Acupuncture for chronic pain

Your doctor has referred you to the Pain Clinic for specialist advice on your pain. The Consultant in Pain Management has recommended that you consider a course of acupuncture.

Please make sure you have someone to collect you afterwards as you should not drive home after your treatment.

This leaflet gives you information about acupuncture before your informed consent to treatment. Please read this
carefully. Ask if there is anything you do not understand. Before going ahead with acupuncture the Consultant will
discuss the expected benefits and risks with you.

Acupuncture is a form of treatment where fine needles are put into the body at specific points. It is one of the oldest forms of medicine originating in China and has developed over the last 3000 years. The traditional Chinese belief is that energy flows freely when the body is in a state of good health.

The basis of Traditional Chinese Medicine (TCM) is that we have energy or qi ( pronounced chee) which circulates round the body, through channels. When disease affects the body, it also affects the flow of energy through these channels and the balance of energy - Yin & Yang. The aim of traditional acupuncture is to restore the normal flow of energy and thus health.

Over the last 30 years we have begun to understand how acupuncture might work in a Western scientific way. Western Medical Acupuncture (WMA) is an adaptation of Chinese acupuncture using current knowledge of anatomy, physiology and pathology, and the principles of evidence based medicine. Western medical acupuncture is principally used by conventional healthcare practitioners, and is mainly used to treat musculoskeletal pain, including myofascial trigger point pain (White et al 2009).

The acupuncture you receive from the pain service will mostly be a Western approach, incorporating some traditional points as required.

There is research showing that acupuncture affects most of the body's systems:

• the nervous system
• muscles
• hormone secretion
• circulation
• the immune system, as well as respiratory, digestive and urinary systems

If we have decided that acupuncture is a suitable treatment for your pain then we will aim to give you between four and six treatment sessions. What we hope for is a progressive reduction in your pain which will last from three to six months after treatment. All treatment of chronic pain is difficult and the success rate is only around 30-50 %.

At the first treatment we will put in only a few needles briefly to assess your response. You don't usually feel the needles going through the skin as they are very fine. Once they reach the acupuncture point there may be a heavy numb feeling which is sometimes uncomfortable. This feeling will usually continue after the needle has been removed. 

Quite often you will be stiff after the treatment then feel better the next day. You may feel sleepy, which is why it is best not to drive home. If there has not been much response after two treatments then we may increase the strength of stimulation by using electro-acupuncture. This is done by connecting the needles to electrodes, rather like a TENS machine, although is not appropriate for all patients.

There are many painful conditions that respond to acupuncture. Recent guidelines for the management of chronic pain in Scotland recommend acupuncture for the short term relief of pain in patients with chronic low back pain or osteoarthritis. (SIGN 136, 2013). It is also worth considering a trial of sessions for Primary Chronic Pain as recommended by NICE 2021.

Is it safe?

• Acupuncture is generally safe when practised by trained professionals using pre-sterilised disposable needles.
• Side effects are rare. To reduce these you will be asked a number of questions about your health.

Does acupuncture have side effects?

You will need to be aware of the following:

• A small number of patients feel drowsy after treatment. The release of endorphins (the body's natural pain killers) can make you sleepy afterwards. If affected, you are advised not to drive after treatment.
• There may be a small amount of bleeding or bruising after acupuncture. Especially if you have blood clotting problems or are taking anticoagulant medicines like warfarin.
• You may feel some pain during treatment.
• Fainting can occur. Although this is rare, precautions are taken.
• There may be temporary aggravation of symptoms after treatment.
• Often there is some stiffness after acupuncture, but occasionally the pain may be made worse. The risk of this being permanent is less than 1 in 10,000.
• There is a very small risk of damage to nerves - less than 1 in 100,000. 
• If the acupuncture needle is put in too deeply over the lung it may be punctured. Although this is rare, precautions are taken. As practitioners have been trained in anatomy we hope to avoid this.
• If there are any other risks particular to you, your acupuncturist will discuss these with you.

Following discussion you will be given a consent form to read and to sign before treatment. This will ask you some questions about your general health. These are important to allow your acupuncturist to decide whether acupuncture is suitable for you.

Please tell your acupuncturist if you feel unwell on the of day of treatment in any way.

Will it hurt?

This is the most common concern of patients. When put in, the fine needles cause a sensation, which should be a temporary discomfort at most. You may also have short-lived feelings of heat or tingling. You may feel your symptoms during the treatment. If you do, please discuss these with your acupuncturist.

Important notes

• Please eat something within four hours of coming for acupuncture treatment
• Acupuncture is safe and almost painless
• Single use sterile, disposable needles are always used
• You have the right to refuse treatment at any time
• There is no hurry to leave the treatment area
• You may wish to make use of the treatment session for rest and relaxation