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134 questions

Q:  My wife had acupuncture yesterday and has a small bruise on her left arm but more worryingly the vein from this bruise has started to show a darker colour. Is this anything to worry about?

A:  The most likely cause of the darkening of the vein is that the bruised tissue is causing a slight restriction in the area which is backing up the flow of blood in the veins of the arm. This is somewhat akin to the way that nurses sometimes use pressure to make a vein more prominent for the purpose of administering an injection. As the bruises go down, so the vein will start to flow more easily and its colour return to normal. This video on Youtube with its somewhat bizarre musical soundtrack

shows what is done.

The only circumstance in which you might need to be concerned is if the bruising goes down and the vein continues to be prominent, or if the extent of visible vein appears to be increasing. In either case it might be wise then to visit your GP to have the area looked at. You may find that the practice nurse would be qualified enough to offer a view, and this may eb far quicker than trying to get a GP appointment.

You might also want to alert the practitioner to what has happened. This would provide useful information about where and to what depth the needle(s) was inserted. This would help to inform the assessment of what is going on.

In short, though, very probably nothing to be worried about but normal monitoring would be worthwhile, as we're sure will be the case anyway.


Q: I have had an ankle sprain for quite a few weeks now and decided to go for acupuncture  .After the  session I feel the pain has become more active and I can feel a tingling sensation. Is it normal to feel like this or what could have went wrong?

A:  It is not uncommon for the treatment of sprains and muscular problems to feel a little different after treatment, occasionally becoming more noticeable and often accompanied by the sorts of tingling sensations which you are experiencing. This is almost always a good sign that the treatment has taken, and that there will be improvements to follow.

Damage from treatment is quite rare, and when it does happen tend to be more fixed and specific in cases where there has been a small bruise or the impingement of a nerve. There is also usually a visible sign at one of the needle sites of slight redness or bruising.

We think that the discomfort will soon ease. However, if it does continue, the first person you should speak to is the practitioner. He or she knows what they have done, and will be able to make sense of the reactions you are having. In the extremely unlikely event that this persists for more than 48 hours, you might want to ask your doctor to take a look, but usually reactions like this subside within three days, and in most cases are a good sign that the treatment is working.


Q:   I had acupuncture about 5 days ago with a different practitioner. Almost straight after the session I got a pain in my right side of my stomach which has not subsided. Could this have been an affect of the treatment?

A:  We are sorry to hear of your experience.

Without knowing exactly where you were needled and for what we are a little limited in what we can say. If the pain is at a needle site it suggests that there may be a little internal bruising which is not visible on the surface but enough to put pressure on nerves and cause some discomfort.  Physical damage after acupuncture treatment is quite rare, and usually transient, so it is quite possible that by the time you get this response after the Easter break your discomfort will have subsided. If it hasn't, and it does relate to where you were needled you might need to contact the practitioner to ask for their advice and possible explanation, and also arrange to see your GP just to be sure that there is nothing untoward going on. It is highly unlikely but it is often better to take this step early to avoid unnecessary worry.

There is also a slight chance that the pain is an energetic consequence of the treatment. It is also quite unusual to experience this, but there are occasions when helping the system to function better reveals blockages which a weaker balance was able to cope with. It is also possible that the treatment was badly chosen, although our experience of choosing the wrong treatment is that the system reverts within 48 hours to where it started. Longer lasting disruption is extremely rare.

The best person to ask is the practitioner himself or herself. They will know exactly where they needled you, and will be as concerned as you to understand what has happened and do what they can to correct it or refer you on for further investigation. We rather hope, though, that it is a transient adverse event, and by the time you received this reply after the break it has subsided or gone. 


Q:  I've been receiving acupuncture as part of my physiotherapy treatment for golfers elbows - though  I don't play golf. The needle was inserted in my inner elbow and tweaked for about 2 minutes causing immense and intense pain at the time, which I still felt the next day.. This is my gear stick arm and I cannot drive. I've never had a reaction like this before. Is this unusual?

A:  We are sorry to hear of your predicament. While not common, this sort of adverse event can happen, but you are right to say that it is unusual.

