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Q:  I recently had acupuncture for severe pain in left leg and lower back from putting lower back out. The 2nd session was so uncomfortable and painful I haven't been back. Needles placed on left side of body and told to stay on back and keep still -that in itself caused problems and I could not lie on my back without a lot of pain, Needle put in between eyebrows to relax/sleep while I was left alone in room for 20 minutes, which was impossible with the pain I had in my leg and back lying that way. 2nd session was the same only this time a needle was put in top of my head as well. Felt like I was being stabbed with a knife and remained really painful for at least an hour after I left session. I had to ask her to check it was all out of my head as it still felt so painful. She checked and said it was fine. The next day my scalp started to itch really badly and I couldn't stop scratching it. Had to go to doctor to get it checked and she prescribed elocon lotion. I am still experiencing itching a month later on scalp and sometimes back of neck. Could the acupuncture have triggered this. I did not have an itchy head before the acupuncture session and as the head needle was so painful I wondered if it could have been the cause. Some days are not so bad but other days the itching drives me crazy and it's hard to not scratch when that happens which I'm sure would make it worse. I haven't had acupuncture before this and didn't realise the needles and session could be so painful, also seemed to do nothing to help the back pain. If anything, I came out worse than I went in after having to lie on my back so very reluctant to do it again.

A:  Obviously we are going to be quite cautious in what we say, because without knowing a great deal more about the way that the treatment was conducted it would be difficult for us to say with any certainty that the needles actually caused the problems you have. The itching on the scalp immediately after the use of the needle does seem suggestive of a causal pattern, though. People do sometimes have reactions to the needles, especially if they contain nickel or are coated with silicone, as some needles are to make them smoother to insert. A very small proportion of people suffer allergic responses, and it may be that you are one of them. The fact that your doctor prescribed a steroid suggests that there is generalised inflammation.

 If there had been signs of an infection the medication would probably have been different. There are again one or two very rare occasions when needles can cause infection by moving bacteria from the skin surface to slightly lower levels of the dermal layers. This is called autogenic infection, i.e. the needles are sterile and inserted correctly, but the infectious agent is moved from where it is contained and safe to where it can run unchecked. Very unusual but possible, but the itching reaction would not be the most common response.

 The fact that the needle in the head was painful is unlikely in itself to have been the cause of the subsequent problems. The reasons why a needle can be painful are sometimes to do with the energetic reaction of the point (some points generate a dull aching sensation called 'deqi' by the Chinese), and sometimes to do with the needle aggravating a local nerve on being inserted. In neither case would this normally generate an itching sensation.

 As far as needles for the back are concerned, it is probably not very good practice to ask people to sit or lie in positions where the position itself is going to aggravate the problem. This is probably not the best way to endear yourself to a patient, and suggests that the communication was not that well organised. We try to ensure that patients are comfortable and certainly make sure that we change what we are doing if they start to feel really uncomfortable - treatment need not be an endurance test.

 We are not sure what else we could offer by way of advice. We suspect that it is highly unlikely that you will go back to the practitioner for further treatment, and may well have been put off acupuncture altogether. If this is so, then perhaps something like cranial osteopathy may well be the answer. If you do want to give acupuncture treatment another go you will almost certainly find a number of our members close to where you live. We are sure that you will be able to explain your problem to them, including the problems you have had with the treatment so far, and be sure that they will taken this into account.

 As far as the itching is concerned you are doing exactly what we would advise anyway, getting treatment from your GP. If the problem persists and causes you longer term problems you may well be able to make a claim against the practitioner's insurance by setting out what has happened to you and asking them to forward your letter to their professional insurers who will then contact you directly. Again, we suspect that you might simply want to draw a line and walk away, but if you have suffered detriment or been treated beneath the standard which you think you were entitled to, nearly all UK practitioners belong to professional associations which can offer support and advice about options open to you.

 We are sorry once again that your experience of acupuncture treatment has not been a good one, and hope that you do find an effective way of addressing your back problems.


