Intense pain behind knee after acupuncture [from PT]

Comment by Chad J. Dupuis, L.Ac.

This question has been answered multiple times on these forums - search "pain from acupuncture" to see most of them. My reply to a very similar post, here, is as good as any that I&#39ve offered previously.

In short, these types of localized tissue irritation do not lead to any kind of permanent problems and should clear up within a few weeks like any soft tissue injury. That said, there are practitioners (primarily non fully trained Chinese Medicine practitioners, such as MD&#39s, Osteopaths, PT&#39s, etc. - but some fully trained tcm practitioners) with stronger needling techniques where tissue damage can happen. At UB 40 this is rare, but if you are fairly thin framed and they used strong techniques or deep needling there is the possibility of tissue damage. Generally speaking some light massage in the area with a pain oil (there are many within Chinese Medicine) will clear it up. For deeper irritation, acupuncture, perhaps paradoxically, will be extremely helpful in resolving it.

Comment by Archived User

Hello Chad,

It was truly a relief to read your reply. Maybe I'll walk away from this...

I know that my acupuncturist studied in China for several months before he begun giving treatments.

I'm still somewhat concerned because there has been zero improvement in last 1,5 weeks. I'm unable to sit, work or drive a car because of this pain. I must ask, have you heard about single case where needle caused permanent damage to sensory nerves?

Comment by Chad J. Dupuis, L.Ac.

I haven&#39t and even clinical studies (quoted in one of my previous replies to similar questions) where they more or less tried to create significant damage, they couldn&#39t do it. While not taking ownership of this issue off your acupuncturist, it is important to note that the causes of back pain, except in acute trauma, generally start years before any pain is experienced and they involve tight hamstrings, weak abdomen, etc. In short, UB 40 is an extremely useful point for low back pain but on thin framed patients with very tight hamstrings (like athletes, for example) it needs to be needled with some caution. Personally, I forgo that point in some athletes we treat because from looking at the area it simply seems too tight. I&#39ll use other points and then use tuina (Chinese medical massage) in the area (and others) to get a similar effect without risk of tissue irritation. But that&#39s just what I do and is in no way meant as a judgement on your current practitioner. It&#39s more meant as an explanation of why this would be fairly rare but somewhat possible in very specific circumstances.

Comment by Archived User

Chad,

I really appreciate you spent your time to help one anonymous guy from the internet.

Your comments make me believe that these symptoms will go away in time. I try keep positive attitude and I repost here in few weeks.

Comment by Archived User

One more question. If I sit down to a hard surface (wooden bench etc) in a way that just my buttocks touch the bench, it causes intense, burning pain shooting down from my buttock to behind my knee. After I stand up and start walking (chewing my tongue to ground beef of agony) pain resolves fairly quickly. Now I try to avoid sitting at all cost.

This started 1,5 weeks ago after acupuncture session. Do you think this is also tissue damage on behind of the knee or something else?

Comment by Chad J. Dupuis, L.Ac.

No, that&#39s from your back - it&#39s the sciatic nerve. In fact, there is a fairly good chance that the pain you feel behind your knee is completely unrelated to anything that may have happened at your knee. I strongly suggest you continue treatment either with your current practitioner or you find someone else (ideally an acupuncturist who also does cupping and tuina/massage). Generally speaking, most back pain cases are either resolved or well on their way within 3-7 treatments.

Comment by Archived User

I sincerely wish and hope that is the case. I'm going to lumbar MRI in next weeks (if situation is not resolved by itself) and I hope it reveals the culprit. Honestly, I can't understand how the pain can originate from my back, because the pain behind my knee and buttock started during the treatment and there was absolutely zero pain in these body areas before the treatment.

I'm terrified by the thought that needle may have damaged the nerve. I really wish I'm wrong here.

Comment by Archived User

I&#39m having to completely agree with Chad. Your pain is stemming from your back or glutes.

I would see an very good massage therapist or acupuncturist again. If there&#39s a language barrier with the one you saw- maybe check in with one that speaks English in your area for a session so you guys can communicate clearly and easily.

Comment by Archived User

Hi there. I agree with what has been said thus far.

However, you say your acupuncturist trained for &#39a few months&#39 in China. To practice at even the most basic level requires many hours training - the WHO suggests a minimum of 2000 hours, and many countries demand more (here in the UK, for example, a LicAc is not granted without at least 3000 hours study at a recognised institution). Did your acupuncturist take your pulses and look at your tongue? These two investigations form the bedrock of Chinese Medicine and it is hard to be an effective practitioner without them (though not impossible). Make sure you see someone who does these things. In the US they will have LAc after their name, in the UK LicAc. It&#39s important you properly check out their qualifications and experience, and that they keep themselves updated.

I don&#39t think your behind the kee pain is the sign of anything serious, although fully understand how it is affecting you. But, it is important to have confidence that your practitioner will get to the root of your main complaint.

Best Wishes

Comment by Archived User

Thank you Chad, Sheila and Yeoman for your supportive posts. I'm going through gloomy moments of my life.

Yeoman: In our country, acupuncturist is not a protected title, which requires one to have certain certificates or education background. Unfortunately. This means that anyone here can start giving treatments and advertise themselves as "licensed" acupuncturist, no matter whether you got your diploma from over-the-weekend-quick-course or take your time studying hard 3yrs on University.
And no, he didn't check my pulse or tongue before starting the treatment. My good mate recommended this acupuncturist and it sort of made me not to worry about his qualifications and experience (I should have!!) because "my friend trusts him - so can I". Big mistake, really.

My doctor prescribed me today some Tramadol and it seems to be only painkiller that really works for burning pain in my leg. Tomorrow I'll see another neurologist and we discuss about my situation.

I called my acupuncturist today and he is engaged to my present issue and tries to give me tips how to make me feel better. I'll keep you guys posted on my progress. I really wish there would be even a little sign telling I'm going to recover

Comment by Archived User

More than 3 months have passed since my last post. Unfortunately I'm still suffering from pain behind my knee, which started during acupuncture session in the beginning of last december. It must be noted, that my PT gave me this "treatment", not licensed acupuncturist.

After discussing with my PT about ongoing pain, he keeps saying that it is originated from by back (see my first post). However pain on my knee started during acu session and there was zero pain before.

I can only hope I will recover some day.

Comment by Chad J. Dupuis, L.Ac.

I&#39m sorry to hear that you are still having trouble, but also sorry to hear that you haven&#39t followed our advice and seen a fully trained acupuncturist to help more quickly. In the absence of seeing someone, it will likely take some time to fully heal and I imagine the potential is there to not heal at all, although that seems unlikely to me.

If you can&#39t find a qualified acupuncturist to see, the only other option would be some potential herbal options - but these really best require a practitioner to guide you to the appropriate ones. There are a number of pain patches and internal and external herbal formulas for trauma in Chinese Medicine. One that is well tolerated, generally with no side effects when used properly, and may work quite well for this type of injury is Jin Gu Die Da Wan. It&#39s technically much better for broken bones and the like, but I&#39ve used it on similar nerve damage cases as well as stubborn tendonitis and it has worked well.

Another option would be using pain patches or sprays (with or without oral herbs) - the couple we have are hua tuo medicated plasters, tsa juk tibetan cream for nerve problems and kwan loong oil.

Most of those except for the tibetan formula would be found in nearly any Chinese herbal shop. These are not a cure all, however, and they can in very few cases cause skin irritation and with nerve damage (very) occasionally the movement the formulas create can temporarily make the pain worse. This is part of why this is all best done with the help of a professional practitioner.