I happen to be convinced that safety issues related to alternative medicine are important – very important, in fact. Therefore I will continue to report on recent publications addressing them – even at the risk of irritating a few of my readers. And here is such a recent publication:

This review, a sequel to one published 10 years ago, is an evaluation of the number and the severity of adverse events (AEs) reported after acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in 6 databases were identified and assessed by two reviewers; no Asian databases were searched and no articles were included which were in languages other than English. 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Three patients died after receiving acupuncture.

A total of 239 of infections associated with acupuncture were reported in 17 countries and regions. Korea reported 162 cases, Canada 33, Hong Kong 7, Australia 8, Japan 5, Taiwan 5, UK 4, USA 6, Spain 1, Ireland 1, France 1, Malaysia 1, Croatia 1, Scotland 1, Venezuela 1, Brazil 1, and Thailand 1. Of 38 organ or tissue injuries, 13 were pneumothoraxes; 9 were central nerve system injuries; 4 were peripheral nerve injuries; 5 were heart injuries; 7 were other injuries. These cases originated from 10 countries: 10 from South Korea, 6 from the USA, 6 from Taiwan, 5 from Japan, 3 from the UK, 2 from Germany, 2 from Hong Kong, 1 from Austria, 1 from Iran, 1 from Singapore, and 1 from New Zealand.

The authors concluded “although serious AEs associated with acupuncture are rare, acupuncture practice is not risk-free. Adequate regulation can even further minimize any risk. We recommend that not only adequate training in biomedical knowledge, such as anatomy and microbiology, but also safe and clean practice guidelines are necessary requirements and should continue to be enforced in countries such as the United States where they exist, and that countries without such guidelines should consider developing them in order to minimize acupuncture AEs.”

When I last wrote about the risks of acupuncture, I discussed a Chinese paper reporting 1038 cases of serious adverse events, including 35 fatalities. I was keen to point out that, due to under-reporting, this might just be the tip of a much bigger iceberg. Subsequently, my inbox was full with hate-mail, and comments such as this one appeared on the blog: “This is tiresome old stuff, and we have to wonder what’s wrong with Ernst that he still peddles his dubious arguments.”

I suspect that I will see similar reactions to this post. It probably does not avert the anger to point out that the authors of the new article are, in fact, proponents of acupuncture. Neither will it cool the temper of acupuncture-fans to stress that the new paper completely ignored the Chinese literature as well as articles not published in English; this means that the 1038 Chinese cases (and an unknown amount published in other languages; after all, there might be a lot of published material in Japanese, Korean or other Asian languages) would need adding to the published 308 cases summarised in the new article; and this, in turn, means that the numbers provided here are not even nearly complete. And finally, my re-publishing the conclusions from my previous post is unlikely to apease many acupuncture-enthusiasts either:

True, these are almost certainly rare events – but we have no good idea how rare they are. There is no adverse event reporting scheme in acupuncture, and the published cases are surely only the tip of the ice-berg. True, most other medical treatments carry much greater risks! And true, we need to have the right perspective in all of this!

So let’s put this in a reasonable perspective: with most other treatments, we know how effective they are. We can thus estimate whether the risks outweigh the benefit, and if we find that they do, we should (and usually do) stop using them. I am not at all sure that we can perform similar assessments in the case of acupuncture.

45 Responses to More on the dangers of acupuncture

  • I’m interested in getting acupuncture done, but infections has been one of my main concerns. Thanks for enlightening me on the dangers of the treatment with this post.

    • The danger of acupuncture treatment is far less severe than a medical doctor wrong treatment. I am sure you agree with me. 2 of my uncles were killed by medical doctors while doing a simple surgery. I wonder if you know any patient got killed by an acupuncturist? Nobody reuses the acupuncture needles (other than China but there the doctors sterile the needles before reusing them). All the needles are one time usage. They come in a sealed, sterilized plastic bag and once used, they are disposed. Acupuncture for treating muscular pain is by far the best treatment you can ever have. I practice acupuncture and I know what I am talking. Give it a try and you will never regret this option of treatment.

      • I am afraid you do not seem to know what you are talking about at all!

      • Wong Chew Onn

        This tragic case made the news a few days ago – would you like to comment on it?

        Canadian Olympian’s ‘nightmare’ after acupuncture needle collapses her lung

        How about this: A Trilogy of (Acupuncture) Terror « Science-Based Medicine.

        Here’s a few more: What’s the Harm?.

        Not all these cases resulted in death after acupuncture, but, given that there is scant evidence of any benefit for acupuncture (despite your beliefs), do you consider such a risk worth taking?

