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Q: I had acupuncture yesterday for anxiety. A needle was placed on both sides of my legs which left me  feeling great and relaxed. A couple of hours later I experienced very strong and uncontrollable muscle spasms/twitching in both legs for a good 10-15 mins. They were accompanied by a sensation of heat within my body. Is this normal? Scared me! 

A:  We're sorry to hear that you had a scary experience - we know very well how unusual events after treatment can be very disturbing.

While we wouldn't want to go as far as to say normal, it is not unknown for someone to experience strange sensations after a treatment. Very few of these are to do with physical damage caused by the needles, and where they are it is pretty obvious, like a bruise or a dull ache. Balancing up the energy of the body, which is what we do with traditional acupuncture, often leads to the release of blockages, and the experience of heat is quite a common one. Some treatments actually talk about 'releasing the interior' , and certainly in cases of anxiety there is often a great deal of internal heat associated with the condition in Chinese medicine terms. It is often the case that the tip of the tongue shows itself to be a little redder, a visible manifestation of heat in the system.

The twitching of the legs is a little less common, although by chance we had a question from someone last week with the same problem, and as you might expect, by the time we managed to reply the symptom had vanished. This can fall into the same category of release, but can also just be a 'ripple' effect from an improved energy flow.

What we always say, though, is that effects like these rarely last more than 48 hours at the outside, and most are gone within the day. If they carry on beyond that or recur over the next few days, the best thing to do is first have a chat with the practitioner and if need be drop into their clinic so that they can see what is happening and advise you on what to do. If things really do carry on for a lot longer it is always worth checking with the GP. Sometimes odd things happen which have nothing to do with the treatment, and it always pays to have things checked sooner rather than later.

We are confident, though, that the symptoms will quickly go away, and hopefully show that your system is responsive to treatment and will start to make positive changes very soon.


Q:  I have had a terrible experience. I had acupuncture  for a  neck problem and tingling sensation on my 4th and 5th finger..She put the needle in scm muscle.. After that I had an odd feeling  around my left ear like somebody pulling my ear down to my  collarbone and numbness in the back of my neck. After that I saw her and  was given a massage. but it hasnt gone.  For the past 10 days I  have felt like  I am in a prision. For  the numbness I went to a massage therapist which has made it worse .  I am dealing with a headache every day because of the stiffness.  

A: We are very sorry to hear of your problem. It is always very difficult to give a clear opinion without having sight of the problem itself. It is not unusual when treating people for a bad neck to find that for 24 - 48 hours after the treatment the problem can get a little worse. We, along with osteopaths and chiropractors, often counsel people that this may well happen so that they are prepared for a slight intensifying of symptoms. When this happens, though, invariably things then start to improve. It is most unusual for a treatment to cause a problem which continues for as long as the one you have has done.

The one possibility to consider is that the treatment may have caused a little subcutaneous bruising which is putting pressure on the cranial nerves and also on some of the muscles at the back of the neck. This might well cause some of the symptoms which you are experiencing. If this is the case then they will wear off within a week or so, and hopefully leave you with the overall improvement you were looking for.

We also have to alert to the possibility that the worsening of your problems might be a coincidence. This always sounds rather defensive but with close on 3 million treatments a year being given by our members there are bound to be occasions when something just happens at the same time as a treatment without necessarily being caused by it. The important thing to do is to establish what is going on rather than getting stuck into arguing about whether the acupuncture did or did not cause the problem to happen. In this situation it is important that you see your GP and get his or her advice about what is happening. This will undoubtedly lead to treatment options which will establish what caused the problem.

We often recommend that people keep the matter under discussion with their practitioner but recognise that sometimes people feel a little reluctant to have more treatment from someone who they feel has caused the problem. The reality is, though, that they are best placed to offer advice, knowing well what the initial presenting problem was as well as what they have done.

We can reassure you, however, that the number of cases in a year which result in anything serious happening are very few indeed, and we are confident that your symptoms will soon subside.


Q: I had acupuncture yesterday afternoon, and it's the night of the next day, and my stomach is still twitching?  I read that muscle spasms are normal after acupuncture, but I was wondering if they really last this long? I had acupuncture for my chronic tension headaches. I had 6 needles; one on each of my upper forearms, one on each of the areas below my knees, and one each between my big toe and second toe. Is it normal to still have these muscle twitches?

A:  The short answer is 'no'.

While muscles in the area which has been needled can twitch slightly when the needle is inserted and may continue to do so for a while, it would be unusual, but not impossible, for a muscle somewhere entirely different to react in this way. You can never rule out the extremely unexpected because acupuncture treatment treats the whole person, so in theory a needle could start a chain reaction which could lead to a palpable change somewhere else. However, changes are more usually functional than structural, i.e. a needle in the foot might make a headache go away but would be less likely to cause an unintended structural event.

