Acupuncture Notes for Patients

[Revised 07-08-2015]

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. Today there is also a modern version of acupuncture which explains the treatment in scientific terms.

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. Traditional Chinese acupuncture uses a complicated system of ancient ideas that are not easy for most of us to understand or accept today. The modern version does not use these ancient ideas and this makes it easier for health professionals to learn and use. Many doctors, physiotherapists, osteopaths, chiropractors, nurses, and podiatrists today offer acupuncture to their patients, and the British Medical Acupuncture Society has over 2000 members.

There are also practical differences.

Which is better, modern or traditional?

Both versions are probably equally effective in some cases, since both use needles. The traditional version is more difficult and time-consuming to perform but there is little if any scientific evidence to show that it gives better results or can treat a wider range of conditions than does the modern version. Modernists have introduced new techniques to acupuncture, some of which, such as electro-acupuncture, have been taken up by traditionalists.

How does it work?

A lot of research on this question has been done in recent years. Much still remains to be discovered, but today we can say that there is a plausible scientific basis for the treatment, at least in its modern form. Here is a summary of the main topics that have been studied.

  1. There are changes in the tissues at the site of needle insertion which are thought to speed up healing of injuries and recovery from disease.

  2. The modern understanding of pain is that it depends on complex patterns of activity in the spinal cord and brain. There is good evidence that acupuncture can alter these patterns and so reduce the intensity of pain or its unpleasantness.

  3. Much musculoskeletal pain seems to be due to what are called trigger points in the muscles and other tissues. Needling these can inactivate the trigger points, and so to relieve pain and increase the range of movement.

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 other 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 and other problems). This assumes, of course, that the acupuncture is performed by someone with an adequate knowledge of anatomy and medicine.

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.

This list does not exhaust all the 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.

May I be worse after acupuncture?

You may find that your symptoms become temporarily worse for a short time after acupuncture. This is called 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 a mild aggravation every time they have acupuncture. They generally feel it is worth accepting this for the sake of the pain relief which follows.

As well as a temporary worsening of your symptoms (aggravation), you might have pain after acupuncture that is unconnected with your original complaint, although this is rare. It may be due to damage to a small nerve and is not totally preventable; it does not necessarily mean that the acupuncture has been done incorrectly. Pain of this kind will usually pass off within a day or two.

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.

Is it safe to drive after acupuncture?

Some degree of drowsiness after acupuncture is fairly common. This may make driving or operating machinery unwise, so you should generally not drive yourself 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 drowsiness to occur later in the day, some hours after treatment. If you have had acupuncture you should therefore be cautious about driving for the rest of the day and should be prepared for your reflexes to be slower than normal.

How soon will I notice an improvement?

You may have partial or even complete relief as soon as the needle is put in but this is exceptional. Most people 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.

How frequent are the treatments

For chronic (long-term) problems like arthritis you may be asked to come back after a week or so. Acute problems (those that have started recently, such as a sprain) may be treated more frequently at first, although probably not more often than twice a week.

How soon will I know if it is working?

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.

Will the effect be the same each time I am treated?

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 possible that acupuncture can tip the balance towards recovery.

Will I need further treatment after the first course?

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 response 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.

Should I stop my conventional treatment?

You shouldn't stop any prescribed medication before discussing it with your doctor; doing so could be dangerous. "Over-the-counter" treatments can be stopped (discuss this with your acupuncturist), but remember that if you are taking medicine to relieve pain and stop abruptly you may get worse. You may think this is caused by the acupuncture although it isn't. It may well be possible to reduce or even stop pain-relieving medicine later but do this gradually.

But I don't actually believe in it!

Belief doesn't matter. In fact, the best results are often seen in people who didn't expect it to work! Provided you are willing to have the treatment it may work.

I'm pregnant. Is it safe to have acupuncture?

Ideally, all kinds of treatment are best avoided in pregnancy, but acupuncture is probably safer than most drugs and a recent review of adverse events in pregnancy has been reassuring. If you are pregnant you should tell your acupuncturist in case any modification of treatment is required. Acupuncture appears to work quite well for nausea and vomiting in the early months of pregnancy and for back pain in later pregnancy.

What if I'm a blood donor?

Discuss this with your acupuncturist. You can be given a letter to show to the blood donor authorities, explaining that you have had acupuncture from a regulated health professional who uses single-use disposable needles. This will usually allow you to give blood.

I still have questions. Where can I find more information?

My book for patients, So You Want to Try Acupuncture?, answers questions about acupuncture in more detail.

Book cover