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Acupuncture

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I have tennis elbow, and have had three acupuncture treatments, the last two have been very painful. Is this normal?

Florian Boschi (Beverly Hills, CA) on Aug 9, 2012
You can ask for thinner needles, which should help. Other possible techniques include Dr. Tan's balance method ( treating the condition without needling in the inflamed area), moxa (the application of heat by burning herbs, no needles required), laser treatment, Epson salt baths, topical herbal solutions, castor oil packs, herbal remedies and massage. Myofascial release massage followed by icing is often very effective for tennis elbow, though it can be painful as well. Just ask. You might be surprised how much can be done without needling the injured area. I am sure your acupuncturist will be more than happy to offer alternative ways of treatment.
Lejla Fazlicic (Lincolnwood, IL) on Aug 9, 2012
There are different styles of acupuncture, and the Chinese style is to needle deeply. But that doesn't mean that you have to be in pain throughout the treatment, and after the treatment. I would adjust the strength of the point stimulation and choose different points. I would also add some points for relaxation, because clients respond to the treatment much better if they are relaxed. It is not normal for pain to increase after acupuncture.
Sung C. Cho (Torrance, CA) on Aug 9, 2012
Some acupuncture points are painful when the practitioner stimulates them strongly. Pain during or after sessions might be normal or abnormal, but the more important thing is whether you still feel pain in the elbow or not.
Jacklin Arastouzadeh (Beverly Hills, CA) on Aug 9, 2012
About 10 to 15% of patients have more pain after the treatment. It doesn't mean you are getting worse. This response is called a healing crisis. Patients who have such a response will heal faster.
Maria Andino (No Ho Arts District, CA) on Aug 9, 2012
I am sorry to hear that you experienced increased pain after your treatments. Occasionally a treatment will cause more discomfort before the issue is resolved. I can not speak to the method of acupuncture your practitioner was using, but I prefer to use an area away from the painful site. This is known as the distal method (for instance, treating the knee to resolve pain in the elbow). I would recommend that you request that your practitioner use the distal method for your next treatment if your pain does not diminish.
Adi Barad (Winnetka, IL) on Aug 9, 2012
An acupuncture treatment can be painful. It depends on the acupuncture style and technique. You should always be comfortable discussing all your questions with your practitioner.
Andy Ly (Sterling Heights, MI) on Aug 9, 2012
Try heat therapy before acupuncture. Heat blocks pain receptors. After heat therapy, needling will be less painful and produce better results.
Daniel Cook (Woodinville, WA) on Aug 9, 2012
Acupuncture should never be "very painful." Although there should be some sensation at the needling site, it should not cause severe pain. You stated that you were in more pain afterward, While this does sometimes happen, I would expect the discomfort to dissipate in a day or two. It is not uncommon to place the needle at the site of pain (though some systems of acupuncture argue against this), but it certainly should not have increased your pain. Talk to the practitioner and tell him/her of your concerns. If you do not get a satisfactory answer, I would suggest a different acupuncturist.
Monica Roslow (Red Hook, NY) on Aug 9, 2012
Acupuncture is not usually especially painful during the treatment. Sometimes there will be an exacerbation of the pain after the treatment, followed by a release. But while you are resting on the table you should be comfortable.
Crystal Dmytryk (New York, NY) on Aug 9, 2012
Yes and no. Often when treating injuries and pain with acupuncture you will experience soreness and pain when injured muscles are affected. After the treatment you may continue to feel sore (like after a strenuous workout or a bruise) but then the next day we would expect you to feel better. If an injury is overstimulated it can result in what we call a "healing crisis" where you feel more pain after treatment. Within a day or two you should experience a marked improvement. You can always ask your acupuncturist to "tone down" the stimulation you are receiving. Acupuncture is cumulative, so it may take a few treatments to see any effects. However if you have had 3 treatments and are not experiencing at least 24 hours of relief (after the soreness wears off) it is possible that you need to seek out a different acupuncturist.
