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Ask an expert - general

206 questions

There is no reason not to have acupuncture when suffering from diabetes.  There are no absolute contraindications of which we are aware, and we have seen no case reports of adverse events where acupuncture treatment has affected someone's diabetic control.

We do, however, issue a couple of cautions to members. The first is that if you see a traditional acupuncturist you are very likely to have treatment for the constitution as well as local treatment for the elbow. There is a small but mentionworthy risk that the treatment may stimulate the residual pancreatic function and cause an increase in body insulin. If this happens and someone has a balanced intake of medications it can force a slight hypo. This is more of a risk with insulin, where the effect is more rapid and a hypo really can cause serious problems. On the meds which people usually have for Type 2 diabetes this is less likely to occur.

The second issue is that long term diabetes can begin to impact on circulation and wound healing, and if the practitioner make a  judgement that this is beginning to be the case he or she may well choose to swab all of the points they use to protect against infection from the needle insertion. This is pretty much only a theoretical risk at best - in the UK there are almost no reports of infections from needle insertion - but where a theoretical risk exists modern best practice is to address it by swabbing. Otherwise we follow generally accepted practice in the NHS for not swabbing unless there is an identifiable risk where a patient might be more vulnerable.

We hope that this reassures you and that the treatment of your elbow is successful.

We would advise you not to worry too much about short term adverse effects after a first treatment. The vast majority of these are short-lived, and we would not be at all surprised to hear that by the time you receive this reply they will have gone. Our experience is that this usually only happens after the first treatment, and you should have no reason to feel any trepidation about the next treatment.

There are a number of possible explanations for this. When someone has had Western medical acupuncture, which we suspect is the case, there may well be some sinus involvement in the pain and the treatment may well have provoked some clearing of the sinus which, in this particular expert's personal experience, can be a very painful business. In Chinese medicine terms we often describe this as the energy of the area being reinstated, but because we treat the person, not simply the condition or pain which they have, there can often be secondary consequences as the system as a whole rebalances. Pathogens are often seen by the Chinese are 'going into' the system, so the process of health can lead to a reverse of this which can cause ripples in the energy as they leave. This can leave the patient feeling a little unwell for a day or two.

It is very important to let the practitioner know exactly what has happened. There may be aspects of the treatment which he or she can adjust. Some people are highly sensitive to treatment, and using fewer needles with less manipulation can make a big difference to the experience of the treatment without lessening the effect.

At any rate we hope that you feel comfortable with continuing, and hope that the treatment deals with your pain

We are very sorry to hear of your problem.

Long-lasting side effects from acupuncture treatment are very rare. Where these happen they are generally to do with the 'wound' of the needle, i.e. puncturing or touching a part of the body. Surface responses are usually transient, lasting no more than 48-72 hours. Where these occur it can result from one or two special cases. First is a possible allergy to the stainless steel of the needle. Needles are usually composite material, and one or two types contain a small amount of nickel to which some people are very allergic. This can trigger a response which can last for some time. The other possibility is that the needles has a silicon coating. This has been a modern development to make the needle insertion smoother, but again there are some patients who find silicon can generate nasty side effects.

Leaving aside the technical causes, there is a small chance that this is a reaction to the treatment in terms of the stirring up of energies which have raised but not removed an internal pathogen. It depends to some extent on the kind of acupuncture you were having - traditional or medical - but in our experience a medical acupuncturist can generate what we call an energetic reaction without having any idea that this is what they are doing. If this does happen, though, it does tend to dissipate relatively quickly, so it would be unlikely to be causing longstanding pain.

Another possibility is that there has been a failure of hygienic practice, and there has been some form of transfer of surface material to areas of the skin where it is not checked. We advise members to take extra care where someone has just had surgery, and to treat them as though they were immuno-compromised because the chance of infection is a little higher.

Finally, there is also a possibility that this has got nothing to do with the acupuncture and may simply be a coincidence. With over four million treatments a year there are going to be a number of cases where something just happens to start at the same time and a spurious causality is assumed. This always sounds overly defensive - 'it wasn't me' - but we have seen a number of cases where the problem simply could not have arisen from the treatment, however it may have appeared to be the cause.

The most important thing, though, is to find out what is happening, and for this you will need to get a referral to a dermatologist via your GP. It would be helpful if you can provide information from your acupuncture practitioner about where needles have been inserted because this will help to establish potential causal factors.

