recognised sensations of deqi in that it tends to be sharper and more acute, and can often be more persistent. Depending on the extent of contact, the patient may still feel discomfort several days, and in rare cases, weeks after treatment. This can range from shooting pains to more vague symptoms such as numbness or pins and needles in the affected limb.

 

 

 

A sharp, burning pain may also occur if a needle has punctured a small blood vessel. This may cause a slight bleed and bruise if superficial, or a slight swelling if at greater depth. The sensation tends to be local to the point needled and does not radiate from the initial point. However, an internal swelling may put pressure on nearby structures and irritate a local nerve in which case the secondary symptoms can be similar to those described in the previous paragraph.

 

If your patient reports unexpected persistence or worsening of symptoms over the next days to weeks and is worried, it would be advisable to send them to their GP for an assessment.

 

 
As our advice to members says, the pains should begin to diminish within a matter of days but if they continue it might be worthwhile seeing your doctor and if necessary arranging an appointment with a neurologist to establish whether there has been damage to a nerve and whether this is permanent. In our experience, however, this is extremely rare.
 
We are a little bit concerned that you are experiencing pains in both your hands and your feet where the needles were inserted. Touching a nerve once would be unusual and unlucky, but to experience the problem in two places from the same treatment opens up a range of questions to do with the practitioner's technique and also the quality of needles being used. There have been rare but recorded cases of a bad batch of needles not made to the appropriate standard, and these might be a source of the problem, althougb were this to be the case every insertion would cause pain or discomfort.
 
If the practitioner is a BAcC member you can rest assured that if this is an accidental consequence of legitimate and correct treatment the BAcC holds professional indemnity insurance for all of its members which covers situations such as this where a patient may suffered detriment after having treatment.
 
We are confident, however, that as happens in the majority of these cases, the discomfort eventually subsides.
 
 

 

Q: Following a brain haemorrhage ( burst aneurism) I have a titanium stent in my head. Is it safe to have acupuncture as it increases blood flow in or to the brain. Is it also safe to have needles actually in my head. The stent has been in situ for 6 years. I suffer from insomnia. I can easily go to sleep but wake in the early hours and cannot return to sleep.

 

 

A: There are no cautions of which we are aware for the use of acupuncture needles after someone has had a titanium stent inserted. We are assuming that your blood pressure is being or has been monitored, and that appropriate medications have been prescribed to stabilise any irregularities. If acupuncture treatment does improve blood flow, this would be unlikely to cause any problems. Acupuncture treatment, understood from a Chinese medicine perspective, is homeostatic in nature, i.e. it aims to restore and maintain normal natural rhythms and balances, and should not put any undue pressure on the circulation.
 
We would advise caution only for the use of electro-acupuncture machines, and if you visited anyone who used this type of equipment, you would be well advised to ask them to check with the manufacturer whether the stent could in any way be affected by what they do. The vast majority of acupuncture practitioners simply use needles, however, and there is nothing in the very extensive accumulation of safety data over the years which has indicated a risk.
 
If you feel uncomfortable about having needles inserted in your head, you simply need to tell your practitioner. Chinese medicine is very flexible in its approach and offers a number of alternative ways for bringing a system back into balance. As a matter of contingent fact, some of the most frequently used points for dealing with insomnia in one of the main traditions are on the feet.    
 

 

Q: Is it safe for the acupuncturist to treat me as I have hepatitis C. I believe it is perfectly safe as after all my dentist treats me on a very regular basis, I have blood taken too on once again a very regular basis. Could you comment please as to whether someone performing acupuncture on me to relieve pain in my shoulder and lower back after I was knocked down by a car would be putting themselves at risk?

A: The short answer is 'no'. The procedures laid down in the BAcC's Code of Safe Practice protect both patient and practitioner alike from cross-infection. Since a practitioner is utterly reliant on what a patient tells them, or chooses not to tell them, about their health, the Codes have to be written from the perspective of ensuring that whatever the health status of the patient there is no risk of infection or cross-infection.
 
We still regard it as important that a patient does tell the practitioner fully about their health status, however, just in case the practitioner does suffer the unfortunate occurrence of a needlestick injury (i.e. a needle that has been in the patient accidentally pierces their own skin. Knowing that the patient has a blood-borne virus makes the post-exposure prophylaxis routine more focused. Such incidents are quite rare, however.
 
 

 

Q:  Please could you tell me if there are any undesirable side effects from acupuncture? How many needles are used?

Is the following registered and recognised: Three Shire Hospital, Northampton.

 

A:  As we point out on our website - please click here
 
 
Acupuncture is an extremely safe therapy. The two surveys we mention showed only a dozen or so transient adverse events, and these were all relatively minor - feeling nauseous or a little faint, small bruising. A second survey provided similart results. However, we felt it was important to keep a chec on this and have just completed a pilot survey of what we call our AIR scheme (Adverse Incident Reporting) to ensure that we get regular updates on the kinds of day to day events that take place. We suspect that minor bruising is more common that reported, and that there are more 'good' treatment reactions, i.e. signs that things are clearing but which still be uncomfortable.
 
The majority of side effects are of this nature - mild headaches, slight nausea, occasional slight bruising, but in the hands of a properly trained practitioner serious adverse events are rare. A responsible practitioner will always warn a patient about potential side effects like tiredness and ensure that a patient does not leave the clinic and speed off down the motorway or handle dangerous equipment until they have had a short rest.
 
A practitioner may use anywhere between two or twenty needles in a session. Some adopt a quite minimalist approach, in line with a famous saying in the classic texts that 'one needle can cure a thousand ills'. Other use slightly more for specific treatments in some of the traditions, but the majority of practitioners would use perhaps 8-12 needles over the course of a session.
 
As far as the hospital is concerned, the BAcC does not recognise institutions, only individual practitioner members. We can find no-one on our database who works at this particular facility, and we suspect that, since it is a private hospital, it is highly likely that the acupuncture is being delivered by a medical professional, either a doctor or a physio. We have checked the two available databases and found no names to match your e-mail, but this may not be the spelling. If you can confirm the name we can check further for you. 
 
 

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