Acupuncture

What is Acupuncture?

Acupuncture is an ancient and important part of traditional Chinese medicine (TCM). It has become a widely recognised, complementary and alternative therapy in clinical practice.

Acupuncture uses very fine needles to stimulate specified acupuncture points. Qualified acupuncturists (Doctors, Nurses and Physiotherapists) insert these. (Yang et al. 2017)

How does Acupuncture work?

Traditional acupuncture is based on the belief that an energy, or “life force”, flows through the body in channels called meridians. This life force is known as Qi (pronounced “chee”).

Practitioners who use acupuncture in the traditional way believe that when Qi does not flow freely through the body, this can cause illness or pain. They also believe acupuncture can restore the flow of Qi, and so restore health.

Western medical acupuncture is the use of acupuncture following a medical diagnosis. It involves stimulating sensory nerves under the skin in the muscles. It stimulates nerve fibres to block out pain signals and helps to reduce the sensitivity of tender points in the body.

This results in the body producing natural substances, such as pain -relieving endorphins. It is likely that these naturally released substances are responsible for the beneficial effects experienced with acupuncture.

A course of acupuncture usually creates longer lasting pain relief than when a single treatment is used. (NHS online).

Acupuncture can also promote sleep by stimulating the release of melatonin in the body (Melatonin is a hormone that occurs naturally in your body. At night melatonin levels rise then return to normal during the day, helping to control how and when you sleep). Acupuncture also encourages a sense of well-being by stimulating the release of serotonin. (Serotonin is a messenger chemical that carries signals between nerve cells in the brain. It can have a good influence on mood, emotion and sleep. (www.nhs.uk). 

What are the uses of Acupuncture?

Acupuncture practitioners (Acupuncturists) use acupuncture to treat a wide range of health conditions including chronic (long – term) pain, chronic tension – type of headaches and migraines. They can also be used to treat dental pain and postoperative pain. (NHS online). Acupuncture is not recommended for the treatment of musculoskeletal conditions such as osteoarthritis (NICE guideline, NG226) or lower back pain (NICE guideline, NG59) unless the pain is very severe in which case acupuncture can be considered (NICE guideline, NG193). 

What are the benefits of Acupuncture?

The use of acupuncture may help to:

• Reduce your pain, to make it easier to cope with your daily routine.

• To help reduce the amount of painkillers you take for pain relief.

• Give you a sense of well – being.

In some cases, you may not notice any benefits.

What are the side effects and possible risks of Acupuncture?

Some side effects and risks are common, usually minor and easy to treat. Serious complications are very rare.

Minor side effects include:

• Pain where the needles puncture the skin.

• Bleeding or bruising where the needles puncture the skin.

• Feeling dizzy or faint.

• Tiredness/drowsiness.

• Worsening of pre-existing symptoms.

• Infection where the needles were inserted.

Rare but more serious risks or side effects include:

• Stuck needle – which may be due to muscle spasm – your doctor, nurse or physiotherapists is trained to deal with this.

• Broken needles – your doctor, nurse or physiotherapist is trained to deal with this but if they cannot remove it easily, you will need to have further treatment.

• Bleeding – bleeding risk may be increased if you are taking blood thinning medications, for example, Warfarin, Heparin or Clopidogrel or suffer from haemophilia (a condition that affects blood clotting), you must tell your doctor, nurse or physiotherapist before having acupuncture.

Acupuncture is not advised in early or late pregnancy due to a risk of miscarriage or early labour. You must tell your doctor, nurse or physiotherapist, before having acupuncture, if you are or may be pregnant.

Very rarely acupuncture could lead to:

• Damage to an internal organ – if needles are used around your chest or shoulder area there is a very small risk of causing a pneumothorax (collapse of a lung).

Can anyone have Acupuncture?

There are certain health conditions that may prevent you being eligible for acupuncture treatment or you may have particular conditions that requires caution.

It is important to let your acupuncturist know if any of the following apply. If you:

• have ever experienced a seizure, fainting episodes or if you have epilepsy,

• have a pacemaker or any other electrical implant,

• have a bleeding disorder e.g. haemophilia,

• are taking anti – coagulants or any other medications,

• have a heart condition, have had recent surgery or have an active infection,

• are pregnant or trying to conceive,

• have a known metal allergy – specifically to stainless steel or nickel,

• have a needle phobia,

• have a known infection or skin condition,

• have a deficient or weakened immune system,

• or if you have cold/flu symptoms, feel generally unwell or anything else you wish to share that you feel maybe relevant.

What will happen at my appointment?