Angie Ng (Chicago, IL) on Aug 9, 2012
Acupuncture can sometimes cause a temporary exacerbation of symptoms immediately after treatment. This is due to the increased blood flow and nervous system activity to the area. Such a response can be beneficial if it leads to an overall decrease in symptoms over time. That being said, this type of response should only happen for the first one or two sessions of acupuncture, and should not be extreme in nature. If you are experiencing a consistently high level of pain immediately after treatment and your symptoms are not improving overall, you may wish to speak to your acupuncturist about using a less aggressive needling technique. If he or she is not willing to adjust, you may want to consider seeking out a different acupuncturist.
Simon Nelson (North Hollywood, CA) on Aug 9, 2012
Electro-acupuncture is very beneficial for tennis elbow.None of my patients have complained about post-procedure pain.
Dale Tope (Pflugerville, TX) on Aug 9, 2012
Each acupuncturist is trained similarly, but the skill of each practitioner varies widely . I am sorry you have had a bad experience, as acupuncturists are in the business of eliminating pain, not causing it. Tennis elbow, or lateral epicondylitis, is usually characterized by damage to one of the extensor muscles, or their adjoining tendons, in the forearm. In a typical treatment, I insert needles above and below the damaged/painful region, and attach an electro-acupuncture stimulus device. This sends a microcurrent through the affected area and stimulates healing while helping to eliminate pain and inflammation. In addition, I put my patient on a Chinese herbal formula (in pill form) that will also help to ease the pain, and heal the damage more quickly. Usually, I will send the patient home with pain patches they can wear at night to increase circulation and speed healing.
Nanette Hale (Albuquerque, NM) on Aug 9, 2012
Everybody responds differently to treatments, but it isn't unusual to be sore when needles are inserted directly into the affected area. For patients who suffer from tennis elbow, I typically mirror the elbow on the opposite leg, and see wonderful results using this method, even within the first visit. This prevents the soreness from direct insertion, and allows the practitioner to monitor your range of motion.
Jennifer Aubert (San Francisco, CA) on Aug 9, 2012
Every patient, every practitioner and often every session can be markedly different. Did you ask your acupuncturist why the last two sessions were more painful? Did they introduce another modality, such as cupping or electrical stimulation or Tui-Na? Needling in the area of pain is common to help break up the stagnation. People mistakenly think that acupuncture is 100% painless too. It can indeed be painless. But often where there has been an injury and there is stagnation in the area (stagnation of blood and/or energy leads to pain in the body) there may be a bit more pain in the beginning. It's like when you get a deep tissue massage - sometimes it can be incredibly painful at first but then it feels much better. Talk to your acupuncturist and see what he/she says - open communication is good. If you are feeling like they're not listening to you or are too aggressive for your liking, you can always try someone else. Sometimes it's just not a good match.
Kim Vandeveer (Rohnert Park, CA) on Aug 9, 2012
You might feel worse at first, but then it will get better.
Katalin Csoka (Mission Viejo, CA) on Aug 9, 2012
Tennis elbow takes a long time to heal. To avoid pain, the practitioner can use "distal" points, or ear acupuncture, so the very inflamed elbow will not be touched.
Richard Ki (Orange, CA) on Aug 9, 2012
This is called "aggressive effect". When an acupuncture needle is inserted in a certain region, blood cells accumulate and start the healing process. During the healing process, your symptoms may get worse temporarily. Patients must have adequate rest after the acupuncture treatment. Please be advised that acupuncture will help your body heal itself but won't impact the condition directly.
Linda Phelps (Seattle, WA) on Aug 9, 2012
Acupuncture should make your pain better and not worse. In a small percentage of cases, the pain may get worse after treatment, but within 24 hours the pain should fade. Normally, there is no increased pain. There are any different styles of acupuncture. In China, acupuncturists employ a strong needle stimulation technique in part because their patients expect that treatment must hurt to be effective. Here in the USA, people expect treatment to be painless, and so a gentler technique is usually used. If it hurts to needle into the painful area, then the acupuncturist should avoid doing so and instead use "distal points", which are points in other parts of the body that can reduce your pain. This is the way I work. I employ a gentle acupuncture technique that is comfortable and soothing. I only needle into the painful area if needling there does not aggravate the pain. Otherwise, I needle elsewhere. In my clinic, patients remain fully clothed and relax on reclining chairs. Therefore, I cannot needle into many areas of the body because they are covered by clothing. I treat back pain by needling a hand or lower leg. There are multiple options for treating just about everything. It is possible to never needle into pain. Your elbow pain can be relieved by needling your leg!
