“Needle Shock” is a condition that can be caused by acupuncture. Read on to learn more about why it happens and what to do if it happens to a patient in your office.
Needle Shock is an adverse effect of acupuncture. It’s uncommon but still present and, as a professional, one must be confident in dealing with this situation if it occurs during treatment. Research, even though limited, shows that this only occurs in about 0.02%–7% of treatments.
Needle Shock is a vaso-vagal response, meaning the body is unable to regulate the blood pressure which can lead to dizziness, lightheadedness, or a range of other symptoms. Needle Shock can also result in fainting. This is often explained as a complex neuro cardiovascular reflex that occurs in response to the treatment.
What Is Needle Shock?
“Needle Shock” is a term used in the acupuncture profession to explain an autonomic response to stimuli, such as a needle sensation, fear of needles, or even too much Qi movement.
Often referred to as yūn zhēn (晕针), translated literally as “dizzy needle” or “needle sickness.” These terms themself can cause unnecessary, anxious thoughts for the patient, and many practitioners of TCM (Traditional Chinese Medicine) are beginning to use the term acupuncture-associated vasovagal response or AAVR.
Some symptoms of AAVR are:
- dizziness
- nausea
- sweating, cold perspiration
- general malaise
- bradycardia
- hypo tension
- in extreme cases: syncope or convulsions
It is important to note that this can happen to anyone, but it’s more likely if the patient has not eaten within a few hours before treatment, is dehydrated, is scared or anxious about the experience, or is deficient in Qi and blood.
A patient experiencing brief symptoms of Needle Shock isn’t necessarily a problem, especially if they are comfortable with you and acupuncture, but that must be determined on a case-by-case basis. The feeling might be disconcerting, but it is often temporary.
How To Deal With Needle Shock
First of all, as in all stressful situations, it is important to remain calm. The patient is looking to you for guidance and expertise, so even if you are nervous, remember to stay calm, take a deep breath, talk slowly, and move forward with confidence.
Prevention is the number one thing to so check into patients’ Qi, if have they eaten prior to the appointment, and always remember to check in with them during the duration of the treatment to make sure they are feeling comfortable and grounded.
If A Patient Shows Symptoms Of Needle Shock
The acronym PEACHES can be helpful for remembering areas of consideration to help prevent needle shock;
- Position: Make sure the patient is as comfortable as possible.
- Experience: Being aware of both patient and practitioner’s prior experiences, and making sure to have taken an extensive health history intake.
- Anxiety: Help to ease the patient if they are having anxiety about the treatment or just in general, utilizing breath work and gentle needling may be important for a highly anxious person.
- Constitution: Being aware of the individuals’ constitution will not only help you avoid unwanted side effects but will make you a better practitioner overall.
- Hydration (Food and sleep too): Checking in with when the patient last ate, slept, and how much water they drink is important to note before getting acupuncture.
- Environment: A very important aspect of not only preventing Needle Shock but providing the patient with the best experience you can, Making sure they are warm, not overstimulated, etc. Again, it is important to check in with the patient to make sure they are comfortable.
- Symptom Recognition: Observation and awareness of the patient are crucial as a practitioner. Check-in with the patient a few times through the course of the treatment to ensure they are stable and comfortable.
In the limited experiences that this occurs to patients, patients most often recover quickly especially when the correct actions are taken by the practitioner.
If a patient starts to show signs and symptoms of Needle Shock or extreme dizziness:
- Remain calm and have them take a few deep slow breaths.
- Pull the patient’s needles.
- Press firmly on KD1 acupoint on the sole of the feet.
- Offer the patient a glass of water.
- Have them rest and continue taking deep breaths within a supported position.
- If Moxa is part of your practice you can use it to help ground them.
- Bach Rescue remedy, flower essences, or essential oil can help as well.
What To Do Next
Research has shown that most people recover from Needle Shock within five minutes, so it is important to hold space until then. One of the most important things that need to be done — after removing needles and making sure the patient is OK — is to document the event clearly in your chart notes. Make note of the steps you took to make sure the patient was calmed, the conversation that occurred, how long the episode lasted, and confirmation that the patient was feeling good before you released them from your care. Accurate documentation is very important.
If you and your patient are both feeling comfortable and confident, do know that there are amazing acupuncture points and protocols to help the patient regain a more stable state. Ending the treatment would be the “safest” call here but checking in with the patient if they would like to try an additional point or two (such as GV 26, ST 36, LI4) is also an option.
It is also extremely important to know when additional medical intervention is necessary, especially if there are red flags.
Red Flags
If a patient is not recovering quickly (about 5 minutes of discomfort) it is important to take additional actions to ensure the patient’s safety. If the patient continues to get worse or loses consciousness make sure to call 911. Loss of consciousness, hyperventilation that does not subside, vomiting, choking, or myoclonic activity would all be red flags and reasons for additional medical intervention.
Commentary
I personally have been practicing acupuncture for about 10 years and have not given a patient a Needle Shock or myself experienced it. I have had to remove needles from a patient because they stated they were feeling too cold or starting to feel slightly dizzy, but with speedy action, removing needles, and doing some grounding, the patient recovered quickly.
I have been in an observation clinic where I have experienced a patient develop full Needle Shock in which they became almost unresponsive and started to faint. In this situation, the practitioner removed the needles, re-positioned the patient, pressed firmly upon KD1, and give instructions for them to take a few deep breaths. The episode passed quickly, as it usually does, but the practitioner moved forward with confidence and ease, which helped the patient also recover quickly and not feel too embarrassed or uncomfortable after the fact.
It is important to explain exactly what happened and why it happened to the patient, so being educated on this topic is crucial.
Resources
- Christensen KA, Gosse BJ, Hildebrand C, Gershan LA. Acupuncture-Associated Vasovagal Response: Revised Terminology and Hospital Experience. Med Acupunct. 2017;29(6):366-376.
- Greenwood MT. Needle shock: Adverse effect or transformational signal. Medical Acupuncture. 2004;15(3):27–32
- Zhu HZ. Running a Safe and Successful Acupuncture Clinic. New York, NY: Elsevier Churchhill Livingstone; 2006