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134 questions

Q:  I had my third session today and when I got there my ankles were very swollen with the heat. I had 20  needles inserted from my skull to my ankles. When the acupuncturist came back he commented that my ankles were leaking which isn't unusual.  However 9 hours later my leg is still leaking. Is this usual and what should I do?

A:  We wouldn't go so far as to say it is usual but it is possible. We usually choose not to needle tissue that is swollen and oedematous but it is fair to say that in China this is often a routine treatment and often very successful in moving the fluids away from the swollen limb. Each practitioner makes a professional judgement based on their findings in each individual case, and your practitioner has clearly judged that this is a safe and sensible treatment for you.

 The major risk is that a point or point can become infected. The fact that you say that fluid leakage is not unusual and that it has happened before suggest that there is nothing to worry about here, and also suggests that this has been looked at before. However,  if you start to get redness and/or pain at the sites where the needle was applied, you would be well advised to get to an emergency doctor's round or call 111 for advice immediately. Otherwise you should keep the area clean and perhaps arrange a visit to your GP to discuss this.

 Fluid leaking for this length of time after a needle insertion is a little unusual and is probably more to do with the short term effects of the hot weather than anything else. However, your GP may decide that the fact that this can happen is not entirely good for you, and may prescribe some diuretic tablets to reduce the swelling. Acupuncture treatment may also over time help to reduce swelling in the lower limb, but the fact that heat raises the chances of it happening suggests that medication may be a good short term measure.


Q:  I had acupuncture with cupping about 4 months ago. The one that was placed on my left shoulder blade area caused local pain which radiated up my neck as a sudden sharp pain. I told the practitioner when he came back after about 5 minutes and he removed that one. Since then I've had pain in that area and in my neck which is getting worse by the day and at times it's agony. What could be the problem?

A:  We are at a loss to explain what might have happened here.

Cupping itself is a relatively safe procedure except for the possibility of leaving some marking or bruising on the back or shoulders when it is used. A responsible practitioner will ensure that a patient knows that this may well happen, and also offer sensible aftercare advice in the unlikely but possible event that a small burn or bruise may appear some time later.

It would be most unusual for cupping to cause a radiating pain, however. The only thing we can imagine is that you may have moved in reaction to the cupping in a way which caused a tendon to stretch and tear slightly, which unlikely as it sounds might happen if you were at all nervous about what was going on and made a sharp manoeuvre with the body already 'set'. Other than that we can think of no other way that this could have happened, especially since the problem appears to be getting worse.

The best course of action in a case like this is to see your GP and ask for an assessment of the problem and potentially a referral either to a neurologist or rheumatologist to find out exactly what is happening. This will probably show how the acupuncture may have caused or exacerbated the problem, if indeed it was the causal factor. In your case something clearly happened at the time you were having treatment, but there remains the possibility that it was a pre-existing problem which treatment brought to the surface.

We say this not to be defensive - if something happens while a treatment is taking place it is a fairly safe bet that the treatment caused it - but to avoid people getting into dispute with practitioners before either knows exactly what has happened. In our experience further investigation pretty much always identifies the cause, and if this does point to the acupuncture treatment then there are ways of seeking restitution for any detriment you have suffered under our professional indemnity insurance.


Q:  My Dad is 73 and has been experiencing lower back and hip pain, the GP is currently considering whether he needs a hip replacement. I took him to my chiropractor and on the second visit 10 days ago he was given acupuncture. Sine then he's had persistent diarrhoea. We can't identify any other trigger; he's eaten the same food as the rest of us and no-one else has a bug. is this a possible side effect of acupuncture and if so, how long can he expect it to last? 

A: We might believe that this was a side effect if the diarrhoea lasted for 24-48 hours, but to have diarrhoea for this length of time suggests a bug of some kind. The only conceivable way that this could be connected with the acupuncture treatment would be if the practitioner's standards of personal and professional hygiene fell incredibly short of the standards which an acupuncture practitioner is supposed to follow. This would have to involve not washing hands properly, and also touching the shaft of the needle in such a way that bacteria were carried into the skin.

Our standards of practice preclude this ever happening, and our health and safety consultant gave an absolute assurance that if the procedures were followed precisely there could not be any cross-infection or infection. We do have some concerns about chiropractors and osteopaths adding acupuncture to their repertoire - many do not register with local authorities as required and some are not working in suitable surroundings - but such is the safety of modern treatment, with single use disposable needles applied with the help of a guide tube that it is inconceivable that someone has managed to infect a patient. The only very remote possibility is that there may have been bacteria on the surface which were carried inwards by a needle, but the chances that this caused a bout of diarrhoea rather than a skin lesion are theoretical rather than real.

We suspect that this is probably a rather unfortunate coincidence, but hope that your father has been seen by a GP. Ten days is a long time for a bout of diarrhoea, and this warrants further and immediate investigation.

