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pain during acupuncture for my tennis elbow

Q. Hi, I have had 3 courses of acupuncture for my tennis elbow. Each time the needles have been inserted around my elbow joint and on insertion and movement (the practitioner twisted the needles once after insertion) there was quite significant pain - I was whinceing. Once in situ there was no pain. Is this normal? Apparently the needles were tapped onto the bone in my elbow to stimulate the healing process. The treatment lasted about 20 minutes.

A. There are two elements to your question, one of which we find slightly puzzling.

It is not unusual for people to experience more sensation when a needle is being inserted than when it is in place. There are a variety of reasons for this. A needle is, after all, a sharp pointed object and fine as acupuncture needles are there are going to be small blood vessels and nerves which it touches on entry and which will cause a sensation, as will the breaking of the skin surface. After a needle has been inserted many practitioners use a quite vigorous action on the needle itself to elicit a sensation called 'deqi' which can vary from a dull ache to something a little more intense. This is particularly the case with Chinese techniques which tend to be a little more forceful than, say, Japanese techniques. Once the sensation has been elicited it tends to subside.

As far as we can tell this is probably what happened to you, and to that extent it is normal. Indeed, for conditions like tennis elbow where there is considerable stagnation of the tissue a more vigorous technique can be advantageous. Even the western versions of acupuncture which recognise what are called 'trigger points' can be a little bit challenging. However, we are a little puzzled by the claim that the needle is actually hitting the bone. This is something we would try to avoid because the tip of the needle might well be damaged by contacting more solid or dense tissue, and we don't really want to be drawing something shaped like a fish hook out of a patient. In the old days when people re-used needles after they had been sterilised this was something which could happen if a bent needle was re-inserted. Thankfully we now all use single use disposable needles, so this particular unpleasantness is a thing of the past.

So, we think there is nothing to worry about. If the practitioner is inserting the needle down to the level of the bone, which is what we suspect they mean rather than deliberately hitting the bone, then this simply means that they are using quite strong techniques which will probably serve you well in getting rid of this annoying problem.


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