What to expect for your first acupuncture appointment.
Acupuncture is branch of Chinese Medicine that uses small needles inserted into specific points along energy pathways in the body to adjust qi to restore balance.
Chinese medicine is a whole body medicine that looks at all aspects of life to assess health, not just the presenting symptoms. Developed over a thousand years ago, acupuncture has stood the test of time proving its validity and benefit.
At your first acupuncture appointment, it is totally normal to feel nervous about the thought of getting stuck with a bunch of needles. We go through life trying not to get poked by sharp objects as a survival mechanism, and here you are signing up to be a pin cushion. When we hear the word needle we usually think of large hypodermic needles and pain associated with getting a shot or a blood draw. For acupuncture the needles use are very small (about as thick as a human hair), single use, disposable, sterile, and flexible. They are solid state needles, so there is nothing coated on them and there is nothing being injected into you.
The appointment will begin with a conversation with your acupuncturist about the reason you are seeking treatment, going over your health history, your current symptoms, and what you have tried in the past to relieve your complaint. There will be questions about your over all health, lifestyle, eating habits and digestion, types of exercise and work, stress level, and how you sleep. Many patients report that this interview process goes more in depth than any other doctor visit they have ever had. Asking a lot of questions helps the acupuncturist develop a Chinese diagnose of your condition and will lead them to the appropriate course of treatment to get you lasting results.
After talking, the next step is looking and feeling. In this part of the appointment the acupuncturist may ask you to perform some range of motion tests or they may palpate areas on the body looking for tenderness or tension. They may also look at your tongue and feel your pulse. Looking at the tongue is a diagnostic tool acupuncturists use to assess the whole body. Different parts of the tongue correlated to different areas of the body and depending on the color and texture of the tongue body and coat the acupuncturist can determine where there are imbalances in the body. To feel the pulse, an acupuncturist will use three fingers placed at the wrists to feel the pulse in three places and at three different depths. It is not so much about how many beats per minute are felt, but it is more about the quality of the pulse and where it is felt. Is it strong and choppy deep down by the bone, or is it soft and sluggish felt in the middle position? These clues tell the acupuncturist where the imbalance lays and help determine how long it will take to improve.
Once the assessment has been made, it is time to treat. The acupuncturist will select the appropriate set of points to treat your condition. The points used are located all over the body, both local and distal points can be used. Local points will be directly into the problem area addressing muscle imbalance and tension. Distal points are located away from the problem area and used to divert energy and blood flow from areas of excess to deficient areas. For example if you are coming for a shoulder injury points may be used directly into your shoulder muscles helping to re-set the muscle motor points or relieve trigger points, while also using points in the lower legs to help rebuild the constitution of the body, so that it is more resistant to injury in the future. If your condition is in the acute stage the local area may be to painful to be needled directly, in that case distal needles would be used alone to draw energy away from the affected area.
You will be asked to lay down on a massage table, either face up or face down, or you may be treated sitting up in a chair if laying down is problematic for you. You may need to partially disrobe depending on the location of points needed to be accessed. Treatments are offered in private rooms, so there is no need to wear special clothing. Linens, gowns, and towels are provided for modesty draping during sessions.
With needling some of the points you will feel and others you won’t even notice. Normal sensations to have with acupuncture include: dull achy, heavy feeling, tingling energy feel, or a hurt so good kind of feel. If anything is sharp or has a stabbing feeling that doesn't calm down after you take a breath or two, you should tell your acupuncturist so they can adjust it. All points should be calm enough that you can rest and relax. Treatments vary in the number of needles used depending on condition and body constitution. Different lengths of needles are used depending on the anatomy being treated. Some points are very close to the skin's surface while others are deep down next to the bone. Thankfully the length of needle doesn't really change the intensity of needling. The sensations felt are at the point of insertion and at "the point" but the distance between doesn't matter.
Once the needles are placed and everything feels good the acupuncturist will leave you to rest. The time needles are retained depends on what is being treated and the overall constitution of the body, typical resting time is between 20 and 40 minutes. For small children or babies needles are inserted then removed immediately, their bodies respond very quickly to acupuncture, us older folks need a little longer to respond to the stimulation. During the resting time you can listen to relaxing muscle or enjoy some quiet time. Most people find this time extremely relaxing and will even fall asleep or go into what referred to as "acu-land", a state of not awake but not quite asleep. On the first visit it is sometimes hard for the body to fully relax, but the more acupuncture you get the more the body gets conditioned to relax.
After resting, the needles will be removed and you will be given a chance to get up and dressed. Some range of motion tests may be repeated to assess improvement from the session. Your acupuncturist will also go over your treatment plan and what to expect after this treatment. There is a settling in period after getting acupuncture where the body is trying to sort out and adjust to the shift in energy and qi from the treatment. It is recommended you take it easy for the 24- 48 hours following treatment. Avoid any strenuous or stressful activities. Drink plenty of water and you can put heat on any sore areas. Most new patients report sleeping really well the night after their treatment.
Follow up appointments are recommended for lasting results. Acupuncture is cumulative, so the more you get the more the body learns to be balanced. It is hard to get too much acupuncture, but easy to not get enough! In the beginning weekly appointments are recommended and as your condition improves appointments will be spaced out accordingly. Number of treatments needed to see improvement depends on the condition being treated: short term (acute) conditions respond quicker than long term (chronic) or more complicated conditions. Most all patients will notice some change after the initial visit and they are asked to pay attention to what they felt and for how long to report back at their follow-up visit.
Once your condition is under control appointments will shift to maintenance treatments which are often referred to as "tune-ups". These appointments may be monthly or at an interval that best suits your circumstances. It has been found that treating things before they become a problem results in a healthier more resilient existence.
Ok, knowing what to expect from your first acupuncture session, now it's your turn to feel what Acu-land is like. After you do, share in the comments about your experience.
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