Q:  Our acupuncturist did micro bleeding on two toes and continued trying to get blood out and now one foot on the side feels numb. The acupuncturist says it is a damaged nerve and will get better? Very worried.

A: Your practitioner is very probably correct in that this is a temporary problem which should resolve quite quickly.

 It is not for us to make judgements about technique, and we are aware that using bleeding techniques can be a slight problem when people do not bleed easily, especially in some areas of the body like the toes where the circulation can be a little slower. If someone has to be needled more than once it is always worthwhile warning the patient that there is a slightly increased risk of bruising.

 We're not sure about the 'damaged nerve'. In our experience if you needle a nerve the patient knows about it very clearly. What he probably means is that there has been slight bruising within the tissue which is not yet visible at the surface, and may never be, but it is slightly impinging a nerve and causing a loss of sensation. As soon as the bruising clears, which may take a few days or perhaps even as long as a week or more, the normal sensation will return. Many people use arnica in one of several forms to encourage the healing of bruising, but that is not within our scope of practice so you would have to take advice from a pharmacist or qualified practitioner on that.

 In the extremely unlikely event that the loss of sensation continues beyond a fortnight then it would be worthwhile getting a referral from your GP to a dermatologist. Any continuing loss of sensation in the toes needs to be investigated, but we think it is highly unlikely that it will come to this.

Q:  I had my 2nd acupuncture treatment  which introduced front needles. When finished and I was lying down, I suddenly felt my heart beating in the sternum needle and then my left arm went completely numb. I have never felt anything like this, and was told it wasn't the needles...... but I'm not convinced..... What happened during this sitting, please help.

A:It's not quite clear from your question whether the strange events took place when the needles were in  or after they had been removed ('when she had finished').

 In either event this would be an unusual reaction. Most adverse effects of treatment occur where the needles have been inserted, so if there were to be a numb sensation,  whether this was a physical effect of touching a nerve or an energetic effect caused by moving energy ('qi'), it would usually be local to the needle insertion site. In some cases the energetic effect of needling can make a sensation travel along a channel, so a needle behind the knee, for example, could cause a sensation to travel up or down the defined route of energy travel. To get this kind of connection from needles on the torso would be more unusual, although not impossible. There are an extremely large number of interconnections between channels in Chinese medicine, and if a point is stimulated very strongly it is always possible that the effects can be stirred up at some distance from the needle.

 Of course, we also have to consider that the effects you experience, rapid heart rate and numbness, occurred at the same time as treatment but were not directly caused by it or simply coincidental. By not directly caused we don't mean that there may be no connection, just that it may be a reaction to being needles rather a reaction from being needled. It is always important if you experience something like this to check in with your GP. It's difficult not to sound alarmist, but while the vast majority of strange symptoms like this are benign one in a thousand may not be. If you were a patient of ours we would send you to your GP to get this checked out.

 We suspect the most likely cause is a form of panic attack brought on by the needles, or some sort of postural reaction to the specific angle at which you were resting. If either is the case then this is something which you need to talk through with your practitioner before your next session. We think it is highly unlikely that you have suffered a physical injury from the needles, and if needles are the cause, it may be to do with too deep insertion, too vigorous manipulation or too many needles. All of these are under the control of the practitioner, and can be adjusted to make the experience more comfortable in future. Good communication is usually the best way to resolve problems like this.

Q:  Had acupuncture more than 30 years ago and STILL have pain and some numbness on the site of a wayward needle. However, I now have chronic back, hip pain with the neck and referred pain to the testicles thrown in from time to time.

A:  Without knowing exactly where the needle was placed we find ourselves a little restricted in what we can say.

