What to Expect After Acupuncture


Is your symptoms worse after acupuncture? Do you feel pain worse after acupuncture? Do you have flu like detox symptoms after acupuncture?

When you are searching and reading this article means you may just had your acupuncture – likely the first one ever – and confused with changes of your symptoms after acupuncture. I have shortlisted the most common reactions after acupuncture, these patterns happen on patients over and over again from my 20+ years of practice.

Immediate Reactions After Acupuncture (the first 24-48 hours)

1. Relaxation: You may feel deeply relaxed which lasts for hours or even for a day. In such a state of relaxation, your concentration may be downgraded: following conversations or focusing in meetings become difficult, or simply can’t keep awake. As modern medical researchers have noticed a higher amount of endorphins (body’s natural morphine in the brain) is secreted after the acupuncture treatment, that may explain why you may experience a natural high after acupuncture.  The best thing you can do in this situation is rest – take it easy and having a nap afterwards or go to bed early. Y0ur body heals faster when you spend more time in a deep sleep state.

2. Emotions: Some patients would become more emotionally sensitive for a short period of time. I have seen patients cried for hours without any reason; grieving for something happened long ago or become irritated and can’t tolerate others. If you experiencing these reactions, congrats. You are emptying your emotional bucket that is timely and healthy. We all have an emotion container to bottle up our negative emotions from everyday stress. When the container is full, even the smallest drop of stress can make it overflow, that is why disproportionate emotional reactions occur at the slightest triggers. For many, they put heavy covers on the top of this emotion container, to hide their emotions from everyone. During the acupuncture session, this cover is melting away and emotions are streaming out. It is healthy to let the emotions set free from time to time. You might use this opportunity to start an in-depth emotional conversation with family or friends, or pause your life and find a quiet corner to absorb your emotions. After this period of emotional liberation -usually two or three days – you will feel lighter and more content with your life.

3. Pain Relief: Acupuncture is known for its instant pain relief. If you were treating acute pain or injuries,  you may experience a long-lasting pain relief after acupuncture. However, if you were treating chronic pain, you may notice the pain easing during the treatment session, but the pain comes back after a few hours or even return with a revenge.

In the Chinese medicine perspective, we look at energy flow within the body as the water flow in the pipelines in a building (when we know it is there, but we can’t see it). When there is a flood in the bathroom, we know there is blockage in the drainage. Similarly, when there is a pain, the Chinese doctor sees a blockage of energy flow. A chronic pain, to Chinese medicine, is a blocked drainage system, and pipes are rusted in the body. Acupuncture works like a plumper, apply pressure at a certain point to flush out the blockage, so the flow is restored and the pain has gone. However, because the pain (blockage) has been there for a long time, the inner layer of the pipe is rusted and attached much rubbish on it. When the flow restores, the rubbish loosens and start to move and block the flow again in sometime later. By then, the pain reoccurs as a worse pain or even moves to a “new” location. So as the acupuncture sessions are persistent the flushing work will continue until all the rubbish and rust are cleaned in the meridians.

Thus, if the pain worse after acupuncture, do not panic or worry, but take some sensible steps to help calm the pain, like resting, apply red flower oil locally, or take some painkillers if needed. It is important for the patient to give the doctor the feedback of how long the pain relief was last and any changes in the pattern or site of the pain.

4. Elimination: Some patients experience detox symptoms like more urination after the acupuncture session. Some have told me that they can’t stop going for a pee, up to ten times within one afternoon, without drinking more water. As you would expect, their bloating and water retention would be relieved significantly. Meanwhile, some may spot changes in their bowel movement: more frequent, increased volume, or stronger odour. Both signs of good eliminations indicate body elevates the level of metabolism, or in the Chinese term, a better energy flow in kidney and spleen meridians.

Long-term Reactions After Acupuncture

(2 – 4 weeks)
Running nose, sore throat and some cold symptoms may appear during the second or third week of an acupuncture treatment. In Chinese medicine, an unresolved cold or flu was the underlying cause of many health problems, like poor circulation, stiff neck and back and migraine. Running nose, fever and body ache is the natural response of body fighting with a cold or flu attack, like casualties and bombarded border during the war that defence force fight the enemy from invasion. When the drug is used improperly, symptoms do suppress but one’s health goes down, like a cease-fire at war by confiscation of weapons from the soldiers, and let the enemy loots the country. Once acupuncture treatment enhanced the immunity as if the army is armed ready to fight the invader again, cold and flu symptoms reappear. These symptoms usually last for a week; some Chinese herbs might be used for a faster healing.

