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
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
What are the differences between traditional and modern
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
- 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
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?
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.