“Nature does not hurry, yet everything is accomplished.” Lao-Tzu

Things to do before coming to your acupuncture appointment.

• Come ready to rest, relax and listen to your body. If possible, try not to schedule things to do immediately after your appointment. It’s not that you won’t be able to do anything, it’s just that sometimes your body will want more rest right after you’ve had a treatment and you may not feel like doing anything at all. The other reason you should try not to have things scheduled right after your treatment, is that your treatment time can vary, and on occasion, you may either require more care or more resting time with the needles in.

• Wear comfortable, loose fitting clothing that can either be easily removed or moved around. Clothes that can be pushed up to over both your knees and elbows are ideal, along with a sleeveless t-shirt underneath, in case we need to access points on your shoulder area. Button down shirts over a sleeveless tank work the best.

• Never come hungry or thirsty to your appointment! This will keep you from feeling lightheaded after standing back up again and you will be able to relax and have a much better experience overall.

How soon will I feel better?

No two people react or recover in the same way. For some people the results can be felt in just a matter of seconds or minutes. It is always very exciting and fun when this happens. Other people may notice an improvement in a day or two after their treatment and still for others improvement may be noticed more slowly, over a period of time. The rate of improvement largely depends on the condition being treated, your overall health, how long you have had the condition, and the severity of the condition. How long that improvement is sustained will depend on those same factors listed above as well as other lifestyle and external factors. The good effects of your acupuncture treatment can easily be built upon as long as it is not counteracted by lifestyle and external factors. The person who tries to catch up on months or years of yard work because their back is finally better is a typical example of how nothing is set in stone. There is this inherent belief in Oriental medicine of accountability and responsibility of our own actions and that nothing comes without a price tag.

It is important for patients to realize that they must keep up with the acupuncture treatments in order to maintain the pain relief. A lot of patients mistakenly believe that acupuncture is a ‘quick fix’ for their problems. They have heard of someone who has received acupuncture and had amazing results. This can be the case, if a person comes in for treatment right at the onset of a problem such as an acute back sprain. Acute problems are much easier to treat, and the healthier the person, the quicker their body will respond. But for most people, a series of treatments is required so a cumulative effect can be built upon. Acupuncture acts as a conduit for the healing to take place. It is your body that must do the healing work and this happens over a period of time.

Immediate relief and the long-term solution of your problem(s) are not likely to come without some determination on your part. I like to be honest with people, so I will tell you that it is simply inaccurate to assume that acupuncture can make up for poor dietary or exercise habits, improper rest or sleep, structural imbalances, emotional difficulties and a hectic lifestyle! These are the things that contribute to imbalance and disease to begin with. The identification of the cause(s) of the imbalances is important because, only by doing that, can you begin to avoid, minimize, or prevent its re-occurrence. For example, too much rest (not enough exercise) or too much exercise, too much work, too much sex, or even not enough sex, an unbalanced diet, an unbalanced emotional life, and extreme weather conditions can all become the cause of disease. Finding the proper balance of everything is the key and this balance is relative to each person. What is too much exercise for one person can be too little exercise for another, and so on. All of these things play a part in your body’s healing response and the rate at which it will respond.

To quote John Muir: “When one tugs at a single thing in nature, he finds it attached to the rest of the world.” This “holistic” perspective is the main principle of Oriental medicine. It not only explains the interconnectedness of what ails us, but also what treats us. All of the parts are connected to the whole. Each of our lifestyle factors make up a part of who we are, which is important to think about on our journey toward better health. And it is why your acupuncturist may choose to needle a point on one part your body to treat a problem on another part of your body!

How many treatments will I need?

Most practitioners recommend that anyone with a chronic health issue should try to commit to a course of treatment – usually anywhere from 6 to 12 treatments. However, sometimes many more treatments are required depending on the severity of the condition and the overall health of the person.

