Can acupuncture cause nerve damage?

Comment by Chad J. Dupuis, L.Ac.

First you must distinguish between neuropathy and nerve damage. But to answer your question directly, acupuncture is regularly used to treat neuropathy and nerve related pain issues - so it is generally helpful for such conditions. There are extremely rare cases, largely (99.9%) from China with certain points (only a couple - PC 6 being the main one) where there can be some damage due to very deep needling techniques. These techniques are rarely used in modern times and are almost non-existent outside China - even by Chinese practitioners. Even the studies that have shown some nerve infiltration (i.e. not damage per se) from these techniques have rarely shown any permanent issues, simply that the needle infiltrated the nerve.... A similar question was asked a while back and you can read my more detailed response on the issue - here....

I am unaware of any case where long term nerve damage was caused by acupuncture, but I am aware of thousands where it has been helpful - post surgery, diabetic neuropathy, etc.. As I said, however, there are incredibly small possibilities of something like that with very aggressive techniques. And, while all acupuncturists in the US anyway are fully trained, in other countries they may not be - and many chiro's, pt's, md's, etc. can often practice with no or very little training which may make them more prone with certain points to cause an issue - again though I am unaware of any studies on the matter and have actually only heard of a few legitimate cases over the years (all in China...).

All that said, you would have to quite a bit more specific both about the techniques used, your existing conditions, and what you are experiencing now for anyone, myself included, to give you any real feedback on your issue...

Comment by Archived User

The sensation that is experienced when an acupuncture needle is introduced by the practitioner into the patient is called the &#39arrival of qi." It is not uncommon for the patient to feel a sensation for a brief period of time after the needle has been removed. Have never heard of acupuncture causing nerve damage, only helping.

Thank you.

SiennaCatherine

Comment by Chad J. Dupuis, L.Ac.

@siennacatherine -- You may want to follow the link, then, that I posted in my reply to read the clinical studies about nerve damage. Practitioners should be more aware of possible complications from certain points. While extremely rare with the methods and training we use in the west it is a somewhat legitimate issue with certain points/techniques. Again, it&#39s never been shown to cause permanent nerve damage, but many of the deeper techniques did go deeply into certain nerves and that is -not- the de qi sensation so often talked about.... The studies talk about this in detail.

Comment by Archived User

When the needle touch the nerve, you will feel strong electronic feeling, usually the practioner will lift the needle a little to avoid the nerve or change an other direction, for bell pallsy patient the needle touch the nerve will good stimulate for treatment. for too sensetive patient may cause needle shock, better shallow needling or use acupressure instead of needle.

Comment by Archived User

Just wanted to say thank you to everyone for your replies. They did help to put my mind at rest somewhat.

I have now graduated from University and am in my first few weeks of practice, which I am finding daunting to say the least!! I work alone and have no back up since leaving Uni, which I am struggling with.

This has caused me to re-visit this subject and I just wanted to clarify a few things.

How can I differentiate from the &#39normal&#39 de-qi sensation elicited by acupuncture and the sensation of touching a nerve with a needle? I am a little concerned that I will make the mistake of manipulating a needle which has touched a nerve and cause come kind of nerve damage.

I have done a 3 year degree at Uni and read all the time, and I know serious side effects/complications from acupuncture are very rare, but I am just so scared that I will do something wrong and harm a patient. The worry feels overwhelming at times and I am considering giving up practising before I have even really got going properly. Is this normal for a newly qualified practitioner? I just don&#39t feel ready to be &#39going it alone&#39.

Please help.

Comment by Chad J. Dupuis, L.Ac.

Didn&#39t you have clinical rotations as part of your training? Please don&#39t take offense to this, but unless the schooling you have is incredibly sub par you shouldn&#39t have any problems starting out. If your program didn&#39t include clinical rotations or not enough for you to be confident in your techniques and diagnostic skills you should quickly find a mentor to train under (this would be good regardless). Many practitioners would not mind at all someone to come a day or two a week and follow them around. Your skills and techniques will develop quickly this way.

