Acupuncture Dos And Don’s: How To Get The Most Out Of Traditional Chinese Medicine Treatment – FAQs 2022 Part 2

What should I do to prepare for my Traditional Chinese Medicine/Acupuncture treatment session?

Before your treatment:

  • Eat a light meal or snack. Heavy meals can cause nausea, and an empty stomach can cause dizziness after treatment.
  • Wear loose, comfortable, and warm clothing—items that can be easily rolled up or removed for best access to points.
  • Avoid caffeine at least five hours prior to your appointment.
  • Do not drink alcohol.
  • Drink plenty of water on the day of treatment up until 1 hour before.
  • Avoid food or drink that changes the color of the tongue.
  • Avoid perfume and scented cosmetics.

During treatment:

  • Try to relax as much as possible; it’s okay to fall asleep.
  • If the mind is too active, try to focus on slow, deep breathing.
  • Avoid moving the areas where needles are inserted.
  • Let the practitioner know if you become uncomfortable for any reason (i.e. too hot/cold, in pain, music too loud, etc.).

After your treatment:

  • Avoid caffeine, alcohol, and greasy or spicy foods.
  • Get adequate rest; allow yourself plenty of time for relaxation. 
  • Avoid strenuous exercise and stress.
  • Drink more water.

Does acupuncture really work?

Numerous studies have been published on the effectiveness of acupuncture for a variety of conditions. A recent meta-analysis done by researchers at Memorial Sloan-Kettering Cancer Center analyzed more than two dozen studies involving 17,922 patients with back, neck and shoulder pain, osteoarthritis or chronic headaches. Their conclusion: 

“We have now done the most rigorous analysis to date, as statisticians, to find out whether it works. We have found very robust evidence that acupuncture is a reasonable referral option for chronic pain. … Many clinicians consider acupuncture to be merely a potent placebo and feel uncomfortable referring their patients to an acupuncturist. But our findings suggest that the effects of acupuncture go over and above the placebo effect.”

With that being said, I believe that acupuncture works for many people… but not all. 
The only way to know is to try it for yourself.
There are usually a variety of factors that affect how well a patient will respond to acupuncture. 

Severity / Duration of the condition

Severe and long-standing conditions are generally more difficult to treat than mild-moderate or recent-onset conditions. If there has been a lot of physical/pathological change or damage to the body acupuncture can take a long time to reverse symptoms, if at all. These patients may get temporary or mild-moderate relief from symptoms but will need ongoing care. Sometimes there is a dramatic shift that takes place after many months or years of continuous treatment, but the patient needs to have “patience” during all those months of treatment where little change is felt.

Frequency of treatment

I tell my patients that going to acupuncture is like going to the gym: you can’t go once or twice and say that you’re in shape. Acupuncture is the same way. Treatments build upon previous treatments. With each treatment I program a message into the body. It can take time for the body to receive this message and gradually start to move in a healing direction. For this reason, coming in for treatments frequently and consistently will generally lead to a better response over a shorter period of time.

Over-sensitivity to pain / needles

Some people are not able to adjust to the sensations of acupuncture even after many treatments. There may be a general over-sensitivity to pain/needles or to the discomfort of laying in the same position for 30-45 minutes. I don’t like to advertise acupuncture as being 100% pain-free. Rather, I like to say that acupuncture has a very small amount of pain, if at all. Some people don’t feel anything, while others may feel a tiny pinch as the needles go in. Most people need only experience a few needle insertions before they realize that the pain they feel from an acupuncture needle is so small (and short-lived) compared to the pain they feel from an injection! 
It’s important to remember that acupuncture is a form of therapy for the nervous system. By stimulating nerves and triggering deeper bodily sensations with acupuncture we can:

(1) stimulate nerve pathways and organs, which in turn can improve their function,

(2) increase circulation, which assists in the healing of injuries, reduces inflammation, and brings nutrients/hormones/new blood to different areas of the body,

(3) bring the body’s attention (i.e. immune/endocrine functions, positive intention) to areas of disease.

Some researchers have suggested that acupuncture stimulates the brain to release endorphins, thus reducing pain and giving the patient a euphoric or blissful feeling after treatment. I believe that over time acupuncture can modulate our pain response on both a physical and psychological level, making our bodies and minds more resilient to stress, discomfort, and disease.

In order to stimulate the nerves, the patient will need to feel some kind of sensation on their end (unless no sensation is felt due to nerve damage). Sensations during stimulation include tingling, dull aching, warm, electrical, throbbing, or relaxed (no strong feeling or feeling of relief). Generally speaking, if the patient can tolerate strong stimulation it can produce a strong beneficial effect. If they can only tolerate a small amount of stimulation it can still produce a good effect, but the best results will be felt over a longer period of time. For patients that are extra-sensitive, I do shallow needling with little to no stimulation. This type of acupuncture (similar to Japanese style acupuncture) can still be very effective and relaxing but generally needs to be done over a longer period of time. 

Most importantly, after the needles have been placed and stimulated the patient should feel no pain or discomfort! Initial pain or discomfort usually goes away after a minute or two. If the sensation is still uncomfortable after that time the needle is adjusted until it sits comfortably or is removed completely. Sensations of “movement” may be felt in certain areas during treatment and are generally a good sign that we are stimulating the nerves. Other than that, the patient should feel comfortable and relaxed during the entire treatment. Falling asleep is encouraged! Some people forget the needles are even there

(4) Inability to relax

I believe that acupuncture is like meditation. Each session the patient is asked to lay still while the needles are inserted. Then they are asked to passively observe the sensations they feel and generally relax for 20-25 minutes. They are asked to calm and center their mind leaving all worries and problems outside of the treatment room. This is very similar to meditation practice. Over time the body and mind become better and better at just observing sensations without reacting to them. In this way, we can re-program the body and mind’s reactionary habit patterns.