 Clearly, the one possibility which you need to rule out is that there is a piece of needle still inside your body. In modern times this would be almost unheard of. The use of disposable needles has eliminated the one main cause of pieces of needle snapping off, and that was the use of autoclaves to sterilise and re-use needles. The constant heating and cooling tended to make the steel in the needles a little more brittle, and there was a risk that a small fragment could break off. Possible as this was we have no records of any such occurrence in the BAcC (formed in 1995) or in the five precursor bodies. We did hear, however, over twenty years ago about a legal case involving a claim that a piece of needle tip had broken off and 'travelled', but we suspect that the matter was settled out of court because there is no trace of it that we can find from our searches.

 The other possibility is that the needle caused physical damage. It is hard to imagine what this might be to have endured for 30 years and to be causing secondary symptoms. However, we think that the best, and perhaps only, thing that you can do is to go to your GP and ask for an X-ray of the area to determine whether there is any physical object in place, and then to discuss with him or her whether the other symptoms to which you refer could be a consequence of physical damage in the area. This might involve a referral for an MRI if there is a chance that the damage is in deeper tissues.

 It may well be the case that you have already done what we suggest; thirty years is a long time, and if you have been experiencing discomfort for this length of time it is highly likely that you have. However, the spread of symptoms needs to be investigated anyway, whatever the root cause. 

 We are sorry not to be able to offer more help or advice than this, but with the information you have sent us this is the best that we can suggest.  

Q:  I've had three weekly sessions of acupuncture having had a miscarriage 5 weeks ago. After the first I felt strong benefits. After the second I experienced unpleasant stomach cramps and diarrhoea and after the third although it was a gentler session, diarrhoea and vomiting 12 hours after. Just for a couple of hours and then I was fine again. obviously I am concerned as to whether I should continue as my body is clearly reacting quite dramatically. She is unable to advise me as she hasn't had any other patients react in this way in ten years! I'm happy to continue if this is seen in TCM as a positive thing but concerned that I may be causing harm to my body.

A: It is always a problem when someone throws a large reaction to treatment on more than one occasion. We do tend to advise patients of the range of possible reactions, what we usually called transient adverse events, and that if these do happen they will last for no more than 24-48 hours. We also tend to say that they are more common when someone has a first session, and we are often quite reassured by a strong reaction that the treatment has cleared something, and that the reaction has been a good one.

 However, if the same thing happens twice or three times, then we start to look at a number of factors. First is the case history. Is there sufficient evidence of prolonged energetic disturbance over a long period of time to warrant the kind of disturbance which is happening? We have come across cases where the 'clearing' of past blockages has taken a number of sessions, but when you look at the case history it was not a surprise. Then we might ask whether the treatment itself was too much for the person to take. There are a number of individuals for whom acupuncture treatment will always be a problem. This 'expert; had a patient for whom any more than three needles with minimal manipulation sent her spiralling out of control for a week or more. It took a long while to establish what the safe limits were.

 However, it looks as though your practitioner has taken this into account by making the treatment more gentle, and vomiting and diarrhoea is a very extreme reaction, even as a positive one. The first thing that we would do is to advise you to see your GP just to rule out that there isn't some sort of background infection which having treatment brings to the surface. It is highly unlikely, but there may be a contingent bug in your system which is causing problems because of the added influence of the treatment, for whatever reason, and you need to eliminate this.

 What we can say with some certainty is that you are highly unlikely to suffer any damage to your body with symptoms such as you report, other than perhaps a pulled muscle or two from heaving and slight soreness from the diarrhoea.  There is almost no evidence that acupuncture can cause harm other than by the physical nature of the needling itself puncturing organs or causing bruising. Reactions such as yours are probably a sign that the body is dealing with a pathogen of the kind which we describe, and this should mean that the reactions will diminish and cease soon. 

 Without knowing a great deal more about your case history there isn't much more that we can say, but we are impressed by the candour of your practitioner and believe that you are in safe hands. We strongly suspect that she will be as puzzled as you and will be talking to experienced colleagues to see what suggestions they may have.

 In any event we hope that these reactions cease and that the treatment can really benefit you without first having caused this rather extreme ripple on the pond.

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