AERD Report 2023 Q1

Published in on Apr 5, 2023

As promised, here’s our quarterly review of AERD reports! From 1/1/23 through 3/31/23, we had ten completed reports submitted to the AERD. Thank you everyone who took the time to share your experiences!

The overall theme for the quarter is bruising. 7 of the 10 reports involved bruising, including: bruising as a result of wet cupping, bruising and noticeable swelling on hand points, and bruising accompanied by feeling cold. Previously, bruising represented only about 15% of AERD reports, so that’s interesting.

One report described a headache that occurred during a treatment that included GV 20 and 24, confirming that headaches during treatment fall into the “AERD Greatest Hits” category (maybe, particularly when head points are part of the treatment? This is worth keeping an eye on.)

Two reports were in the category of “symptoms worse”, and once again, these reports are intriguing because they highlight how little we understand about how acupuncture works. Here are the edited versions with commentary:

  1. Pt reported burning nerve pain in left hand and arm during treatment. This patient has MS and says that her hand was numb prior to starting acupuncture. She also reported bruising that she noticed right after tx at PC6.

Burning nerve pain is definitely an adverse event, but what does it mean when it occurs on a limb that was previously numb? Is it a sign of progress? Is it a nicked nerve? Is it related to the MS? Is it a coincidence?

  1. 26th Acupuncture Treatment. Patient coming in for bilateral occipital neuralgia from an injury in 2018 that resulted in 2 occipital fractures and a brain bleed. Patient can't lay on her back or apply any pressure to back of head - so she sleeps sitting up and this aggravates the muscles in her neck and upper back. Has a history of TMJ as well. Has slowly been adding in points in jaw, and this was her second visit getting ST7 for jaw pain. Points needled were: CSL_CXSL, UB60, LV4, KD9, SJ5, SI3, UB10, ST7, A_MR, A_SM. ST 7 felt a little achey during treatment, and fine afterward. Patient woke next day with inflammation in upper gums around third molars (extracted) and along the rear upper palate near the throat. Very painful to brush her teeth, gums around second molars very sensitive as well. Reporting 5-8/10 pain level. Concerned it was from acupuncture point ST7. Patient self-reports having strong reactions to things in general and frequent adverse reactions.

This incident reminds me of the “ears and neck on fire” report from 2022 -- another example of acupuncture apparently triggering temporary inflammation in an area that wasn’t directly needled? Obviously this isn’t a common occurrence but without these reports I wouldn’t have thought of this as a potential category of adverse events. It seems like something important for acupuncturists and acupuncture students to be aware of.

And finally, this quarter we have our first report of an error that didn’t overlap with an adverse event. A student reported that they needled LI4 on a pregnant patient. It sounds like nothing happened as a result. Using historically “forbidden points” during pregnancy is a topic of some debate among acupuncture researchers.

So in summary, I love our AERD as an exploration of the murky and ambiguous areas of acupuncture safety! These are the same areas that can be challenging for practitioners to navigate with patients, so I really appreciate that we’re having an ongoing conversation about them here. Big thanks to the acupuncturists and acupuncture students who took the time to share their experiences -- your generosity makes the practice of acupuncture safer!