Meanwhile, some patients may notice reappearing of many other symptoms, which bothered them previously but have forgotten for sometimes. It means the increased body energy expelling many underlying ailments. For example, reoccur of appendicitis or hemorrhoids that happened years ago. While the body is in a reversing process of healing, it often notices that the recurred symptoms are not causing as strong discomfort as a normal attack. Reassessment of patients condition and modify treatment plan would be required. It is important to let the practitioner know the previous history of illness may just happen to be remembered again.


  1. Gale says:

    I recently had acupuncture for lower back pain. The five needles was placed in my right ear. Right away I noticed pain relief in my lower back, and my mood increased the same of the accunpunture, I was able to stand straight up without help. I did have problems communicating, frequent ruination, I did runny nose and scratchy throat but I did feel my body fighting off the cold so it cold on last a few hours. Overall the acupuncture was worth it and I agree with articles, it’s pretty accurate about what am going through and been through.

  2. Rachael Reeves says:

    I had acupuncture to treat migraine. and felt very hot in the night and a migraine came for two days after the treatment. I’m hoping this will improve with more treatments.

    • Qiang Chen says:

      Hi Rachael, Thank you for sharing your experience. Indeed sometime it can flare up before getting better. I have witnessed many patients had the improvement of migraine by reduced intensity and frequency with a course of acupuncture treatments. All the best.

      • Neeka Wilson says:

        Hi I’ve been having acupuncture every week for month now every time after treatment I get flu like symptoms i.e. sniffle nose, sore ears, stuffy head
        for about 3 days at the most I also have cupping first before acupuncture and Chinese therapist has put me on Chinese herbal hormone repair, I have a low immune system keep getting ear infection flu colds etc and have GAD general anxiety all due to having contracted tetnus disease over 12 months ago hence my low immunity and anxiety my last treatment I got sore throat and it hurt to swallow and heart elevated are all these normal effects of acupuncture? I do feel much better within my self and so far have avoided antibiotics normally on antibiotics every month due to getting infections so fingers crossed it helping fix my immunity and nervous system and anxiety also how many treatments would I need before my issues are healed?

        • Qiang Chen says:

          Hi Neeka, The combination of acupuncture, Cupping and herbal treatment support immunity very well in my clinical practice. Glad to hear you have noticed the improvement already. I usually suggest my patients that patient and persistence are the key to the recovery of chronic issues, such as the low immunity or run down. Meanwhile, the energy book offers some easy-to-apply tips to restore your energy. Let me know if it helps.

  3. lynn says:

    I have had my first acupuncture sessions yesterday and the day before .. and now I feel more pain than ever.. I’m really nervous!
    is this really normal? I can barely move my neck and arm!

    • Qiang Chen says:

      Hi Lyn, Only realised your post here today. Your pain most likely have settled down within the first 48 hours. Let me know it was the case?
      Cheers. Chen

  4. Arvand says:

    I recently started acupuncture sessions because of having a sever pain in lower back and lumbar, after the first session I felt a little better, however, there is a part in my lower back when encounters with the needle, an ugly nerve pain (like sting bite feeling) surges that lasts for hours after the session, the sensitiveness of this area against needle is so ugly that in my second session (also my last session at the moment) has made me kind of felt unsure about the treatment…
    Not sure if these types of sting bite feeling in my lower back is a part of my treatment process or not…

    • Qiang Chen says:

      Hi Arvand, Hope you are better by now. (PS I just realised your post today).
      I did receive many patients feedback about those highly sensitive points during their pain treatments. It is a very useful insight to pass on to your acupuncturist. It could be a key to unlock all your pain. Let me know if acupuncture already helped you.

  5. Susie says:

    I had acupucture today. I had it last Monday & felt tired & slept better all week. Today, I felt sick @ my stomach & so tired. The reason for my going is that I have constant tingling in the back of my knee down to the bottom of my left foot. I am praying that we can fix this with acupucture. I have been journaling my everyday feelings overall since beginning this treatment.

