Below is a picture of a patient with interosseous muscle atrophy of the dorsum of the hand, who was asked by a participant if he could undergo acupuncture treatment because he has cervical spondylosis. The patient presents with atrophy of the interosseous muscles of the back of the hand. In addition to considering cervical spondylosis (neurogenic type), it is important to consider whether it is due to neuronal disease – amyotrophic lateral sclerosis. In addition to muscle atrophy of the hand, neurogenic cervical spondylosis is often accompanied by abnormal sensation; while amyotrophic lateral sclerosis, although it also has atrophy of the large and small interosseous muscles and interosseous muscles, often has normal sensation and is accompanied by tremor of the muscle bundles. In the view of some patients, acupuncture treatment inevitably has the concern of nerve damage, and the result of nerve damage is naturally corresponding muscle atrophy and sensory impairment. For this patient, I think further examination (such as electromyography) is still needed, if it is amyotrophic lateral sclerosis side do not do needle knife treatment or to inform the patient of the expected effect, because the natural development of amyotrophic lateral sclerosis is the result of the hand muscles more and more obvious, do not let the patient think that it is due to damage during needle knife treatment. (The above is purely a personal experience, only for the reference of colleagues!)