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Acupuncture Notes for Patients

If you want more help in deciding whether to have acupuncture and how to go about it, please see my new book So You Want To Have Acupuncture?

Book cover

Also see the FAQ.


What is acupuncture?

Acupuncture is a treatment that consists in pricking the patient with a special needle. It developed in China about 2,000 years ago. Traditional Chinese acupuncture uses a complicated system of ancient ideas that are not easy for most of us to understand or accept today. However, many modern Western practitioners find that acupuncture can be understood in scientific terms. This makes it easier to use in a Western setting and it is becoming increasingly acceptable here. Many hospitals today offer acupuncture to their patients and the British Medical Acupuncture Society has over 2500 members.

Today, therefore, there are two main forms of acupuncture: traditional and modern.

What are the differences between traditional and modern acupuncture?

The differences are mainly at the level of theory - ideas about what is going on when one inserts an acupuncture needle into a patient. There, are, however, also some practical differences.
  • Modern acupuncturists do not use traditional diagnostic methods such as the pulse or the appearance of the tongue.

  • Many, though not all, modern acupuncturists leave the needles in place for quite a short time: often about two minutes or even less.

  • Many, though not all, modern acupuncturists use only a few needles - perhaps four and sometimes only one! Surprising though this may seem, experience shows that doing acupuncture this way is quite as effective as using a lot of needles and leaving them in for longer and is less likely to have unwanted effects.

Which is better, modern or traditional?

It is not possible to give an objective answer to this question because there is little good research evidence that bears on it. Probably both versions of acupuncture are roughly similar in effectiveness but modern acupuncture is generally quicker and easier to perform. There are also some techniques in the modern version that are not used in traditional acupuncture and which are particularly effective in certain circumstances, e.g. for the treatment of joint pain (arthritis).

How does it work?

We cannot yet explain this in detail but we do have some clues.

  • In many cases the acupuncturist makes use of "trigger points". These are areas, usually in muscle, that hurt when pressed and cause pain to radiate to other places that may be some distance away from the trigger point. Needling the trigger point can relieve pain in these distant areas, although we do not know exactly how this happens.

  • Acupuncture can still work even when there are no trigger points. In such cases it probably acts by changing the ways in which the central nervous system (brain and spinal cord) is transmitting information about pain.

  • It is important to understand that acupuncture does have measurable effects on the body even though we can't explain them all in detail. You don't have to believe in it for it to work!

What diseases can be helped by acupuncture?

It isn't possible to give a complete list, partly because a lot depends on the reaction of the individual patient. Some people are much better subjects than others, and some don't respond at all.

In general, acupuncture is good for pain, especially pain in the muscles and joints (including some kinds of arthritis). It can also help in a range of other disorders, including headaches and migraine, some allergies, painful periods, and ulcerative colitis.

Does it hurt?

Acupuncture is usually not pain-free. However, it is no more painful than an ordinary injection or blood test and in many cases it is less painful than these. As a rule it is necessary to produce a little pain to achieve an improvement but some people feel nothing at all. Oddly enough, you may even find that acupuncture makes you feel relaxed and happy. If this happens it probably means that you are a good acupuncture subject and are likely to benefit from this form of treatment. (If it doesn't happen to you, however, that is not a bad sign; you may do well anyway.)

Can it cause any harm?

Acupuncture carries the same risks as any other medical procedure involving needles, such as damage to internal organs or structures, though this is rare. To put it in perspective, the risk of harm occurring as the result of acupuncture is probably less than the risk of taking aspirin or an anti-inflammatory drug for arthritis (these drugs can cause bleeding). This assumes, of course, that the acupuncture is performed by someone with an adequate knowledge of anatomy and medicine.

Are there any particular adverse effects I should look out for?

Sometimes a small bruise appears where the needle was inserted. This isn't serious; it just means that a little vein was broken by the needle. There is no need to do anything about it; it will go away by itself.

Some patients find that their symptoms become temporarily worse for a short time after acupuncture. This is termed an aggravation. Tell the person who is treating you about this next time you come; it may be possible to avoid the aggravation in future by treating you more lightly, with fewer needles or for a shorter time. But some people will get an a mild aggravation every time they have acupuncture. In general, aggravation is followed by an improvement, so it is quite a good sign.

As well as a temporary worsening of their symptoms, patients may sometimes have pain after acupuncture that is unconnected with their original complaint. This may be due to damage to a small nerve and is not totally preventable; it does not necessarily mean that the acuppuncture has been done incorrectly. Pain of this kind will usually pass off within a day or two.

Some degree of drowsiness after acupuncture is fairly common. This may make driving or operating machinery dangerous, so patients should generally not drive themselves home after treatment, particularly on the first occasion. Sometimes drowsiness does not occur after the first treatment but does occur on a subsequent occasion, and it is also possible for the onset of drowsiness to occur later in the day, some hours after treatment. Patients who have had acupuncture should therefore be cautious about driving for the rest of the day and should be prepared for their reflexes to be slower than normal.

This list does not exhaust all the adverse effects that have been reported but it does summarize the commonest ones. If you have any particular anxieties about the treatment you should discuss them with the person who is going to treat you.

Can acupuncture transmit AIDS or hepatitis?

No, because all the needles are disposed of after use. There is therefore no possibility that infection could be transmitted.

How soon will I notice an improvement?

Some patients notice partial or even complete relief as soon as the needle is put in but this is exceptional. Most find that improvement takes longer to appear - sometimes later the same day, or perhaps up to two or three days later.

How many treatments will I require?

Sometimes one treatment is enough but this is unusual. Most people require a course of roughly 3 to 6 treatments. At first you may be asked to come back after one or two weeks; as improvement occurs the intervals between treatments may be made longer.

Generally speaking, there should be at least some effect after two or three treatments. If nothing at all happens you are probably not going to respond to this form of treatment. You should never be asked to book in for a fixed number of treatments in advance, since the course of treatment is always unpredictable.

You may find that the effects of treatment vary from time to time. One treatment may help a lot, the next less or even not at all. Don't worry too much about this; provided there is a long-term trend towards improvement all is in order.

Will acupuncture cure me completely?

In general, acupuncture doesn't 'cure' diseases although it can give good relief, especially for pain. It is best thought of as a form of symptom relief. At the same time, if a disease is capable of recovering by itself it is likely that acupuncture can tip the balance towards recovery.

In many cases an occasional 'top-up' treatment is needed to maintain improvement. As a rule only one treatment is required for this, even if the initial course was longer. Patients appear to have individual patterns of relief which remain pretty constant. For example, you may find that it always takes 24 hours before you notice an improvement. And the duration of improvement - 8 weeks, 12 weeks, or whatever - is also fairly constant for a given patient.

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