        • Interesting comments Alan given that in the UK acupuncture is now recommended by NICE as a treatment option for both low back pain and headaches and is used extensively within NHS pain clinics by physiotherapists and medical doctors.

          • andy said:

            “Interesting comments Alan given that in the UK acupuncture is now recommended by NICE as a treatment option for both low back pain and headaches and is used extensively within NHS pain clinics by physiotherapists and medical doctors.”

            I’m sure you’ll be aware that the 2009 NICE guidelines have been heavily criticised as being biased and not representative of the robust evidence. Additionally, the prevalance of its use does not improve the paucity of good evidence for it.

            But do you believe acupuncture is useful for anything else?

        • Unfortunately Kim Ribble-Orr was done by an unqualified acupuncturist. It is not enough just to attend some weekend courses and starts sticking needles. Acupuncturist went through thousands hours of classes and practical training. One of the most important training is to identify the danger zone such as the thoracic region which may lead to pneumothoraces and this we are all aware. But in real life the malpractices by medical doctor in treating patients are far more than malpractices in acupuncture. Don’t believe that every medication you take is the right medication. Most of the time it is under-dosage or over-dosage and most of the time it is wrong medication.

      • It would be unsurprising if the risks of a real doctor doing real medicine, were greater than those for an acupuncturist simply sticking needles in, a procedure for which the evidence of any useful effect is, to put it at its most charitable, not strong.

        It is a truism that any treatment that has an effect, has a potential side-effect. It is equally true that the presence of side-effects does not actually require any provable therapeutic effect (e.g. the chiropractic hangman’s twist).

        Fortunately, acupuncturists in the West rarely treat people who are seriously ill, at least for their illness itself.

        People who polish cars rarely cause accidental damage to the vital innards, and sane people rarely go to the car wash for servicing. The fact that they take real bodily illnesses to people who explicitly opt out of the whole business of knowing about human anatomy, disease processes and the like, is baffling to me.

  • I’ve done TCM on and off since childhood and very comfortable with alternative and modern medicine. Recently I had acupuncture and the Dr. put the needle in my upper groin area too deep and two days later I had an infection. He put in more needle and gave me some Chinese pills and said it should be OK. I ended up in the hospital with a mango sized abscess under the skin and an internal infection. I had to have an operation and am still packing my open would with gauze everyday. This was an unlucky instance but it can happen. I have some friends that are using an electro-stimulation device to the same effect without stabbing the skin to stimulate meridians to good success. I may do acupuncture again but this was a very unpleasant experience that happened to me as a result of sloppy work, done by a 20 year Chinese veteran in Asia.

  • I had acupuncture for my back pain. He used disposable needles a new one for each point. Two sessions later the pain is so much more reduced.
    I worry about taking pills , how many died from the reaction to drugs the doc gives them . I bet that is bad.

  • please can you help me can electroacupuncture cause tears under the skin to the muscles.
    if the current is too high and the treatment is too long.
    by an unqualified acupuncturist.

    • Susan

      It’s clear that acupuncture can cause harm in several ways but it sounds like you need to see your GP and a lawyer. As for electroacupuncture, the machines used are generally limited to being able to provide a low current that is unlikely to cause any more than a slight tingling sensation, but of course, there is no way of telling what the machine your acupuncturist used was capable of.

  • Mr Henness,
    Thank you for your help , why did you mention seeing a lawyer my Dr is trying to help me , do Chinese Acupuncturists use a different technique do they go in deeper, if the machine was faulty can it do damage to the soft tissues.
    I have read that damage from electroacupuncture can cause damage .
    is this true.

  • have you ever heard of electroacupuncture causing damage to the soft tissues the muscles, ligaments ,

  • Mr Henness,
    Do you have an email address I can let you know the full extent of the damage he has done , I have got a solicitor involved , and my Doctor is trying to help me , I have been left housebound because of the treatment , he did a very hard acupressure treatment down my back where he had just taken the needles out.
    He put needles into my head and both sides of my spine.

  • Thank you for your help , who is capable of checking his machine , who would know its faulty or the wrong machine.

  • Susan

    I’m sure your solicitor is best placed to advise you.

  • Who is there to help you when something has gone seriously wrong with a treatment , a solicitor would not know anything about machines an acupuncturist uses, there must be someone who regulates the use of the machines to see they are in working order , would there be someone in this country that could test his machine.

