Once the needle is inserted a number of things may happen. The effects of acupuncture are well known and applied nowadays.
Local effects of acupuncture
You may feel a resistance to twirling the needle. What produces this effect is not known, but it is a common finding and is sometimes called ‘muscle grasp’. It can be surprisingly strong and may make it impossible to withdraw the needle at first. If so, wait for a few minutes and then try again. The books say that one can release a ‘caught’ needle by inserting another needle a short distance away, but this is seldom necessary.
The patient may feel a variety of sensations for a variable distance round the needle. These are usually difficult to describe. They may travel up or down the limb; occasionally they are felt in distant parts of the body.
All these phenomena, those experienced by the acupuncturist and those experienced by the patient, are collectively called teh chi. TCM practitioners attach a great deal of importance to it and indeed often say that it is essential for a good therapeutic response. Although this may not always be so, teh chi probably does mean that a response is more likely. In needling muscle TPs it seems to be an indication that the needle has reached the right spot.
General effects of acupuncture
A certain degree of relaxation is so common with acupuncture as to be almost the rule. In some people this is more pronounced and reaches the stage of actual drowsiness. There may also be euphoria; patients may compare this to the effects of alcohol or hashish. These very interesting effects may possibly be due to endorphin release, although they come on surprisingly quickly, often almost as soon as the needle is inserted. If they are marked they suggest that the patient is a strong reactor.
Approximately 2 to 5 per cent of the population can be classed as strong reactors (the exact percentage depends where one draws the line). They can sometimes be identified before treatment: they are generally fairly young (under about 35) and may have noticeably clear skin and eyes. They may give a history of multiple allergies or adverse reactions to numerous drugs. Children should always be regarded as strong reactors.
It is important to recognize strong reactors because although they respond well to acupuncture they can also easily be made worse by over-enthusiastic needling. They should be needled at only one or two sites, at least on the first occasion, and the needles should be inserted for only a few seconds, with minimal stimulation or none at all. Because it is not always possible to recognize strong reactors in advance, new patients should always be treated lightly . This both helps to prevent adverse reactions and makes subsequent treatment easier, because if many needles are used on the first occasion and the result is good the same number have to be used the second time, whereas if only a few points are treated it is easier to see which have been effective. Some patients react strongly the first time they are treated, less so the second time, and hardly at all subsequently. Such patients are pseudo-strong reactors; genuine strong reactors usually experience the same effect for months or years, even if they carry out the treatment themselves.
Another effect sometimes seen is uncontrollable laughter or crying, sometimes lasting for an hour or more. Emotional abreactions of this kind are very interesting theoretically. They are quite unpredictable and sometimes occur after a number of treatments; in some patients they occur every time they are treated.
Acupuncture and driving
Because of the occasional occurrence of these effects, patients should preferably not drive for an hour or two after having acupuncture. (Sometimes the effects take some time to appear.) This is not an absolute rule, but it is important at least to warn patients of the possibility. (One man found himself driving the wrong way round a roundabout!)