Why are my shoulder blades and upper neck in excruciating pain after acupuncture?

Q: My doctor advised me to contact a physio as I was experiencing joint pain in my knees. I had acupuncture on my first visit and after three days my shoulder blades and upper neck are in excruciating pain. Painkillers are not even helping and I don't know what to do. I can't deal with this any longer. Why Am I experiencing this and will it ever stop?

A: We would probably need a little more information before we could give a definitive view. The first question we would ask would be where the needles were inserted. Acupuncture is a very safe treatment with very few serious adverse effects, and most, when they do rarely occur, are the result of damage caused by the needles themselves, hitting nerves, causing deep bruising, etc etc. If someone throws a very specific pain then the first thing to check is whether the treatment as a physical act of needle insertion could have caused it.

The second thing to check is whether the treatment has caused a change in your posture, especially if needles have been applied to the lower back as well as the knees. The physios pay particular attention to this, often because they use slightly more vigorous techniques than we do as traditional acupuncturists. Occasionally a muscle might be tense and 'guarding' because it is supporting an inherently unstable spine. If this relaxes then it can generate problems locally or even higher up. It can even be the case that the correction of gait problems can affect the spine which in turn can make a change higher up for which the muscles are not yet prepared. The physio may well be able to recommend some exercises if this is the case.

Of course, a third possibility is that by using  acupuncture from a physical/medical perspective only the treatment has caused systemic effects in a wider way of which the practitioner may be unaware. It has been one of our constant themes with western medical acupuncturists that using points within a medical context does not mean that you can switch off the effects they have from our perspective in Chinese medicine. Why this might have resulted in neck and shoulder pain would very much depend on the nature of your energetic balances from a Chinese medicine perspective.

What we think is very likely, however, is that unless a needle has caused physical damage in the area where your pains are they are very likely to subside within the next few days. You would be well advised to contact the physio anyway to ask what it going on, and any of our members would in the same circumstances be only too happy to discuss the problem and perhaps invite you back to take a look at what is happening. Nobody wants a patient to be in pain after treatment. It may well be that further discussion reveals why this is happening and also go a long way to ensuring that the same thing does not re-occur.

The other thing we should say, though, is that although it looks fairly likely that the treatment was causally implicated in the pains it may not be the case. If by the time you get this response the pains continue and are beyond simple pain control you would be well advised to see your GP in case this is something different which has by pure coincidence happened at the same time. With over four million treatments in the UK each year there are bound to be occasional coincidences, and the key thing is to get problems checked out first before getting engaged in discussions about what caused what.

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