That said, we don't think there is anything particularly worrying in what you describe, and we strongly suspect that by the time you get this response it will have stopped happening. If by some chance it does continue, then you should discuss the matter with your practitioner in order to see if they can understand what is going on. If this is a mystery to them it may be worth popping along to your doctor to see if there is something else going on. We say this because most unusual consequences of treatment disappear within 24-48 hours, and something which goes on beyond that may have coincidentally happened at the same time as treatment but not be related to it. In these circumstances it is important to find out what has happened rather than spend time trying to find out what caused it. The process of establishing what it is usually does that anyway.

Q:  I was looking for some advice or reassursnce..I had t accupuncture 5 days ago and ever since I am  having tingling sensations in my  hands and feet and burning up arms.  i did have the needles in both hands and shins.  It  still feels like i have the tight sensation that the needles are still  there. I am slightly concerned as. I am also sensitive now to heat eg if take a  hot bath my body skin seems to burn.  Can you advise?

A:  It depends to some extent whether this was your first session or whether this has occurred in the middle of a longer course of treatment.

There is no doubt that first sessions, or early sessions in a course of treatment, can have some rather strange effects. Chinese medicine deals in diagnostic categories which sound rather odd to the western ear, like 'heat trapped in the interior' and the like, but most people make sense of this when treatment releases heat and the experience is literally one of heat travelling to the outer surfaces of the body and being let go.

However, reactions like this tend to be short lived and transient, perhaps lasting no more than a couple of days. The fact that you not only have a heat sensation but also tingling in the hands and feet suggests a more complex reaction. The first person you should speak to is your practitioner. He or she will know exactly what they have done, and hopefully be able to make sense of what is happening in Chinese medicine terms. We can think of a number of possibilities to do with heat in the system, but without knowing the exact patterns of your energy we can't really say a great deal.

If this is your first session, we do have to say that there are a number of patients who are remarkably sensitive to treatment and for whom we have to use the most gentle techniques to avoid reactions which can be like yours. This is utterly unpredictable, but once someone has thrown a large reaction to a simple treatment we always scale back what we do and build back up slowly. This doesn't sound quite right for what you describe but it remains a possibility.

The third possibility is that there is something going on which has nothing to do with the treatment itself. This is always difficult to say without sounding like evasion, but with three million treatments performed every year there are going to be a number of occasions when an unexpected problem occurs just after a session by chance. The key thing, if it persists, is to visit your GP for a conventional view rather than get involved in discussions with a practitioner about whether or not the treatment caused it. This can sometimes waste time when a solution is readily to hand, and inevitably treatment usually establishes causation.

We think the most likely cause, though, is an energetic reaction arising from treatment itself, so it would be wisest to contact your practitioner and if possible see them as early as you can so that they can see the problem for themselves. This may have a significant impact on how they carry on treating you and is bound to offer useful diagnostic advice to help them treat your more effectively in future. 

We hope that the experience has not put you off treatment, and hope that it addresses your problems well in future.

Q:  I received acupuncture today from a new practitioner. He was treating me for a hormonal disorder. . He inserted a needle into my spine and  I felt a  sharp, painful sensation in my spine and down the back of my right leg. The practitioner saw that I tensed up and  after I told him what I felt but he didn't seem concerned. Now I have pain and stiffness in my lower back, if feels like it did when I injured it a few years back.  It's very painful. TDo you have any advice for me?

A: It is always difficult to say in the first 48 hours after treatment whether there is a permanent problem or a short term adverse effect which will wear off shortly. We tend to advise patients having treatment for a back problem that things can be exacerbated a little by treatment, and this can mean on occasion a return of symptoms or even an increase in symptoms. This can often be a normal healing response which can often feel like a more intense version of an original problem

However, there is a great deal of delicate tissue and blood vessel in the back, and if someone has needled a small blood vessel and caused minor bruising this can often put pressure on local nerves and cause a quite nasty and prolonged pain until the bruising subsides. This is the most likely cause, and you may find that the bruising becomes apparent on the skin surface within the next day or two.

We have to admit to a slight amount of concern about the fact that you felt a reaction down the back of your leg. This might suggest that the practitioner has caught the sciatic nerve, which would be very painful and could cause a slightly longer lasting sensation. We don't think that this would cause any lasting damage, but we would certainly want to know if the needle was inserted in the midline into the spine or just to one side. Great care has to be taken for midline needling.

We are confident, though, that this will prove to be what we call a transient adverse event, which means that it should have disappeared within a couple of days. If the pain continues beyond that, or if you get any return of the sensations down the back of the leg, it would be a good idea to pop along to your GP just to let him or her have a look. You might also want to call the practitioner and ask for advice. He or she will know exactly what has been done, and can advise you with a little more accuracy than we can here with only a basic account to go on. 

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