In the majority of cases like this, the problem arises because the practitioner has inserted the needle too deeply or too vigorously, and the needles has either slightly damaged a nerve or more likely caused some deep internal bruising.This small haematoma will 'saw' a nerve each time that the arm is move or the muscles tense. Given that this joint is rich in nerves and blood vessels in transit, resting the area is rarely possible,

If this is what we suspect, the effect should wear off in about 48 hours. If it does not, then it would be prudent to make an appointment with your GP to see what is going on. Permanent damage is rare; we receive very few reports in each year of adverse events which are more than transient, but it is always worthwhile placing yourself within the system early in case it doesn't clear up quickly.

We are assuming that the treatment was administered by a physio who also does acupuncture rather than a professional acupuncturist. Most physios base their work on what is termed western medical acupuncture, which has a different conceptual basis from that which we do. The treatment is usually aimed at reducing muscles knots and inflammation based on a conventional diagnosis. It would also be fair to say that the techniques used by most are a little more vigorous than most traditional acupuncturists employ. However, a needle is a needle in anyone's system, and if there is an unintentional energetic effect as we might understand it, then a dull aching sensation could be stimulated and persist for about twenty four hours.

It is much more likely, though, that there has been minor physical damage and it is well worth discussing this with the physio before any further treatment is done. They may even be able to help resolve some of the pain which you are experiencing.

Golfer's elbow, by the way, is  the generic term for problems on the inner aspect of the elbow, whereas tennis elbow is usually the generic name for problems on the outer aspect. Windsurfer's elbow is also starting to appear more frequently.

We should add that treatment is not an endurance sport. We always remind our patients that if something hurts and continues to hurt they should tell us immediately and we can either adjust the depth and vigour of insertion, or simply remove the needle. Gain through pain may be an old adage, but not to the point where the treatment hurts more than the problem. 

Q:  have been diagnosed with tendinitus in my shoulder.  I have had physio four times but I am  no better. On my  last visit he suggested acupuncture. Needles were put in in my neck, shoulder and arm. After a few minutes I started to feel dizzy ..My shoulder has been worse since and also my muscles in my legs feel weak causing me to have trouble with getting up from a kneeling position and up and down stairs.  Would this be side affects from the needles? 

A:  We can understand that you might feel a little dizzy after having treatment, and also the slight aggravation of the shoulder problems, but the more general feeling of weakness is a bit of a puzzle.

On the leaflets we hand out to patients about aftercare advice we mention that there may be some minor adverse events after treatment, and a slightly dizzy or 'spaced out' feeling is certainly possible. This can happen during treatment too. We mean no disrespect to our physiotherapist colleagues, but the techniques they use for musculo-skeletal problems are often a little more vigorous than those we employ, and this can sometimes cause what we would describe as a disturbance or stirring up of the energies which can make people feel a little woozy. This usually passes off quite quickly, but there are some patients who are quite sensitive to treatment, and for them treatment will always have to be slightly more gentle to avoid over-excitement of the system.

'Getting worse before getting better' is a potentially dangerous principle; sometimes people are simply getting worse. However, in the treatment of necks, backs and shoulders we tend to routinely tell new patients that there first 48 hours after treatment can sometimes see an aggravation of their symptoms. There is no commonly accepted explanation for this, although many believe that the pains arise from the muscles and tendons starting to re-gain their true positions, rather like the pains you get from warming your cold feet in front of a fire when the circulation returns. However, whether there is a simple explanation or not it is a common enough experience that we tell patients that this might happen, and if often does.

The weakness in the legs is an entirely different matter, however. There is no obvious connection between treatment in the neck, shoulder and arm which would impact on the strength of the whole system, at least not in the conventional medical terms under which treatment has been given. We could perhaps make a case in traditional acupuncture for a temporary and transient event of this nature, but it would almost certainly be a short term problem. Our best advice is to monitor this and see if it starts to dissipate. If it doesn't there may be a case for going to your GP and just getting things checked. What we always advise patients to do is not to get over-focused on establishing how something has happened to the detriment of getting proper treatment. Things can happen contingently, and it is always worth getting an unusual symptom checked, arising from treatment or not.

Of course, the first person to whom you should address your concerns is the physio himself. he will know far better than we can what he has done and we are sure that he can out your mind at ease about some of the problems you have experienced.


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