Lisa Nicholson (San Diego, CA) on Aug 9, 2012
People respond differently to acupuncture, and there are a variety of ways to treat tennis elbow. Some practitioners needle directly into inflamed areas, others needle around them, still others use only distal points - for example, on the opposite knee. I personally do deeper needling around areas of inflammation, and very superficial needling directly on an inflamed area. In my practice, if someone reports that they have more pain after a treatment than before and it is not just temporary soreness, I assume I am treating the area too aggressively. While the needles may sting a little going in, and may give a strong aching sensation while inserted, acupuncture should not (in my opinion!) be very painful. It sounds as if your practitioner is doing a treatment which is too strong for your body.
Michael Moy (Willowbrook, IL) on Aug 9, 2012
Acupuncture treatment can be painful if the person is not relaxed during treatment. Some dull soreness the next day is also normal. Breathing techniques may reduce discomfort.
Andrew Rader (Lagunitas, CA) on Aug 9, 2012
This question is best answered by your acupuncturist. There are differing styles of acupuncture and some elicit a stronger needle sensation than others. In general, acupuncturists from China prefer a stronger needle sensation. Acupuncturists who practice Japanese methods usually prefer a milder needle sensation. Both methods get results. Many American patients would like to not feel the needles. In my practice, I ask people what they are feeling. If they don't like the needle sensation I remove it and try a different point. I tell people that some sensation is necessary but it doesn't have to be painful to get results. How is your tennis elbow doing? That is the real question. Is it better now than it was last week?
Ellen Goldsmith (Portland, OR) on Aug 9, 2012
There are many styles of acupuncture and some are indeed more painful than others. One ought to have a significant lessening of pain within 6 treatments. It is always best to speak with your acupuncturist about your experience and go forward from there.
Donna Cain (New Canaan, CT) on Aug 9, 2012
Every person responds differently to acupuncture, so it is very important that you communicate with your acupuncturist about what you are feeling. Sometimes, the body undergoes a "healing crisis" during treatment and you do feel worse than before your treatment began. This should not be a permanent state, however. Explain to your acupuncturist what is occurring. He or she will be better able to determine what points to use based on this information.
Amy FitzPatrick (New York, NY) on Aug 9, 2012
Acupuncture can cause increase blood flow to the area temporarily which can increase swelling and therefore pain. However, this discomfort should be mild. I f, for example, your pain went from a 5 out of 10 to a 7 or 8 out of 10 - then that does seem abnormal. Talk to your acupuncturist and describe the type of pain (sharp, burning, dull etc) and he or she can adjust your treatment.
Maria Baraybar Lee (Denver, CO) on Aug 9, 2012
Sometimes a brief spike in pain after treatment is normal, especially when electro-stimulation is used, but you should feel better the next day. It is not normal to feel constant pain for days after your acupuncture treatment.Talk to your acupuncturist about it.
Kim Yoo (Overland Park, KS) on Aug 9, 2012
If you haven't had some relief of your symptoms after three treatments, I would suggest that you speak with your practitioner about your results and your painful treatments. Acupuncture treatment can be uncomfortable at times but it is rarely painful. Positive results should have been achieved by now.
Aram Akopyan (Glendale, CA) on Aug 9, 2012
Usually acupuncture does not produce severe pain. However, during the treatment some pain is expected. Sometimes conditions will produce severe pain just before they resolve completely. I would suggest you discuss this with the practitioner. If the pain continues, perhaps he/she can adjust the treatment protocol.
