Post-dural puncture headache following acupotomy using "Wonli-acupuncture needle" - A case report -
Anesthesia and Pain Medicine
Lower back pain (LBP) is one of the most common painrelated complaints that lead patients to seek medical care  . Underlying disc herniation and subsequent radicular symptoms from direct compression of nerve roots or inflammatory mediators related to disc disruption are frequent causes of the pain, leading to these consultations. Various treatments for these lumbar diseases have been introduced. Acupuncture has also been studied as an alternative treatment modality, with worldwide
... orldwide application, particularly in clinical pain management. Acupuncture has been recognized as relatively safe for patients, especially in East Asia, and many patients with LBP are treated with acupuncture in clinical practice. Spine surgery has limited effects for the management of LBP , so the need for non-operative therapies such as pharmacological therapy, physical therapy, and manipulation has increased, but these methods do not have satisfactory therapeutic effects and are not commonly used . Acupuncture was introduced as a way to remove attached tissues, reduce pressure on the nerve, and improve the circulation of the surrounding area in cases of lumbar spinal stenosis or lumbar disc herniation. New acupuncture treatments for these diseases are also being tried . However, the effects of acupuncture are still controversial, and the principles of treatment are unclear. Although many studies have evaluated the effects of acupuncture in the management of LBP, few have evaluated the side effects of acupuncture-related procedures . Here, we report a case of dural puncture headache due to acupotomy, a recently introduced long-needle acupuncture technique in the oriental medicine, and discuss the principles of acupuncture treatment necessary to provide useful information for pain physicians. The authors received written permission from the patient to report and provide details about this case. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Acupuncture is a popular technique used worldwide, particularly for clinical pain management. Diverse methods of acupuncture with several types of needle have recently been introduced; however, medical evidence of the treatment and safety of many of these techniques has not been established. In addition, severe, life-threatening acupuncture-related complications have been reported even though the treatment is considered to be safe. We report a case of a post-dural puncture headache that occurred following acupuncture for the treatment of lower back pain, with a literature review. Pain physicians should consider that acupuncture can cause far more serious side effects than those previously known.