Acupuncture Notes for Patients

[Revised 19 December 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 version of acupuncture which explains the treatment in modern scientific terms. This is often called Western medical acupuncture.

What are the differences between traditional and modern acupuncture?

Traditional Chinese acupuncture used a complicated system of ancient ideas that are not easy for most of us to understand or accept today. The modern version doesn't use these ancient ideas and this makes it easier for health professionals such as doctors, physiotherapists, osteopaths, chiropractors and podiatrists to learn and use. The British Medical Acupuncture Society, which takes the modern approach, has over 2000 members.

There are also practical differences.

Which is better, modern or traditional?

The ancient traditional type of acupuncture is difficult and time-consuming to perform but there is little if any scientific evidence to show that it gives better results or can treat more conditions than does the modern version.

Enthusiasm for the traditional ideas is more widespread today in the West than in China itself! Since the 1930s Chinese acupuncture has been largely based on modern ideas of how the body works. Much of the acupuncture research coming from China today uses modern scientific ideas.

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 probably 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. A lot of pain in muscles and joints is thought to be due to what are called trigger points in the muscles. These are like knots, which hurt when pressed and cause pain to radiate to other places. Needling these can 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 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 tension headaches and migraine, some allergies, and painful periods.

Does it hurt?

Acupuncture usually hurts a little. However, it is no more painful than an ordinary injection or blood test and often it is less painful than these. 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, don't worry; the acupuncture may work well anyway.)

Can it cause any harm?

Acupuncture carries the same risks as any other medical use of needles, such as damage to internal organs, though this is rare. To put it in perspective, acupuncture is probably safer than taking most over-the-counter medicines for pain. 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 summarise the commonest ones. If you have any particular anxieties about the treatment you should discuss them with your acupuncturist.

May I be worse after acupuncture?

You may find that your symptoms become 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 that follows.

You might also have pain after acupuncture that isn't connected with your original complaint, although this is rare. It may be due to damage to a small nerve and is not totally preventable; it doesn't 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. (Never have acupuncture from anyone who doesn't use disposable needles.)

Is it safe to drive after acupuncture?

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. It is also possible for drowsiness to occur later in the day, some hours after treatment. You should therefore be cautious about driving for the rest of the day and be prepared for your reflexes to be slower than normal.

How soon will I notice an improvement?

You may have some improvement as soon as the needle is put in but 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 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.

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.

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. But 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?

Sometimes 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 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 medicine before discussing it with your doctor; doing so could be dangerous. Over-the-counter treatments can often be reduced or even stopped (discuss this with your acupuncturist). 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.

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 acupuncture 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