A recent case report details the story of everyone’s worst post-acupuncture nightmare: a collapsed lung. It featured the story of a 79-year-old woman who, two days after having an acupuncture treatment, went to her general practitioner because of sharp pain in her right shoulder that she’d felt ever since the treatment.

Her doctor ordered chest radiography, and it was revealed that the woman had a collapsed lung. She was taken to the hospital where she had a chest tube inserted to expand her lung and relieve her pain. On her second day in the hospital, the chest tube was removed, and the patient was discharged on her third day.

Health spoke with an expert to find out how patients can minimize their risks of suffering complications from acupuncture.

Juhi Singh, licensed acupuncturist and founder of the Juhi Center in New York City, recommends asking friends who have seen an acupuncturist if there is anyone they really like. “Ask friends who have gone.” she says.

It also can’t hurt to quiz the practitioner before you let them do any treatments. “Call up and speak to the practitioner and ask questions. You want to make sure the person is well-versed,” Singh recommends. If you feel like they don’t know what they’re talking about when you ask them about their treatments, consider reevaluating whether or not you should see them. “Trust your instinct. If someone isn’t able to answer your questions—that’s a [bad] sign,” Singh says.

While we’re talking about your instincts, note that you shouldn’t follow through with any treatments you aren’t 110% comfortable with—even if it means leaving after you decided to be treated by a particular acupuncturist. Changing your mind is fine. “If you feel uncomfortable at any point, leave. You’re trusting this person [with your health],” Singh explains.

If you’re uncomfortable asking your acupuncturist how treatment works or asking them to clarify any details, that probably means you should think about finding a different treatment provider. Singh explains, “If you feel embarrassed, it’s probably not the right fit.”

Not everyone has a variety of acupuncturists at their fingertips, so we asked Singh what to do if the pickings are slim where you live. If you live in a rural area with few options, ask a local university for a recommendation And if you’re considering acupuncture but don’t know where to start, consult the nearest medical school for a name or two, she suggests.

The new case report, published in BMJ Case Reports, calls on the medical community to keep the risks associated with acupuncture in mind. “Both acupuncturists and clinicians need to be aware of the possibility of adverse events following acupuncture, especially in those who develop symptoms,” the report says. It notes that having a collapsed lung, technically called pneumothorax, is the “most common serious complication” associated with acupuncture.

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