For example, the patient may start to feel less reactionary to typically stressful situations (e.g. work, traffic, relationships, etc.). They may be better able to separate themselves from an “illness-identity” – observing their symptoms, but no longer making those symptoms a part of their identity. They may also be able to tolerate pain and discomfort with less stress, which can reduce the need for pain or psychiatric medications. When stress, in general, is reduced: digestion improves, sleep improves, mood and energy improve – the list goes on.

In the 20 minutes that the needles are placed, I believe we are able to take a patient from a sympathetic-dominant state (i.e. stress, “fight or flight” reaction) to a parasympathetic-dominant state (i.e. restful, relaxed, optimum for reproduction and digestion). The patient has to be willing to go there during the treatment though. For this reason, the use of headphones, iPods, cellphones, magazines, and books are all discouraged while on the table. It may take some time before you get used to laying still for 20 minutes, but you will get better and faster results by trying to quiet the mind and body during treatment as much as possible. Those patients who already have a mind-body practice they engage in regularly (e.g. yoga, meditation, martial arts, tai chi, art, music, dance, etc.), will generally tend to have a better response to acupuncture because they are already very in tune with their bodies.  

(5) Other lifestyle or dietary factors

In addition to acupuncture services, I also give my patients a detailed consultation on lifestyle or dietary factors that contribute to their particular condition. It is the patient’s responsibility to assist their body in the healing process by adhering to a healthy lifestyle and diet. Pain conditions especially will not improve unless the patient is willing to work on posture, stretching, or strengthening exercises, as well as avoid repetitive movements or activities that worsen the condition. Stress plays a major role in slowing the healing process and needs to be avoided altogether and/or managed properly. Acupuncture alone can be very relaxing and used to reduce stress, but most people need a combination of acupuncture/massage, aerobic exercise, meditative exercise (qigong, yoga, tai chi, meditation, deep breathing etc.), a clean diet, and inner happiness to achieve optimum health.

What if I am REALLY afraid of needles?

Acupuncture needles are extremely thin – some are about the diameter of a human hair! In fact, about 20 acupuncture needles can fit inside the hollow of a hypodermic needle or syringe. When asked, many patients do not feel pain as the needle is inserted. Acupuncturists are trained to stimulate the needles until the patient experiences the “qi-sensation.” This sensation can range from a dull pressure to a sharp electrical sensation. For sensitive patients, many practitioners will vary their technique and the needles used in order to provide the most painless and relaxing treatment possible. 

I am trained in many different needling techniques (from very gentle to extremely vigorous/stimulating) and I use a gentle style of needling most often. In my experience, even the most fearful and nervous patients become devoted acupuncture enthusiasts after they overcome their anxiety and experience the intense relaxation of acupuncture treatment.

And if you are still too scared to try acupuncture, I have many other needle-free options including cupping, scraping, acupressure, aromatherapy, qigong or other guided exercises.

Can acupuncture treat children or teens?

Treating children can be especially challenging if they are afraid of needles. Very young children can often be distracted during treatment, but as they get older it becomes much more difficult to fool them. I am happy to do consult-only appointments for young children which cover diet, lifestyle, herbs, and supplements for their particular condition. Young adults and teens (younger than 18 years old) are generally easy to treat but must be accompanied by a parent or legal guardian for their first appointment.

Can acupuncture treat animals?

Animals make great acupuncture patients! California state law requires that licensed acupuncturists be trained by a veterinarian who has taken a short-course on acupuncture for animals. After that, they are only allowed to practice acupuncture on animals in a veterinarian’s office. If interested, you need to be referred to a vet or acupuncturist in your area who does work with animals.

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I want to receive acupuncture that is covered by my insurance plan. There are a number of MDs who practice acupuncture and are In-Network providers for my policy. Wouldn’t it be better to get acupuncture from a medical doctor than from a licensed acupuncturist?

First, I encourage all patients who have insurance coverage for acupuncture to try and get their visits covered. This of course, depends on the terms of your individual policy. Calling your insurance provider is the first step in finding out the details of your coverage. Often, if you have met your deductible many plans will pick up 80%-100% of the cost for acupuncture treatments. However, most policies only cover acupuncture treatments for particular conditions – mostly pain and nausea-related conditions. Anything else may be considered medically unnecessary and is ineligible for reimbursement.
Some therapists do not bill insurance directly but can still provide you with a superbill for insurance coverage. A superbill is a detailed receipt/invoice listing codes for all the services you have received and your diagnosis. These are then submitted to your insurance provider for direct reimbursement. All of your policy’s limitations for services from an Out-of-Network provider are still applicable.

Second, I personally do not recommend receiving acupuncture from an MD for difficult, complex or chronic conditions. While I think there are many MDs who are quite good at acupuncture, most have learned their skills through an acupuncture short-course designed specifically for MDs. Licensed acupuncturists, on the other hand, put in over 3,000 hours of classroom and clinical training in Chinese Medicine (with an additional 500+ hours for some massage programs). Compare that to the 300 hours that MDs spend learning acupuncture in a short course. The training is drastically different! The focus for MDs learning acupuncture is usually on pain management (i.e. what can be covered by insurance). They often use a Western Medicine model of understanding acupuncture and choosing points. And they get little to no training on prescribing herbs or making diet or lifestyle recommendations. If acupuncture was as easy as putting needles where the problem is, then acupuncturists wouldn’t need to put in 4+ years of study in order to become licensed! 

With all that being said, Traditional Chinese Medicine is complex! It contains thousands of years of medical literature and case studies (“the Classics”), requires extreme sensitivity for diagnostic and treatment purposes, and requires a thorough understanding of many different theories/applications in order to be effective. Please remember this when choosing an acupuncture practitioner

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