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One
of the most frequent questions I am asked is- “Does
acupuncture hurt?”
In answer to this question I have to give an honest answer-
only occasionally. More often than not acupuncture is almost
completely painless. The needles used for acupuncture are very
fine indeed, with a diameter as small as 0.2mm- almost like a
hair. The needles are sterilised and never used more than once
so they remain incredibly sharp- hence almost no pain as they
pass through the skin.
Sometimes, when treating trigger points that are extremely
sensitive a slight pain is associated with needling, however
this is always short lived- over just a few minutes.
I have frequently administered acupuncture to myself, so I
know exactly how it feels. In the vast majority of cases, the
pain that patients are consulting me about is far more
troublesome than any discomfort or pain associated with the
acupuncture.
Some patients may feel a temporary exacerbation of pain for up
to 24-48 hours after treatment. This is almost always mild and
temporary.
Frequency
of acupuncture treatment
Deactivation of trigger points with acupuncture usually takes
a course of treatment. The muscles associated with trigger
points have often been dysfunctional for many months, so the
re-education of the nervous system takes time.
As discussed elsewhere on this website, acupuncture is not the
treatment, it is only part of the treatment. The
rehabilitation of muscles that have been weakened and
dysfunctional need to be strengthened and stretched by
exercises.
As a general rule I tell patients that if they have not had
any change in symptoms after four treatments at weekly
intervals, they are unlikely to do so. This does not mean that
people should expect a cure after four treatments, however
some change is expected. The character of the pain may change,
the timing of the pain, the position of the pain may change,
the associated symptoms may change, and hopefully (and
usually!) the intensity of the pain will reduce.
If after four treatments there has been no change in symptoms
whatsoever, then it is worth considering other treatment
options which may be tailored to the individual.
Treatment
plan
Every patient is different and will require tailoring of the
treatment to suit the individual. I have however listed below
a typical treatment plan for a patient that has had a
longstanding myofascial pain problem.
I would see the patient for an initial assessment where a
detailed history and examination is undertaken. Acupuncture
treatment is given and the effects monitored. I would not
typically give an exercise programme at this time as I like to
see the effects of acupuncture alone. The first treatment is
usually a very gentle treatment using only a few needles with
minimal stimulation.
The second treatment is ideally one week after the first when
further discussions and examination will reveal the effects of
the first treatment.
A further treatment is given, however it is usual at this
stage to suggest specific rehabilitation exercises targeted at
the affected muscle group. This usually requires significant
patient input.
The third treatment will be in a further seven days where
progress is monitored.
I will typically see an individual for 4 weekly treatments,
and then, depending on response start to reduce the frequency
of treatment- usualy at this stage reducing to fortnightly
treatment and then monthly.
For an individual who has suffered pain for several years, a
typical treatment course equates to 6 treatments over a period
of 8-12 weeks.
What
to expect from acupuncture
Every patient is an individual with different symptoms,
different health problems and different attitudes and
expectations. It is no surprise therefore that patients
responses are also different.
As a general rule, because the majority of the effects of
acupuncture are mediated through the nervous system, it is no
surprise therefore that individuals who have a “sensitive”
nervous system tend to do better than those who are
insensitive.
Acupuncture has its effects predominantly through nerves who
supply pain messages to the brain. These nerves are part of
the bodies sensory mechanism. If other aspects of an
individuals sensory mechanism are sensitive, such as
sensitivity to colour, shape, music, sound, mood, temperature
etc,it is no surprise therefore that their pain detection
mechanism is also sensitive. I find that “strong reactors” to
acupuncture exhibit features of being sensitive individuals in
many ways. Typically the person will have a whole host of
drugs or foods that will cause upset. They may work in the
creative arts- music, dance, theatre, teaching or where
expression is encouraged. They often feel the cold, may be
particularly intuitive (I have treated a large number of
healers and psychic patients). I have also treated a large
number of athletes at the height of their game- often
competing on the International arena. These individuals are
highly bodily aware and are very sensitive to subtle changes
of their own physiology.
On the contrary, patients I have found difficult and less
rewarding to treat are patients who tend to lack the
appropriate brain chemistry or who are particularly
insensitive. Examples include degenerative brain disease such
as Parkinsons disease and senile dementia and also severely
depressed individuals.
Risks
of acupuncture
In experienced hands, acupuncture is extremely safe. The most
frequently experienced adverse effect is a temporary
exacerbation of the pain being treated. This is normally only
a mild exacerbation and it lasts for maybe 24-48 hours.
Occasionally a bruise may develop at the site of the needle,
however usually there is no bleeding.
The needles used are sterile and single use. I use a
“no-touch” technique which means at no time at all does my
hand come in direct contact with the needle as a sterile
insertion tube is used. I have treated many thousands of
individuals with acupuncture and I have never encountered a
serious adverse reaction.
Very occasionally (maybe only once or twice per year do I see
this) a patient may feel a little light headed or faint. This
will always disappear when the individual is able to lie flat.
The medical literature holds a few examples of patients who
have suffered serious problems from acupunture. These have
almost always resulted from poor tecnique- not using sterile
disposable needles or not understanding the anatomy of the
region being needled. These serious complications are
therefore completely avoidable by using the appropriate
precautions.
Acupuncture
and pregnancy
Acupuncture has been used for centuries in the treatment of
pregnant women however it is always worth discussing a
particular individuals requirements. If you are pregnant and
are considering acupuncture it is always best to discuss your
particular case with your doctor.
Very often relief from pain is immediate-
i) Pain and acupuncture
ii) Sterility of needles etc, freq of rx etc
iii) Risks of acupuncture
iv) Acupuncture and pregnancy
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