Was my Median Nerve damaged on PC6?

forum post

Was my Median Nerve damaged on PC6?

Published on 05-04-2016


"acu_mike" - this is their first post.

Hello everyone… long time reader, first time poster… I need some advice.

I have been receiving acupuncture with great success over the past 10 years with an acupuncturist in the United States from China who still goes back to China several times a year and practices there . A few years ago, we started including the PC6 point on the wrist, which has been helpful. I’ve always have tried to be careful, since I’ve read about the dangers of this point on this very forum, so I don’t move, and I am very quick to tell him to stop turning the needles as soon as I feel any tinge of anything.

So, I was at acupuncture last week, and I had placed a towel under my back that was causing me a lot of discomfort. I needed to move it, but I was afraid of irritating PC6. I managed to lift myself up and gently get it out of the way with my right hand. I felt nothing unusual in my hand or wrist, and felt I was in the clear. The rest of the appointment went fine without incident. Soon after we were done, I noticed a strange burning near the tip of my right index finger. I’ve had burning near acupuncture points before that have lasted a few hours, but this wasn’t near any point. It has persisted for 9 days running now.

The irritation is on the left side only of my distal knuckle of my right index finger. The actual tip of the finger is spared–it goes from halfway in my nail to the knuckle on the left side of the finger only. It is an area about 1/2 inch in diameter. Sometimes I feel it under my nail. It has been actually more like allodynia instead of a constant burning. Any light touch or brushing causes it to burn like fire. Leaving it alone typically has relieved the discomfort. Cold has not bothered it so far, but heat can aggravate it. Moving it can cause problems, too since it causes friction on the skin with the knuckle moving. The area is not numb at all, and can feel light touch, pinprick, vibration, heat, and cold just fine. There is no tingling, shock sensations, nothing like nerve pain I’m familiar with–just the burning allodynia in that one small spot. that has tended to go away (so far) as long as the spot isn’t touched or moved a lot. There is no inflammation, redness or swelling. At one point last week, it might have looked a bit puffy, but not by much. It certainly doesn’t look that way now. No tiniel sign at the wrist. The pain isn’t aggravated by wrist movements that I can tell. There was no visible bruising by the point. There has been zero improvement in the 9 days since it started. None.

I am convinced that my median nerve got nicked at PC6 in a small spot of fibers that innervates that area of my finger and since there has been no improvement and a delay in diagnosis or treatment, this burning allodynia will likely be permanent. Problem is, I can’t get anyone to believe me. Since it is so localized with “no connections” and there are no shooting pains, no tingling or numbness, and no pain or other symptoms in the wrist, palm, or other fingers, everyone tells me I must have injured my finger at some point in some way prior to the appointment. That is possible. I was running errands, but to have zero improvement in 9 days? “It doesn’t sound like nerve pain to me” is what I hear, and yet what else can cause such a persistent allodynia with no sign of swelling or inflammation?

I am asking for your expert opinions on this issue, since it is acupuncture related. Can a localized symptom like this be caused by nicking the median nerve at PC-6 or is this likely something else? Any help or advice is greatly appreciated! I’ve been greatly despondent over the thought of permanent burning pain in a finger I use a lot the rest of my life over something like this. Did acupuncture possibly do this or am I barking up the wrong tree?

Any thoughts, observations, advice would be greatly appreciated. Thank you again!

Comments / Discussions:

comment by "ChadD" (acupuncturist)
on May 2016

So I’ve answered questions along these lines multiple times before - and from my answers you can get my general sense of what I think about needle manipulation and aggressive needling techniques (in short, I think they carry higher potential risk with very limited clinical value if any). The short of it is you will likely be absolutely fine but if you did irritate the nerve it can take 4-12 weeks for it to improve - that is just how nerves are.

Some of my previous responses that may be valuable are here:
Can acupuncture cause nerve damage? and Pain during and after treatment.

I’m sure you will be fine but it may take a number of weeks. That said, I don’t like those techniques, so personally, I would find another acupuncturist who doesn’t do deep needling and/or heavy needle manipulation - but that is admittedly my own clinical bias.

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comment by "acu_mike"
on May 2016

Thank you for your response! I have read those articles you posted, which is why I was so nervous. So, you do think that it was the acupuncture and not something unrelated? Darn it! Being such an isolated spot of discomfort with no shooting pains or anything, I wasn’t very sure, and no one else thought so, either. My wife thinks it’s the beginnings of arthritis! Ironically, I felt so much better overall after my last treatment, except for this finger thing!

I’m not sure what would be considered “deep needling”. I don’t know how deep he puts the needles in. The process he uses is, I come in… lie down… he puts the needles in. Comes back, turns each one a bit until I “feel” it and tell him “OK”, takes another 10 minute break, does the turning again, and after another 10 minute break, removes the needles. I find the turning to be the most beneficial part of the treatment. Is this what you consider aggressive needling? What is a non-agressive treatment regimen like?

Is there anything else I can do? He’s really been good for me over the years. This is the first long term adverse effect I have had and it’s probably because I moved my arm and hand more than anything he did. Any chinese medicine that can help… other acupuncture? Splint my wrist? Ice it? Heat it? Steroids? Vitamin E? I already take B12. This stinks. I don’t really want to find anyone else. They wouldn’t know what my points are. I guess I can skip the PC-6 point next time at the very least.

The ironic thing is that I may have jinxed myself, since I said a few days before my last appointment that I’ve been with the guy for 10 years and I haven’t had any bad effects, yet, I should trust that it will all be OK (I get nervous every time I go). I should have just waited for him to come in and ask him to move that darn towel instead of me…

Thank you very much for your response… Your advice has been greatly appreciated… not sure what to do now… I’ve become very dependent on my treatment… it has helped in so many ways, and now this freak occurrence… Thanks again for responding and for any other advice you may be able to give!

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comment by "ChadD" (acupuncturist)
on May 2016

If you are comfortable with your practitioner, just tell them about it, keep up with your treatments, let him/her work on it in addition to what they were doing and, like I said, somewhere in a few to 12 weeks or so you should feel absolutely fine. There is no way to know for certain, besides the timing of the pain if the acupuncture contributed to this.

With regards to your questions about needling, in my opinion if you are afraid to move during the treatment it is likely too aggressive. But again, just my opinion and not the techniques that I personally use. And not, to knock your current practitioner because I don’t know what you are being treated for, how often you go and what real results you have received. But I always have people entertain the idea that perhaps they could get better results elsewhere - or even the same results but more comfortably done - perhaps you could have seen someone for 6 months or a year or two instead of 10 years. Again, I have no real information on your case, just making a general statement for you to consider. If you are the exploring type, consider trying a few practitioners an experiment in better understanding both acupuncture and how people may view and treat your conditions differently.

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