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I have been having chiropractic treatment on my neck (no cracking manipulation) and back for 6 months.

Q. I have been having chiropractic treatment on my neck (no cracking manipulation) and back for 6 months. For the last 3 months have also been having some acupunture (at the same appointments). My neck problem has always effected my right side. However in the last few sessions my chiropractor has said my left (neck/shoulder) was a little tight. He treat this also with acupunture. After my last session, i developed a large bruise in the area (I rarely bruise), and a strong sharp pain in my left shoulder blade, plus a horibble gripping like pain around the spine area between the shoulders. It has now been 2 weeks since this last session. I am still experiencing sharp 'needle like' pains in my shoulder muscles and back ache. Is this normal? i've not had it before. Any aches in the past have normally gone after a couple of days.

A. We think that it is highly unlikely that there has been any serious damage; serious adverse events after acupuncture treatment are extremely rare. However, in cases like this where physical therapists use needles as an adjunct to their work we often advise people just to check in with their doctors. This is not intended to be disrespectful to these practitioners but we do find that many of the osteopaths, chiropractors and physios who undertake short course training use slightly more vigorous techniques than we might. This can on occasion cause some fairly deep bruising which can take a number of weeks to disperse, and during this period it can cause a number of unusual pains as nerves which traverse the area are impinged. If, of course, your practitioner is a fully trained acupuncture practitioner we offer our apologies for any intimation that he or she is only 'short course trained', and can only say that these things can sometimes happen, however much experience someone has.

Basically, though, any treatment which causes pain lasting longer than a few days is worth investigating, and very often this can establish causation. It is not uncommon for practitioners and patients to get involved in arguments about what caused what when the problem gets left untreated, so for our own members we always recommend that they send patients to GPs for a check. Accidents are rare but they do happen, and it is always better not to be too categorical.

We can reassure you, however, that there is extremely unlikely to be any part of a needle inside the body causing some of these sensations. The use of single use disposable needles has rendered needle breakage almost unknown, so although pains can sometimes feel like pieces of needle left in situ they aren't. In the bad old days when needles were sterilised and re-used it could make the steel brittle and able to fracture, but since 1999 we are unaware of anyone still sterilising and re-using needles.

We do hope that this problem resolves itself relatively soon.

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