    • Qiang Chen says:

      Hi Susie, Hope you are better by now. Those fatigue/relaxation with better sleep is a very good sign of you have got systematic improvement from acupuncture. Send all my positive vibe for your recovery.

    • Kristen Blankenship says:

      I have chronic pain, inflammation and 3 herniated discs in my neck. I am also being check for autoimmune disease as well. I had my first appointment yesterday and my pain worsen at night it was awful and i was so irritable. I finally went to sleep but didnt sleep well. Today i do fell better. I read people with chronic pain sometimes their symptoms worsen at first. Just curious if i should proceed?

      • Qiang Chen says:

        Hi Kristen, Congratulations, you have noticed certain changes by your first session. This worsening pain is the most common reactions when we working with chronic pain because it turns the chronic pain into the acute state. I recommend to proceed for at least 2 weeks and judge by yourself again.

  6. E says:

    I had a treatment today for a very swollen knee. Needles were placed around my one knee and in the shins and ankles of both legs. Also near the elbows in both arms. Now I have a very heavy dense pressure/soreness in my mid to upper back also the front of my throat under my chin. Is this just the meridian trying to “unclog my pipes” or was something possibly hurt during the session?

    • Qiang Chen says:

      Hi E, You’ve got an insightful understanding of energy work. As acupuncture works in a holistic manner, the site without needling got activated is a good sign of systematic healing. I would suggest just take it easy for the first 24-48 hours. Please pass on this information to your acupuncturist. It could be a useful for your future treatment strategy.

  7. How the tingling last

    • Qiang Chen says:

      Hi Barbara, The tingling may last from a few hours to a couple of days, depends on your condition and the treatment offered. If it is got too intense, it is worth to give your acupuncturist a call and discuss it.

  8. Lynn says:

    I have had Glandular Fever for 16 weeks now. I had 1st acupuncture last Saturday & felt relaxed, that night I had pain & soreness in my liver area. The following morning my water works greatly increased & had more energy for 2 days. On the 3rd day I was back to sore throat, feeling cold & aches & pains. Thur I had 2nd acupuncture & was so fatigued, a bit anxious & today white spots have reappeared on my tonsils again (part of my ongoing problem) Does acupuncture bring symptoms out more at first? Is this a sign it is working? Is it eliminating toxins? Any advice much appreciated, thanks in advance.

    • Qiang Chen says:

      Hi Lynn, Congratulations! You have had exactly what I meant of the positive acupuncture reaction. It works like when flushing the blocked drainage pipe, and the water turned to be dirtier before it cleaned up. Keep going for a few weeks and then look back to see how it has helped you.

      • Lynn says:

        Thank you I had my 3rd session on Tues night. Yesterday my neck glands were up again & I had a horrendous headache all afternoon & into the night then I couldn’t sleep. Is this a normal reaction? Is this likely to help my Glandular Fever? Thank you

        • Qiang Chen says:

          Acupuncture helped many people with glandular fever, but it is not for everyone. It requires patience and resilience to experience the benefits. Please take at least 3-4 weeks to try out.

  9. Bal says:

    Hi I had my first accupuncture session 2 weeks ago and 2nd yesterday for severe sciatica and right lower back with right thigh pain and some numbness.
    After both times I suffered awful nausea and vomitting with stomach pains.
    After first session 2 weeks ago I ended up in hospital as was vomitting bile and complete dehydration.
    Please could you help me understand what is happening and if accupuncture is no good for me.

    • Qiang Chen says:

      Sorry to hear that you suffered so much. I didn’t come across people has such a violent reaction from acupuncture in my 28 years practice. Please call your acupuncturist ASAP and discuss your reactions and your next steps of care. Getting to and from the acupuncture clinic itself may taxing your body too much.

  10. Amy Varela says:

    I had accupuncture yesterday, and about 2 hours after, my back felt like I had a bad sunburn. The sensation stopped suddenly after an hour. Now today, about 24 hours after my session, my back is burning again. It feels normal to the touch, but like a bad sunburn. Is this something with which you are familiar?

    • Qiang Chen says:

      Hi Amy, The altered sensation phenomenon does occur after acupuncture in my practice. It is worth to share it with your acupuncturist. All the best.

