What is acupuncture?
Acupuncture involves the insertion of very fine stainless steel needles into the skin. It has been used in China for over 2,000 years and increasingly in Western Medicine since the 1970s.
Acupuncture may be used to treat a wide range of common health problems and to reduce pain. For example, NICE guidelines (2009) recommend a course of 10 sessions of acupuncture for persistent, non-specific low back pain. In September 2012, NICE recognised acupuncture's benefits for migraines and tension-type headaches too.
Acupuncture can be combined with other physiotherapy treatments such as exercise, manual therapy and relaxation techniques. It can also be used when other more conventional treatments have failed.
How does acupuncture work?
Acupuncture stimulates the body to produce endorphins and oxytocin, its own pain- and stress-relieving chemicals. It may promote sleep by stimulating the release of melatonin in the body and may encourage a sense of well-being by stimulating the release of serotonin.
Acupuncture also stimulates nerve fibres to block out pain signals and helps to reduce the sensitivity of tender points in the body.
Can anyone have acupuncture?
There are certain health conditions that may stop you receiving acupuncture or mean that the treatment should be used with caution. It is important to let your physiotherapist know:
If you have ever experienced a fit, seizure, faint or if you have epilepsy;
If you have a pacemaker or any other electrical implant;
If you have a bleeding disorder e.g. haemophilia;
If you are taking anti-coagulants or any other medication;
If you have any heart valve problems;
If you have any risk of active infections;
If you are pregnant or trying to conceive;
If you have a known metal allergy - specifically to stainless steel;
If you have a needle phobia;
If you have a known infection or skin condition in the area to be treated;
If you have a deficient or weakened immune system;
If you have diabetes;
If you have low blood pressure;
If you have been prescribed any medicine;
If you have cold/flu symptoms or feel generally unwell.
What happens when I see my physiotherapist for acupuncture?
It is a good idea to make sure you have something to eat 1-2 hours before your treatment. This will help reduce the risk of you feeling faint during your session by keeping your sugar levels up.
When you first see your physiotherapist, he or she will take your full medical history and ask you about your current health problems. You may be asked to complete a 'consent to treatment' form.
Between 1 to 10 needles may be used at a time at an acupuncture session. The number of needles used will vary according to your condition and symptoms.
The needles are inserted through the skin either at the sites where you feel pain, away from the pain or a combination of both. The needles are usually left in for as little as a few seconds or for up to 30 minutes. During the treatment, your physiotherapist may stimulate the needles by gently rotating them.
The needles may also be stimulated using electrical impulses. The stimulation of the needles is done to increase the treatment's effectiveness.
The needles are removed at the end of the session. You will then be asked to rest for a few minutes before you leave.
How many sessions will I have?
The overall number of treatment sessions required will depend on you, your condition and your physiotherapist's assessment.
Most patients receive a course of up to 6 treatments although just one or two treatments may be enough. Sometimes 1 or 2 'top up' treatments are required. Treatments are normally given at 1-2 weekly intervals although this can also vary.
It is generally clear after a few sessions whether or not acupuncture will benefit you and if the treatment should be continued.
How long until I see an improvement in my condition?
The effects of acupuncture treatments are cumulative: different people respond in different ways and at different rates. Some people may feel an immediate relief of their symptoms whilst others may only see a gradual improvement after a few treatments. Some people may find that their conditions/symptoms flare up for up to 24 hours after the treatment but then see a marked improvement.
Although acupuncture can help reduce pain, particularly when other more conventional treatments have failed, it does not work for everyone.
Does acupuncture hurt?
Acupuncture should not be painful. The needles used are the same width as human hair so having acupuncture does not feel the same as having an injection.
When needles are inserted, you may feel a temporary, sharp, pricking sensation. During the treatment itself, you may have a feeling of warmth or 'fullness', heaviness, pins and needles, numbness, tension around the needle, or a mild ache or discomfort.
You may also feel a little light-headed or relaxed. It should not feel unpleasant. These are signs that your body is reacting to the acupuncture. Alternatively, you may not feel the needle at all.
Is acupuncture safe?
Acupuncture is a very safe procedure when carried out by fully qualified professionals. Acupuncture is safe when practised by a member of the Acupuncture Association of Chartered Physiotherapists (AACP) becuase of the strict hygiene guidelines that must be adhered to and the training courses and educational updates that are required to stay on the membership register.
Your AACP physiotherapist is also bound by a professional code of conduct through the Chartered Society of Physiotherapy (CSP) and is regulated by the Health and Care Professions Council (HCPC).
The needles used by your physiotherapist are individually packaged, sterile and disposed of after one use. They may also be supplied in guide tubes for easy insertion which means that there is no risk of anything touching the needle during the procedure.
Are there any side effects to acupuncture?
Any side effects tend to be mild and short-lived. They may include: fatigue, light-headedness, bruising, localised bleeding, soreness and redness or mottling of the skin around the needle sites.
If you continue to feel tired after a treatment, it is recommended that you do not drive or operate machinery.
If you have or are concerned about any possible side effects, please speak to your physiotherapist.
1. Kaicun Zhao, "Acupuncture for the Treatment of Insomnia," International Review of Neurobiology 111, (2013): 217-234
2. Lin JG, Chen WL. "Acupuncture analgesia: a review of its mechanisms of actions," American Journal of Chinese Medicine 36, no. 4 (2008):635-645.