    • Susan

      Solicitors know little about a lot of things, but that does not mean they can’t find out or know who to talk to. However, I assume that the acupuncturist isn’t about to hand the machine used over to you to test. That would take the courts and your solicitor is still best placed to advise.

      There are rules on such equipment. I am sure it would be classed as a medical device (even though there is no good evidence of medical effect) and, as such, it need to be CE marked according to the Medical Devices Directive. There is no regulator of these devices as such, but the MHRA is the statutory body (in the UK) whose remit covers medical devices. They have a page Reporting adverse incidents involving medical devices that might be of interest.

  • I have been told by people who sell these machines in this country that they don’t have any Chinese customers as they get them from China.
    I don’t know if that makes any difference .

    All I want to know is can they cause tissue damage,
    Thank you for your on going help.

    • Susan

      I cannot advise you on whether these machines can cause tissue damage, but your lawyer will be able to find out.

      It is illegal to place a medical device that falls within the remit of the MDD on the market without it having the CE marking properly applied – and there are rules about this. The MHRA might be worth asking as they enforce them in the UK, but your solicitor will know this.

      I don’t think I can help you any more on this.

    • “All I want to know is can they cause tissue damage”

      Not unless someone actually uses the machine. This might sound like a facetious reply, but it isn’t. The question is not “Can the machine cause tissue damage?” because you cannot sue a non-sentient machine. The question is “Can a practitioner, who uses one of these machines, produce tissue damage?” to which the only logical answer is: Yes.

      This is why you need to present the full details of your case to a lawyer rather than keep asking questions here.

  • I do understand all I wanted to know in the first place can serious damage occur to the muscles, tendons , ligaments all the soft tissues by a practitioner using the machine incorrectly can this happen.
    And how is the damage caused, the wrong machine, a faulty machine , someone must know. or is it all down to the practitioner not knowing what he is doing, my Doctor wants to know.

  • This is my last email Mr Henness, I am desperate for an answer please can you tell me if an acupuncturist can cause serious damage to the muscles all the soft tissues , by incorrectly using the electro stimulator Electroacupuncture.

  • I have got in touch with a solicitor she has been to see me , she can see I am in a really serious condition I have shown her this site she wants to know what your position is , are you an acupuncturist yourself .

  • Please can you tell me when you said there were 9 cases of central nerve system injuries , what are the symptoms .

  • Hello! I would just like to say I appreciate your work. I am suffering from a rather severe soft tissue injury which resulted from an acupuncture treatment. Acupuncture is definitely not as safe as most acupuncturists claim.
    Granted, I think the acupuncturist made an error. However, there is a risk of human error in everything so I think the public needs to be informed that this can happen.
    Believe it or not, prior to the treatment the acupuncturist claimed that the worst outcome for an acupuncture treatment is that nothing would happen at all…. I wish that had been the outcome for mine.

    • Tammy , what happened , you said tissue injury what sort of injury .

      • Thanks for your interest in my situation. I had sought acupuncture treatment for plantar fasciitis in my right foot. The treatment seemed to have been helpful and the problem cleared up. A year later, I began to experience stiffness and some muscle spasm in the same leg so I returned to the same acupuncturist for treatment. The stiffness and spasm was interfering with my ability to walk and cycle longer distances.
        The initial acupuncture treatments did not seem to impact the situation so the acupuncturist resorted to dry needling directly into the leg. The spasm was in the right calf and the acupuncturist inserted a needle into the left calf. He also put needles into various other points at the back of the right and left knee.
        After the appointment I had difficulty walking back to my car. By 8pm I was not able to put any weight at all on the leg. I was initially not hugely concerned. I had had the same reaction from a massage and the problem had cleared up within 24 hours.
        Over the next couple of days my leg became severely bent and four months after the incident, I am still not able to staighten it. I was eventually able to put weight on it but due to the severely bent leg I was walking on a very bad angle. My body hurt everywhere –my back hips and both legs. There was severe inflammation at the back of the knee where the needles had been inserted.
        Within a few days of the incident I visited my Medical doctor who prescribed muscle relaxants and antiinflamatory. I began attending physio therapy twice a week . For the next 6 weeks my employer allowed me to work from home because it was extremely difficult for me to get to the office. I used a cane to assist with walking.
        Although I am not qualified to say for certain what caused the injury I am thinking it was probably incompetence on the part of the acupuncturist. The physio therapist I am seeing as well as my neighbour (who is a mortgage broker) both noted that my symptoms seem to be consistent with an IT band problem. The physiotherapist noted that my right ankle was misaligned and in his opinion this was probably the root cause of the IT band problem. If I was experiencing muscle spasm due to an alignment issue I would think dry needling into those muscles to try and force them to relax would be a bad idea. The acupuncturist did not seem to understand the initial injury. He diagnosed it as ‘pain at the back of the knee’.
        Four months after the incident I am slowly healing from this injury. I am back at the office and do not need a cane anymore. But I am waiting for an MRI as I am still not able to completely straighten my right leg. I am still not able to walk very far. However, things are slowly improving so I am hopeful that I will eventually recover.

