Acupuncture for chronic pain and headache

Acupuncture is recommended by the National Institute of Health and Care Excellence (NICE) for people with the following conditions:

• Chronic pain (pain that lasts for more than three months) for people over 16 years old, including:

  • Chronic widespread pain or fibromyalgia

  • Chronic musculoskeletal pain (muscle and joint pain, such as chronic neck pain)

  • Chronic facial pain (such as temporomandibular joint disorder)

  • Chronic organ pain (such as chronic abdominal or pelvic pain)

We cannot offer acupuncture if you have only chronic low back pain, osteoarthritis, or neuropathic (nerve) pain, unless the pain or its impact is considered by your doctor to be out of proportion to the underlying condition.

• Headache for people over 12 years old, of two types:

  • Migraine (when the recommended preventative medications, propranolol and topiramate, do not work or cause unacceptable side effects)

  • Chronic tension-type headache

All treatments and procedures have risks and we will discuss the risks of acupuncture treatment with you before the treatment starts.

Risks that can happen during the treatment:

• Some people may feel a light-headed. In very rare cases they may actually faint, especially the first time they have acupuncture, or if you have not eaten or drank enough water before treatment.
• About one in a hundred people may feel pain during the treatment. Most people may feel a little discomfort as the needle is inserted; some people feel nothing at all.

Risks that can happen after the treatment:

• About three in a hundred people have minor bruising or bleeding after the treatment.
• Fewer than three in a hundred people find their symptoms get worse after their first treatment. This is often a good sign, but please inform your acupuncturist about this if it happens to you.
• Some people can feel sleepy or light-headed after treatment. If you do, you should not drive or operate machinery until it is safe do so.

Rare but serious side effects:

Acupuncture is very low risk if practiced safely. But there is a risk that about 1 in 10,000 treatments could lead to a serious adverse event, such as a punctured lung (i.e. pneumothorax).

You should get medical help if you suffer from a sudden cough, breathlessness, chest pain, painful breathing within 48 hours of your acupuncture treatment of the chest, middle back or shoulder region.

Acupuncture is a drug-free treatment. It may ease pain or improve the symptoms of your condition. Some people can reduce the dose of painkillers or other medication they are taking. Please speak to your GP of hospital consultant before changing the dose of any prescribed medication you take.

Compared to many treatments such as some medications or surgery, acupuncture is considered very safe. It can work alongside your existing treatment or on its own. If your doctor refers you for acupuncture treatment we advise you to complete at least six sessions to give it a “fair trial”.  However, if you choose not to have acupuncture treatment, please notify your practitioner.

Please note if you miss 2 appointments without informing us in advance, you will be discharged from the service as per hospital policy.

As part of the consenting process, we want to involve you in all the decisions about your care and treatment. Your acupuncturist will explain all the risks, benefits and alternatives to acupuncture before you sign the consent form. If you are unsure about this treatment, please discuss it with your acupuncturist.

Your first assessment is often offered over the telephone and may last up to an hour. At this appointment, the acupuncturist will ask you about your medical history and assess if acupuncture is suitable for you. Please bring a list of your current medications (or update the list on the MyCare portal if signed up to this). You will be asked to complete some questionnaires about your health condition.

• Please arrive on time for your appointments. If you arrive late, it may affect the number of needles and duration of your treatment. If you arrive more than 15 minutes late, we may not be able to treat you.
• Each treatment visit is up to 30 minutes long.
• If possible, ask a friend or family member to go home with you after your first appointment, in case the treatment makes you feel sleepy or light-headed.
• Please wear loose clothing so that the acupuncturist can easily access the main areas of your pain into which the needles will be placed.
• You should take meals and medications as normal before your acupuncture treatment. We recommend you drink plenty of water before and after acupuncture treatment.
• The acupuncture session may sometime require you to lie on your tummy for the duration of treatment (e.g. for acupuncture to the back and neck). We therefore advise to only have a light meal before acupuncture treatment to allow you to lie comfortably during the session.

Following an initial assessment appointment, up to 10 acupuncture sessions will be arranged. At the last appointment the acupuncturist will assess how effective acupuncture was by asking you to complete some questionnaires (+/- symptom diary in headache cases) and discharge you. A letter summarising the outcome will be sent to the referring doctor and your GP as well as a copy to yourself.

During the treatment, fine needles are inserted through the skin and left in position for a few minutes or up to 20 minutes. The acupuncturist may twirl or move the needles to increase the effect. The number of needles varies but may be only two or three.

You must tell your acupuncturist if you:

• are pregnant
• have ever experienced a fit, faint or funny turn
• have a pacemaker or any other electrical implant
• have damaged heart valves
• have a bleeding disorder
• if you have any joint replacements or implants
• are taking anti-coagulant medication such as warfarin to thin your blood
• have any other particular risk of infection.

This may affect the treatment you receive but may not mean that you cannot have acupuncture.

To reduce waiting times, we often offer acupuncture in a group setting of up to four people of any gender. There are curtains around each cubicle so that you can receive your treatment in private. If you have reservations about group setting, please inform us during initial assessment appointment.

It may take several acupuncture treatments before you notice any improvement. We recommend that you continue to attend the appointments for 6 sessions even if you do not see any effect at first.

If you are unable to attend your appointment, please let us know at least 48 hours beforehand (or as soon as possible) so we can offer your appointment to someone else. If you do not attend your appointment without informing us in advance, we will need to discharge you as per hospital policy. On completion of your treatment programme you will be discharged from the service.

The British Medical Acupuncture Society supports health professionals who practice Western medical acupuncture. Their website provides information for patients and health professionals.

The British Acupuncture Council promotes traditional Chinese acupuncture and provides information for patients and practitioners.

RLHIM cannot accept responsibility for information provided by other organisations.

RLHIM is a teaching hospital and from time to time, as part of their training, other healthcare professionals may observe outpatient clinics. We will always ask for your permission for colleagues to observe your treatment. Colleagues or students do not have to be present if you would prefer them not to be. Please inform your acupuncturist if you have any reservations about this.