More than this we are sorry to say we cannot say. Sight unseen it is very difficult to give a definitive view when an adverse effect arises, but we hope that we have given you enough information to consider what might have been the case and to find an effective way to get rid of the irritation and pain.

File under general - uncategorised

We are very sorry to hear of your problem.

Long-lasting side effects from acupuncture treatment are very rare. Where these happen they are generally to do with the 'wound' of the needle, i.e. puncturing or touching a part of the body. Surface responses are usually transient, lasting no more than 48-72 hours. Where these occur it can result from one or two special cases. First is a possible allergy to the stainless steel of the needle. Needles are usually composite material, and one or two types contain a small amount of nickel to which some people are very allergic. This can trigger a response which can last for some time. The other possibility is that the needles has a silicon coating. This has been a modern development to make the needle insertion smoother, but again there are some patients who find silicon can generate nasty side effects.

Leaving aside the technical causes, there is a small chance that this is a reaction to the treatment in terms of the stirring up of energies which have raised but not removed an internal pathogen. It depends to some extent on the kind of acupuncture you were having - traditional or medical - but in our experience a medical acupuncturist can generate what we call an energetic reaction without having any idea that this is what they are doing. If this does happen, though, it does tend to dissipate relatively quickly, so it would be unlikely to be causing longstanding pain.

Another possibility is that there has been a failure of hygienic practice, and there has been some form of transfer of surface material to areas of the skin where it is not checked. We advise members to take extra care where someone has just had surgery, and to treat them as though they were immuno-compromised because the chance of infection is a little higher.

Finally, there is also a possibility that this has got nothing to do with the acupuncture and may simply be a coincidence. With over four million treatments a year there are going to be a number of cases where something just happens to start at the same time and a spurious causality is assumed. This always sounds overly defensive - 'it wasn't me' - but we have seen a number of cases where the problem simply could not have arisen from the treatment, however it may have appeared to be the cause.

The most important thing, though, is to find out what is happening, and for this you will need to get a referral to a dermatologist via your GP. It would be helpful if you can provide information from your acupuncture practitioner about where needles have been inserted because this will help to establish potential causal factors.

More than this we are sorry to say we cannot say. Sight unseen it is very difficult to give a definitive view when an adverse effect arises, but we hope that we have given you enough information to consider what might have been the case and to find an effective way to get rid of the irritation and pain.

Accidents and adverse events following acupuncture treatment are quite rare. Where they do happen the majority are caused by a needle damaging a part of the body directly and immediately, and there is usually a very clear cause and effect relationship between the two, like puncturing a lung or causing a large bruise. As we said, though, in the UK these sorts of accidents and adverse effects are very unusual, as our insurance records show.

We do, though, often see people get a little worse after an initial session, sometimes for up to 48 hours and especially where we are treating a back of joint problem. The increased stiffness is quite common, and while there are several possible explanations for why this occurs, there is general agreement that the effect will wear off quite quickly and be replaced by a gradual improvement in the joint or back function.

Could acupuncture do done wrongly? Well, yes. It is always possible to needle too deeply or too vigorously, and this can have longer lasting effects. When someone has a pre-existing condition this becomes almost impossible to prove, because a practitioner will always claim, often legitimately, that this is just a worsening of the original condition which could have happened anyway. We have some sympathy with this argument; with over 4 million treatments a year there are bound to be times when treatment happens to coincide with a deterioration which is has not caused. However, the fact that one of the needles was wiggled and caused pain could indicate that there has been some deep bruising which is taking a long time to recover, especially if the joint is somewhat 'stuck' anyway. We would always expect this to clear up eventually, though.

We don't think that acupuncture per se would exacerbate an existing condition, though. Certainly from a Chinese medicine perspective we are trying to change patterns of stuck energy, and our experience is that if we do a treatment which the system does not accept it merely reverts to how it was before. This is, indeed, one of the challenges in treatment, because the 'habit' energy can be quite hard to dispel. We have rarely seen a condition get worse directly because of treatment, as we said at the beginning. 

We are sorry to hear that you are still being troubled in this way, and understand if you are not too keen on acupuncture treatment as a consequence. We do believe, though, that the use of traditional acupuncture rather than western medical acupuncture might still offer a solution to your problems and we would be happy to suggest that you visit a BAcC member local to you for informal advice on how best to proceed. Most of our colleagues are happy to give up a little time without charge to prospective patients, and this would give you a far better idea of what may be possible.

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