  • I went to see an acupuncturist for some peripheral neuropathy in my feet as I’d read it had been helpful to some. He was/is a friend and so I felt safe. The first few treatments may or may not have been helpful but I had some sense of improvement although I simultaneously was taking gabapentin. That has caused side effects separately but, this last visit I went because I’d gotten a back spasm. Instead of going to his office, I went to his house. Not that it mattered really, but in the work up I had mentioned I get numbness in my hands also like maybe sleeping on them causes it but thinking this whole neuropathy is connected to my back. So he puts a needle in my left hand between ring finger and pinkie and tells me it may sting a bit. Holy mother of terror! Hurt like being stabbed… Which I guess I was. So painful. Well along with the other needles I laid there for I don’t know, 20 minutes or so, then he removed them. Now three weeks later the pain is still there. I can’t grip with that hand if my arm is extended without feeling tight tendon shock. I hope this is not permanent. I’m worried. I’m a golf pro (was) and a musician and this is debilitating. What ought I do?

  • I have found out that the electro stimulator device used on me when I had electro acupuncture does not have a CE mark is this illegal and what can be done, is it classed as a medical device .
    I have sustained serious injury , the machine is G6805

  • I have been having left buttock pain for 6 months. Various western doctors: orthopedic, pain specialist, sports and medicine own GP all kept saying different options. Sacroliac joint, piriformis, nerves, troncharic bursa, tight pelvic muscles. Also had M.RI ‘s of back and pelvis . I was getting no where, swimming every day but in constant chronic pain and when someone mentioned A Chinese acupuncturist I decided to try. On the second visit he put needles in then one electro one on my left buttock, turned it on and left the room. He had asked me if it was OK but as it was merely seconds before he left it did seem OK. Soon after I realised it was pretty strong but the room was quite a way from reception and I did not know what to do. I stuck it out fir about 10 minutes then hollered fir Help.
    Since then I gave been in agony, worse than when I went in. I now have pain in my hip as well.
    My question is what has happened am I damaged in some way and how am I going to get better?
    He says he asked me and I said it was OK and he has never had it happen before .
    That really does not help me in my pain.
    I would appreciate any insight or places I can contact to find out if I am permanently damaged or how long will it take fir me to get better

    • They always say it’s never happened before… Leaving you for 10 minutes without coming back to check is not okay. And to blame you is a very narcissistic response. He needs to take care of any Dixie build you incur for going to get your self checked. If he hit a nerve, it will take a long time to heal but repairs itself eventually. May be painful fit awhile

      • I have tried to find out what could have happened on the internet but cannot find any site that mentions the consequences of overstimulation except to say it shouldn’t be done. I see you already had one painful site, though not the same as me.
        Did you find any sites that gave you answers?
        I can’t imagine he will pay for any bills I will incure.

  • I didn’t proof my last reply and I think you gleaned I meant doctor bills….

    I found some sites on nerve recovery but also went to my dr after the incident and the acupuncturist paid for that visit. My hand has mostly healed. Been six months an there’s a little tingle when I touch the area. You can ask him to pay for your dr appt and if he refuses you can let him know you may have to recover costs in court

  • Hello,
    I had electroacupuncture done on my knees. He put small needles along the inside of my thighs and both kneecaps. My initial injury was a sprain on my left knee. The pain went from my left knee to both knees to all down my inner legs- where he put the needles. Initially, the treatments were all right. I didn’t feel pain during the treatment but I noticed that I had intense pain a day or two later. I had one last treatment where he turned up the electricity to level 6. That was a mistake. For the next day and the following three months, I felt like I had nails driving into my kneecaps. I haven’t been able to walk for 3 months. The pain was so bad that I couldn’t put a sheet over my legs, without it hurting. I looked up ‘nerve pain’ on the internet and discovered that he might have damaged the saphenous nerve. A simple exercise relieved the pain. I’ve also been doing Classical Stretch exercises (Miranda Esmonde-White) for connective tissue (fascia, ligaments) and that also helps. I went to a homeopath and she gave me a remedy. The pain looks like it is finally going away.

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