Steven Gordon (New York, NY) on Aug 9, 2012
Sometimes when an acupuncturist needles the site of pain, the pain becomes worse. This is known as needling the "Ashi points". Ask your acupuncturist not to needle the local pain but to needle the adjacent and distal points. Even better would be to find an acupuncturist who practices the style of Master Tung. In Tung's acupuncture, often the opposite knee would be needled to treat the pain in the elbow. There is usually an instantaneous reduction of the pain and no additional trauma to the injured site. Two treatments per week for 5 weeks will usually resolve even the most difficult cases.
Ta-Li Chang (La Habra, CA) on Aug 9, 2012
This type of situation can happen. It could be that the needle hit a vein, and removing the needle caused bleeding or bruising. The acupuncturist should press on the needling point after removing the needle. Puncturing a nerve can cause localized swelling.
Paul Kempisty (New York, NY) on Aug 9, 2012
Depending on the acupuncture techniques used and the location of the points chosen, some moderate discomfort is sometimes experienced, but acupuncture should not be extremely painful. Let your acupuncturist know right away if something doesn't feel right. They should be able to make immediate adjustments to help you feel more comfortable. There are lots of ways to tone down the intensity of an acupuncture session without losing the benefits.
Cari Cater (Smyrna, GA) on Aug 9, 2012
If you are experiencing more discomfort following an acupuncture treatment where needles are placed in the problem area, that style may not be for you. Try to find a Balance Method Practitioner. The needles are strategically placed on the arms and legs (not in the area of pain). The relief is often instant!
Chester Dickerson (Austin, TX) on Aug 9, 2012
There are other treatment methods for treating tennis elbow. Most acupuncturists have been taught that results can be seen just by treating the contralateral side. For instance, theory shows treating the lower knee helps with treatment of the upper elbow or the right elbow to treat the left. It is not always necessary to insert needles into the injured area.
Chantal Davis (San Diego, CA) on Aug 9, 2012
That depends on what painful means to you. With some people, I insert the smallest needle possible and they wince and shout out. Others come in and I use slightly larger needles and get no reaction from the patient at all. Sometimes the sensations you get from acupuncture are new, so they seem strange and unusual. Typically it is normal to feel a dull ache. You should never feel sharp pain or a burning sensation. If you do, tell your practitioner and he or she can adjust the needles. Is the pain you are experiencing during the treatment or after? Talk to your practitioner about your concerns. Maybe he or she can take a different approach.
Mindy Boxer (Santa Monica, CA) on Aug 9, 2012
I have never had a patient report that to me after an acupuncture treatment. Perhaps you need to see someone with a lighter, more gentle approach. I utilize a very gentle Japanese style of acupuncture. It does not hurt at all, and I get excellent results!
Sharon Rose (Portland, OR) on Aug 9, 2012
For a small percentage of patients, acupuncture can make the symptoms temporarily worse (a few hours), but it should be followed by a longer period of big relief (days or weeks). If that's not what's happening, I would recommend you see a different acupuncturist!
Jill Levine (Hershey, PA) on Aug 9, 2012
The treatment should not be painful. You should not have more pain after a treatment, you should have less.
Steve Snyder (Portland, OR) on Aug 9, 2012
It can feel more painful after acupuncture but that Should go away after a day or two and quite often Patients report that they feel better at that point.
Steven Schram (New York, NY) on Aug 9, 2012
Needling directly into inflamed and tender tissue often causes more pain right away. But the increased pain should subside within a day and the inflamed area become less tender. Icing the area after treatment is advisable. If you don't have any noticeable improvement after three treatments, it might indicate a couple of things. First, the style of treatment might not be ideal for you. You might benefit from a gentler needling style, massage of the proximal and distal muscular tissue as well as application of cupping, moxa or estim. Sometimes the problem may not be in the area of pain, and treating only where it hurts could be missing the actual area of injury. Use of specialized topicals may also help. The best approach going forward might be to discuss these options with your acupuncturist.
Jason Bussell (Wilmette, IL) on Aug 9, 2012
Chinese acupuncturists have a reputation for being more painful needlers. They believe that the more sensation, the better. In my experience, that is not the case. So I do not try to inflict pain with my needles. Chiropractors and physical therapists are allowed to perform acupuncture in some states but they have very little training and so their treatments also can be painful. If you find acupuncture too unpleasant, you may want to try another practitioner.