Firstly, it is advisable to have something to eat 1 – 2 hours before your treatment. This minimises the very small risk of feeling faint during your treatment.

During your initial consultation, your clinician will discuss and document your consent, your medical history and current health challenges. Your clinician will also talk you through the process and what to expect from your treatment.

Some patients worry acupuncture will be painful but contrary to this belief, this is virtually pain free. Acupuncture needles are very thin, and different from traditional needles which are used to take blood.

Generally, only a small number of needles will be used during your first treatment, Additional needles may be implemented as your treatments progress at the discretion of your clinician and in accordance to your symptoms.

Each needle is inserted into the skin at various points on the body, this may be at a specific site where you feel pain, or more a distal point which has beneficial effects. Generally a combination of both will be included. Each treatment lasts approximately 20 – 30 minutes, however your clinician will advise the optimal duration for your individual complaint. During the treatment your physician may stimulate the needles by gently turning or tapping the needles. This process is carried out to stimulate the site where the needles are inserted and promote effectiveness of treatment.

At the end of the treatment, the needles are removed and disposed of appropriately. You will then be free to go about the rest of your day as you wish.

Lastly, it is always a good idea to drink plenty of water as this will support the treatment and ensure you remain hydrated.

What is Electro-Acupuncture?

During electro-acupuncture, needles are inserted as described and can be coupled to the electrodes of an electro-acupuncture apparatus. These units are designed to deliver variable amplitudes and frequencies of electrical impulses. Low frequency electro -acupuncture is intended to contribute to the mechanism of pain reduction, especially stimulating chemicals from the brain which will aid analgesia, relaxation and sleep.

How will I feel after my treatment?

Following your treatment you may feel very relaxed or tired. It may be a good idea for you to arrange for someone to take you home, after your first appointment, in case you feel tired. You should not drive yourself home if you feel tired.

You may feel some pain relief following your first treatment, but sometimes the pain can be worse for a few days before you feel any improvement. Acupuncture does not always relieve pain for everyone.

Will I get a follow up appointment?

You will be able to discuss your acupuncture treatment and any further management of your pain at the end of your acupuncture treatment. Some services providing acupuncture will have this discussion during your final acupuncture treatment session, whilst others services will arrange a telephone review appointment.

Contact Number

Pain Clinic

Telephone: 01642 383201

Monday to Friday, 09:00 a.m. to 05.00 p.m.

University Hospital of North Tees

Outpatient Department

Telephone: 01642 383724

Monday to Friday, 08:00 a.m. to 05:00 p.m.

University Hospital of Hartlepool

Outpatients Department

Telephone: 01429 522567

Monday to Friday,08:00 a.m. to 05:00 p.m.

Integrated Musculoskeletal Services

(Including Physiotherapy, Hand Therapy and Community Pain Management)

Telephone: 01429 522471

Monday to Friday, 08:30 a.m. to 04:30 p.m.

NHS

Telephone: 111 (when it is less urgent than 999)

References/Further Reading

• Yang, Ziyi; Zhao, Ling; Xie, Xianze; Xu, Tao; Zhang, Yutong; Wang, Xing; Du, Jiarong; Wang, Ziwen; Zhou, Menguan; Li, Ying; Zhou, Siyuan. The effectiveness of acupuncture for chronic pain with depression: A systematic review protocol. Medicine (2017) Volume 96 Issue 47.

• Lemon, R; Hampton, A. Non-pharmacological treatment for chronic pain: What works? The journal of Family Practice. (2018) Volume 67 No 8

• Acupuncture NHS https://www.nhs.uk/conditions/acupuncture/ (accessed online 9^th May 2024)

• National Institute for Health and Care Excellence (2021) Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193) https://www.nice.org.uk/guidance/ng193 (accessed online 9^th May 2024)

• Acupuncture Associated of Chartered Physiotherapists https://www.aacp.org.uk/ (accessed online 9^th May 2024)

• Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain https://www.nice.org.uk/guidance/ng193 (accessed online 9^th May 2024)

• Selective serotonin reuptake inhibitors (SSRIs) https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/overview/ (accessed online 9^th May 2024)

• About Melatonin NHS https://www.nhs.uk/medicines/melatonin/about-melatonin/ (accessed online 9^th May 2024)

• Osteoarthritis in over 16s: diagnosis and management https://www.nice.org.uk/guidance/ng226 (accessed online 9^th May 2024)

• Low back pain and sciatica in over 16s: assessment and management https://www.nice.org.uk/guidance/ng59 (accessed online 9^th May 2024)

Comments, concerns, compliments or complaints

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