Q:  I have had  three  acupunture  treatments for chronic back pain.  I had needles placed in my lower back,  my ankles  and hands hands.  New  this week I had numbness in my back for a few hours, severe nausea for two days with sweats and light headedness also my hands have been very painful.  Is  this normal?

A:  We would never say that pains  and discomfort such as you have suffered are 'normal' but they are not impossible, and there are a number of occasions each year when we hear from people who have suffered a disproportionate reaction to treatment.

The numbness in the back we can easily make sense of; there are several points in the back which are very powerful and can sometimes cause a mild anaesthetic effect which wears off after hours, but can last for a couple of days. The pain in the hands might also be a reaction to the needles. Aside from any local damage which needles can do by causing internal bruising (where someone experiences pain but with no immediate visible external signs) there is sometimes an element of discomfort as the flow of energy improves and subtle changes in the structure start to take place as the muscles and tendons return to proper use.

The severe nausea and lightheadness are another matter, though, especially lasting for two days. One obvious explanation is that the treatment and its  after effects coincided with a bug. We never say this to avoid responsibility, but we have to be realistic that with over 2.5 million treatments a year it could well be that something which happens after a treatment has nothing to do with it. We emphasise this because it sometimes stops people from seeking conventional help, and we always advise people to get conventional treatment where necessary. This usually establishes what the cause of the problem was.

The other possibility is that the treatment may have been too powerful for you. Some people are quite sensitive energetically, and treatments for things like back problems can often mean the use of some very powerful points and some quite strong manipulation of the needles. For some people this can be too much, and the system can become quite disordered for a while. Symptoms like nausea and lightheadedness are often a part of this kind of reaction. You need to discuss this with your practitioner to find out whether the treatment can be adjusted, or to look at what other factors might have been involved. Sometimes people can be quite badly affected by treatment if they have specific foods, drinks or exercise too soon after a session.

However, if the problem has persisted even to a small degree by the time that you receive this reply you would be best advised to pop along to see your GP in case you do have some kind of bug and need conventional treatment. There are quite a few of the norovirus-type bugs going around at the moment, and in their milder forms they can often create these kinds of symptoms.

We do hope, though, that these effects were transient, and that you can work with your practitioner to make sure that your progress is less hampered by side effects.

Q:  I have had two treatments for mild anxiety which included needles and burning of moxi around my ankles.Prior to the treatments my anxiety had been reduced thanks to counselling and reading books that made me understand the cause etc.After the first treatment it returned that night and led to a woolly headed and dizzy feeling and heart palpitations.These lasted for a few days and then subsided.After my second treatment the feeling returned (again during the night following) although this time I  worked out the cause so have not felt anxious.I am annoyed that the accupuncturist did not warn me of these side effects and am concerend as to whether they are normal .Please let me know if these are normal side effects as so far I have paid £100 for nothing but a whole load of additional anxiety.

A:  It is not unusual when someone has treatment for the first time that in the first few sessions there can occasionally be a rebound effect where the symptoms can be more pronounced. This is much more likely with musculo-skeletal problems like back and neck pain, and we routinely advise patients that things are very likely to get a little worse before they get better. We tend to speak of 48 hours of disruption, and while there is no conclusive explanation of why this happens, there are several theories about re-arranging of the structure which are plausible. Certainly osteopaths and chiropractors tend to offer the same kinds of advice.

When it comes to problems like anxiety or depression this is more of a professional judgement call. One of the terrible things about anxiety states, as you probably know well, is that they tend to feed off themselves, so that the first hint of anxiety causes fresh anxiety and a vicious spiral can kick in. If you tell a patient with anxiety that things may get a little worse it is almost a guarantee that things will get worse, and given the circularity of the problem this can sometimes precipitate a sharp attack. Our experience is that for the small number of people who, when not alerted, have a panic attack are far outweighed by the numbers who find the treatment very relaxing and find immediate benefits with a reduction of their anxiety levels.

We cannot speak for why your practitioner did not alert you, but it is quite probable that he or she felt that your situation was not such as to warrant a warning. Your feedback is essential, however. If someone has a very powerful reaction to treatment, then there may be aspects of the treatment which can be adjusted to reduce the chances of the same thing happening again. Some people are highly sensitive to treatment, and have very marked reactions which can be quite unpleasant. It can sometimes simply be a matter of reducing the number of needles or of using less manipulation to make the side effects more tolerable or even disappear.

As for whether the situation is normal. We are always reluctant to say ‘normal’ because this implies that it happens on a very regular basis. ‘Not unknown’ is a better way of putting it, but what we can say is that when people react strongly it does suggest that the treatment may well have a beneficial effect. Had you had two sessions with no reaction at all it might have been more puzzling. We suspect that further sessions from now on will start to generate positive benefits. There is certainly a growing body of evidence that acupuncture can help with anxiety states, and the BAcC has been working with Anxiety UK on some research into the positive benefits of treatment.

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