People may not know what to expect from their first acupuncture appointment.
Acupuncture is believed to have been started in China, although the term was invented by a Dutch physician in the 17th century. The practice is anywhere from 2000-4000 years old. In the “Taoist concept of health”, health is a harmony of the Yin and Yang opposing forces, and “disharmony brings disease and death”. Acupuncture was first practiced with needles of pottery and stone, but metal needles eventually replaced them, save for some parts of rural China. Originally, there were classic needles—“nine needles”—that were each different types, but now the main needle is the “filliform”. Other needles have been replaced by surgical instruments. The filliform needles are now made of stainless steel, but they had been made of gold, silver, and bronze in the past. Historically, there was a practice called “moxibustion”, which was “the burning on the skin of the herb moxa”. While scarring occurred in the past, moxa is now “used to provide local heat over acupuncture points”. Some point on the body are “forbidden to moxa”, such as the area around the eye. Acupuncture did not used to have specific body locations, but now there are particular points of the body that are targeted. These are “grouped into a system of channels…conducting the flow of vital energy through the body”.1
Today, acupuncture is a complementary and alternative medicine (CAM) that is a type of Chinese medicine. It is based on the idea that “chi”, or energy, “flows through and around your body along pathways called meridians”. If something blocks the chi, or if the chi is unbalanced, acupuncturists feel that this is why illness occurs. By using thin needles on certain body points, energy flow is influenced. There are variations of acupuncture that use pressure, heat, or a “mild electrical current” with the needles. Several needles are tapped into the skin at varying depths. It may require many treatments to “restore the flow of chi”, and each treatment runs up to an hour, although it can take as little as 15 minutes.2 6-8 overall treatments are common, typically once or twice a week. Acupuncturists’ styles are different, and some blend Western and Eastern approaches.3 It is thought that acupuncture could work for insomnia, lower back pain, headaches, osteoarthritis, migraines, asthma, and other conditions. It is possible that it influences endorphins and “works on the body’s stress response system”.4
What to Expect During the First Acupuncture Appointment
During the first acupuncture visit, a practitioner will ask a patient about lifestyle, symptoms, and behavior. They will examine the painful parts of the body, check the color of the face as well as the color, coating, and shape of the tongue, and they will also monitor the quality, rhythm, and strength of the pulse. Depending on the treatment, the patient may or may not need to remove clothing. The general process includes “needle insertion”, “needle manipulation”, and “needle removal”. The needles are thin and usually painless. A treatment generally involves “between five and 20 needles”. The needles may be twirled. While the patient relaxes, the needles remain in the skin for up to 20 minutes, until they are painlessly removed. After the visit, a patient may feel energized or relaxed, but “not everyone responds to acupuncture”. While many find acupuncture helpful in controlling painful conditions, there are some studies that show that “some types of simulated acupuncture appear to work just as well as real acupuncture”. It may work better in people who have the expectation that it will work. There are few side effects to acupuncture, so patients might want to try it if conventional medicine has not worked to control pain.5 After the appointment, patients should rest, perhaps nap, and consider going to bed earlier. Strenuous activities and exercise should be avoided, unless it is light and gradual exercise. For example, runners should walk, or advanced yoga practitioners should try a beginner class, instead. Instead of using ice (which can cause stagnation and slows healing), patients should use heat to help with the “flow…to eliminate blockages”. Coffee and alcohol should be avoided, as patients will need to help remove toxins from the body and hydrate. Alcohol and coffee dehydrate the body and impair the senses, which can mask acupuncture’s effects. Patients should also eat healthy food and turn off the TV to remain in a calmer state of mind.6
Preparing for Acupuncture
The first appointment is usually the longest one, perhaps lasting 90 minutes. Practitioners may recommend that patients leave enough time before and after the treatment so that they are not rushed, and they often suggest that patients not engage in certain strenuous or stressful behaviors (exercise, sexual activities, alcohol, eating heavily) close to their appointment. Before the needles are inserted, the acupuncturist will check the pulse “on both wrists in three locations” and palpate the patient’s body in order to find “the most effective acupuncture points” for treatment.7 It is important to eat two hours before the appointment, as arriving with an empty stomach can lead to lightheadedness. Coffee should also be avoided for two hours prior to an appointment. Coffee, a stimulant, releases “norepinephrine and epinephrine, which kick your body into fight-or-flight mode”. Acupuncture is working to bring the body to a “rest-and-digest” mode, and coffee inhibits that and makes it harder for the practitioner to get an accurate pulse reading. In addition, the coffee stains the tongue, making it more difficult for the acupuncturist to examine the tongue properly. Alcohol numbs and reduces awareness, so it is also counter-productive to indulge in before acupuncture. The patient should share family history regarding diseases or any other medical events, illnesses, and surgeries, as well as current medications so that the practitioner has enough information. Wearing loose clothing is helpful, as well. Patients should turn off their cell phones during the visit so that they can concentrate on their therapy.8
Acupuncture can be combined with massage, cupping, electrical stimulation treatments, and other therapies, such as moxibustion.9 A study of patients with constipation showed that acupuncture, combined with Chines herbal medicine (Senna Granule and Plantain), “can significantly decrease gastrointestinal transit time and defecation cycle” and “change stool property”.10 For insomnia, another study showed that acupuncture was better at improving sleep duration and quality than sham acupuncture, no treatment, or medications. Further, the “combination of acupuncture and other interventions appears more effective than those interventions alone”.11 Acupuncture is believed to reduce pain by “untying muscle straightjackets”, according to Tim Rhudy, an acupuncturist at the Cleveland Clinic. It helps to regulate the nervous system to stimulate the release of endorphins to fight pain. In addition, Rhudy noted, when the acupuncture needles is inserted, “the body pays special attention to the micro-trauma and emits healing factors”. It alters the perception of the pain, as well. A Chinese study found that acupuncture and electroacupuncture can reduce tenderness in patients with rheumatoid arthritis. A German study showed that osteoarthritis patients treated with acupuncture, in combination with their medical care, had “less pain and stiffness, improved function and better quality of life” than those who only had the routine care. A fibromyalgia study found that acupuncture “increased the activity of pain-killing receptors in the brain”, while “sham acupuncture did not”.12
7, 9 http://www.acupuncturetradition.com/expect.html
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