Training aside the one word of advice I can offer you regarding the "de qi" sensation is to forget about it. Just put the needle in and move on.... don&#39t overthink what is or isn&#39t happening, just let it be. It&#39s really not that complicated - the body (not us) knows what to do with the information. We didn&#39t create the acupuncture meridians, the body told us they are there - keep that in mind... For needling, use the insertion tubes, perhaps starting with Japanese style or light guage needles (36/38/40), don&#39t go in more than a 1/4-1/2 inch in most places (it&#39s unnecessary anyhow), and don&#39t worry about hitting nerves it&#39s really quite difficult except at PC 6 (still quite difficult)... As your skills improve you can focus more on what is happening and trying to "make" certain things happen. Personally I feel you will be a better practitioner the less you think about de qi... which is a nebulous concept at best. Just put the needles in - train with a Japanese style practitioner to see how little needs to be done to get results - that alone will give you a broader perspective.

Most importantly, find a teacher and practice Tai Chi or at least some qi gong variant. You will get more from this than you can imagine as a practitioner...

Comment by Archived User

I am also stunned by this, and like Chad said, don&#39t take this as an offence but how do they teach at the university you attended? I am also a student and we have ongoing clinical practice with patients under the supervision of instructors and TCM doctors, and also get acupunctured ourselves nummerous times (tonifying ... etc.) to get the &#39Chi&#39 feeling. You should be well aware of the difference between a nerve and Chi feeling as a nerve sensation is instant, Chi sensation generally occurs about 3-5 minutes after the needles are insterted. Again, take this as no offence but I am very stunned about hearing you graduated from a 3 year program and not be aware of the basic concepts. Our school offers the 4 year masters program but even at the beginning they teach these very basics. Can I ask what kind of program were you enrolled in? It is very clear to me that they did not give you the proper training that you need to be a confident acupuncturist.

Comment by Archived User

Thank you for your replies. My course was a 3 year BSc degree with highly renowned TCM doctors, and while we did have lots of clinical practice, we were not always supervised a great deal, and it was never mentioned to us the likelihood of touching a nerve or the difference between nerve pain and deqi.

Comment by Archived User

Wow ... your school is very different from mine, but sounds legitimate. I am very surprised Newmoon that they don&#39t teach about possible nerve damages. In our school we had to learn the nerves surrunding each of the points to be aware where they are and to avoid any possible damage.

Like Chad also mentioned it&#39s more of a problem in China where I read people often request doctors to deep puncture them because they feel the effects more - most poeple don&#39t use this in the West. The nerve damages that are caused also usually local damages that do not impair any physiological funtionalities but rather loss of feelings in the area. In China some poeple take this &#39sacrifice&#39 for their good health..

You should not be afraid of puncturing any of the points; just like Chad pointed it out, just stay shallow whener possible.

Comment by Archived User

I do believe I received an excellent training in TCM from my University and completed many hours of clinical practice in which I obtained good results with patients.

When I graduated from University I was very confident in my ability and felt sure that I would make the transition easily into private practice. However, after a couple of months of pracitising, I seem to have had something of a &#39panic&#39 and realised I am now very much alone, with all the responsibility on me, and without the security of having a supervisor and colleagues around me.

This has lead to an increased nervousness and caused me to worry a lot about what may go wrong.

I am hopeful, however, that I will regain my confidence with experience and the help of a supervisor / mentor.

Comment by Archived User

I believe it can be &#39frightening&#39 all of a sudden to be alone, I think the best if you keep in contact with others and I have been here on Chad&#39s site for years and can tell you that a lot of people here can help you out with advice. I am still a student but I can also give you at least encouragment. :)

Blade~

Comment by Archived User

I just wanted to let you know that the risk of nerve damage is extremely little.

I have practiced acupuncture for 15 years and often pinched a nerve, but it has NEVER resulted in anything but a tingling sensation that went away usually after minutes, seldom lasting more than a few hours in some cases.

Testing with piercing of a nerve of a rat did not show morphological changes even after 100 piercings of the nerve. So the likelihood of damaging a nerve of one of your PT`s is quite small even if you try very hard!:-)