  11. Steph T says:

    Hi I had my first acupuncture session on June 13th for chronic pain. I have nerve pain in my body. I felt horrible that day but the next day felt much better. I discontinued for 3 weeks as my father in law passed away. My pain in those 3 weeks were very minimal. I started acupuncture again on July 18th and have had 4 sessions 2x a week so far. I skipped today bc I just feel so sore and my pain is much worse and I was afraid to go. Like I’ve been flairing up. Is this normal for chronic pain? He has been doing acupuncture for 60 years and I am combining with herbal medicine too. Please help!

    • Qiang Chen says:

      Hi Steph, Hope you are better again today. The flair up like what you have experienced is very important information for your acupuncturist to know. Can you call hime or let him to know? It would help your acupuncturist to form a better treatment protocol that suits you.

  12. Lindsay Nemeth says:

    Hi – I had facial acupuncture for the first time yesterday. Almost immediately afterwards I noticed that my vision was slightly blurry, not as crisp and I have slight photosensitivity. She did a lot of work on the lymphs in my jawline (as I grind my teeth). Is this normal or something I should get looked at? Thanks!

    • Qiang Chen says:

      Hi Lindsay, Most mild adverse reactions are gone within 24-48 hours. If you still experience the discomfort after 24 hours, it is worth to discuss with your acupuncturist. Hope you are radiate with joy by now.

  13. Angie says:

    I’ve been doing acupuncture for 3 weeks for depression, anxiety and chronic neck pain. After every session I notice pain in my body where I didn’t previously have pain before. Extreme leg/hip pain the 1st time and lots of muscle twitching. The second time also leg pain, more anxiety/nervous system issues (feeling off balance and lightheaded for almost the whole week after). The third week a lot of joint clicking and popping throughout my body. I’m talking I crack and pop all over now whereas maybe I would pop in a few places like my leg and hips but it’s so noticeable and is making me nervous to continue. How many more session should I endure so I am “over the healing crisis hump”?

    • Qiang Chen says:

      Hi Angie, If you were my patient and I heard your feedbacks, I would modify the acupuncture treatment protocol thus you will not continue to experience such continue reactions. Can you talk to your acupuncturist on your next visit and explain all your reactions? Adverse reactions do occur, but we as acupuncturists are not intend to let you suffering through.
      With best regards, Chen

  14. Tiffany says:

    Hi everyone. I just started session two weeks ago. This week I had two sessions. One 30 minute one and the next day a chiropractic and accupuncture session for 75 mins together. I felt extremely nauseous during the session and started to panic a bit. I tried to sleep during the session but kept being woken up by feelings of nausea and anxiety.
    I’ve been suffering with a lot of gut issues and inflammation in general. After the session I felt great. But then I went home and had dinner and took some activated charcoal to help detox from a CT scan with contrasts a couple days prior ( have not felt great since the scan stomach wise 🙁
    I felt awful during the night. Woken up with the feeling of wanting to throw up, nausea, and then woke up drenched in sweat ?

    Is this common? I have no idea what is going on?

    • Qiang Chen says:

      Hi Tiffany, I can only remember one person had extremely nauseous during an acupuncture session in 28 years of my practice, which was caused by food poisoning. Have you discussed it with your acupuncturist during or right after the session? I recommend calling your acupuncturist to address your gut issue. Best luck!

  15. Veronica Nabbosa says:

    Dear Dr. QC, I have had chronic back pain for more than 20 years that goes on and off. The last 2 years have been so challenging because much as I lived a very active life (5 days /week of some sort of exercise eg walking to work – 5KM, hiking, kick boxing cardio, elastic bands exercise or playing bad minton. I got a variety to avoid monotony and boredom, So I keep switching them depending on the mood), I have had on and off pain in the knees very frequently, on the rhomboids for almost a year, as soon as it left, I had pain in the left side of the neck for almost a month, (each condition managed by a professional physiotherapist in western medicine). As soon as the pain in the left side of the neck felt like leaving, I had new severe pain in the right side of the neck striking through deep in my ear. I thought it was due to a deep root canal that I had a few months ago but my dentist took an x-ray and found nothing wrong. I took pain killers for almost 2 weeks due to severe pain in the ear ( feeling like a contraction). I went to see my GP about it who found nothing wrong but referred me to an ENT who checked everything and found nothing wrong but assured me that it was a pressing on the nerve in the neck area ( i hadn’t told him about the history of my pain , so I believed him). He suggested acupuncture. I am seeing a western doctor trained in neurology and alternative medicine, including accupuncture. Yesterday, wwas my first session (out of 10 which will be taken weekly), I told him everything about my pain history. After the session, I felt super sleepy and went to bed at 7:00 pm after resisting for an hour ( I usually go to bed at 9 0r 10 pm). I woke up a bit at around 1 before falling asleep again to wake up at 6:30 am. I don’t have any pain anywhere except I have so much pain in the lower back now which wasn’t there before. Is this normal?

    • Qiang Chen says:

      Hi Veronica, I came cross many patients have their secondary/tertiary pain sites activated after their primary pain was getting better. It almost happening daily in my clinic. Don’t worry, just let your acupuncturist to know the changes in pain. It would be a part of the your recovery process. All the best.

  16. sharon davis says:

    Hi i had my second acupuncture session for plantar fascitis and my well being yesterday.
    THE next day I woke up feeling sick and bottom of my legs aching and head ache I spend that day in bed sweating and drained of energy .
    is this normal as I didn’t get anything symptoms first session

    • Qiang Chen says:

      Hi Sharon, sorry to hear that you have had such a strong reaction. It could be possible to have these reactions at the second session or any sessions afterwards. Can you discuss with your acupuncturist about it? It would give him/her new insight which pressure points/acupuncture techniques works the best for you.

  17. Paul Blackburn says:

    I have just had acupuncture for anxiety which was causing me to be breathless I feel a bit better this morning but how long before I start to feel normal.Thanks

    • Qiang Chen says:

      Hi Paul, The more you are trusting in the process the fast you will heal. However, adversity event does occur. Please talk to your acupuncturist if you continue feel breathless ASAP.

  18. Malavika237 says:

    I started acupuncture 2 weeks ago for acne on both cheeks. The first week the redness had subsided but the second week I have more breakout with lot of pus on my left cheek. Could this be a side effect ?there is definitely an improvement in my knee pain and itching on my forearms. I hope that my skin will improve.

    • Qiang Chen says:

      Hi Malavika, Congratulation on your improvements. As a general rule, there is always a bit bumpy on your road to recovery. Be patient and be resilient, you will see more positive changes as the body always heal.

  19. Hayley says:

    Hello — I’ve had acupuncture 2x now, a month apart, and after each time I vomited for an extended period, the first time a few hours after the session the second time around 5am the next day. I didn’t seem to be sick otherwise either time. It is for extreme lower back pain after 2 surgeries in my neck and lower back this year. I seem to be vomiting mostly stomach acid, liquid, both times. It is VERY unpleasant. Is (or how is) the acupuncture triggering this and should I continue?

    • Qiang Chen says:

      Hi Hayley, It could happen if you have had extreme pain in the first place. The key point for you to pay attention to is whether you feeling better (more relaxed/reduced pain) after the reaction. If so, you are on the right path. If you didn’t experience any improvement, can you to discuss with your acupuncturist about your reactions? Don’t wait for another month to go by, call him/her today. Have a zen day!

  20. Cali says:

    Recently started acupuncture sessions back up after about 3 yrs. I’ve noticed after the sessions I’m filled with raging anger and extreme irritability! It’s almost scary! Good to know this is a good sign. Whew, my poor spouse those first 48-72 hrs after acupuncture LOL.

    • Qiang Chen says:

      Hi Cali, I am glad to hear that you are aware of the reactions. Wish your spouse well for me, I knew what is been going through. 😉

  21. Kamila says:

    Hi, I started to go on acupuncture due to my chronic problems with UTI, cold feets and stomach problems. After my first visit, I felt great but in two days I started to have chills and being kinda tired. In 4 days I went for the second time and right after I felt very tired and the chills have been even worse that I am extremely cold all day. Do you think it is normal or connected with the acupuncture? Thanks a lot!

    • Qiang Chen says:

      Congratulations! Kamila. My understanding of your reaction as the inner ice cube (coldness) is melting and fast. I had one patient had the same reaction and he was wearing a ski jacket during the summer after an acupuncture session. Please wrap up, stay warm and talk to your acupuncturist about it.

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