Patients who come for treatment at least once a week will see the best results. Sometimes more treatment is needed when a patient first begins receiving acupuncture care to try to develop and build up a cumulative effect that will provide them with longer lasting relief. Generally speaking, most patients can expect to see at least some improvement. Pain that was originally rated as a 9 or 10 on a scale of 1 to 10 can drop down to between a 2 and 5 and if patients take good care of themselves, sometimes even lower.

Patients who decide to come for acupuncture regularly, meaning, over a course of several months or even up to several years, will see the best results. If the patient does decide to continue treatment consistently for a few months, often the pain will go away, at least significantly, and will not return for over a long period of time or could even be permanently relieved. It is then important to remember to do “maintenance” (preventative) work, much like what we do for our cars. This tends to be a routine situation in China because the government pays for the cost. These facts are not as well known among people in America, but are essential for one to know before they agree to engage in this healing process. Acupuncture is a process. It does work but it takes time.

How does acupuncture work to treat pain?

There are many different mechanisms of action that have been identified with how acupuncture works to affect the body. No one reason can be used to explain what happens to someone when they receive acupuncture. However, there are some obvious effects that seem to account for why people feel better after an acupuncture treatment. Here are a couple of brief explanations below.

When the body gets external pain relievers, called opionoids, the body, by a feedback response, will decrease or even stop producing its own natural pain relievers. This makes people gradually dependent on these external opionoids – a.k.a. drugs. If the patient does not get the drug or an increased dosage, the patient will suffer continuous pain and will not be able to live happily without having some sort of external stimulation from drugs. Acupuncture is one way to try to improve this situation. Pain management with acupuncture can help to prevent drug tolerance, drug addiction and drug misuse among patients with chronic and intense pain. Acupuncture is very good at stimulating the body to produce its own natural pain killers (endogenous opionoids) again. These endogenous opionoids are also called endorphins.

In order for the body to feel pain, two nerve systems are involved. The sensory pain nerves (nociceptors) are the nerves that tell the brain “ouch!” there is pain. Proprioceptor nerve fibers are the ones that tell the brain where the pain is located. They fire continuously at the affected area and send signals up the front of the spine to the midbrain where a release of the endorphins occurs – and remember, these are what bind to the pain receptors to relieve pain. In people with chronic pain, the body locks into a habit of pain and the signal to the midbrain becomes too low to trigger the release of the endorphins. When this happens, I often notice that the person cannot pinpoint the EXACT location of the pain. Acupuncture helps by creating a stimulation and “re-boots” the proprioceptive nerves. Needling makes the body go into a “fight or flight” response and stimulates the brain to release the endorphins. This is called “stress analgesia”. When the signal gets weak again the pain habit comes back or tries to reestablish itself. This natural endorphin release is often felt by patients immediately and can produce initial pain relief that can last anywhere from a few hours to a few weeks. It’s important to continue having the acupuncture to keep jumping the threshold until the body REMEMBERS and RE-ESTABLISHES the normal threshold to signal the brain on its own. After several treatments the proper threshold is achieved and the body is able to get out of the pain cycle. The body doesn’t want to be in pain, it just doesn’t know how to get out of it.

Another way that acupuncture works is through the vascular system to increase circulation throughout the whole body and it can target specific areas in need. If the body senses pain somewhere – it vasoconstricts blood flow to that area. The needles stop this pattern and cause the blood to flow again in the affected area. This increase in circulation is another way the body to begins to get better.

Integrative approach to pain management

Optimal treatment requires a multi-modal or integrative approach. You cannot expect that acupuncture is going to be able to correct the many years you may have forgotten to take care of your body overnight. Nor can you expect that you can continue to engage in behaviors that are bad for your health and ignore good health habits and that acupuncture will make up the difference for you. Think about how long you have had the problem. Think about the hours, weeks, months, years that you have had this problem and think about how it’s going to require more than 12 acupuncture treatments (i.e. 12 hours of your life!) to improve this problem and correct whatever those underlying problems are.

You are going to need to do other things like eat a good diet, get adequate rest, find some sort of movement that feels good to you, and whatever else your doctor and other healthcare practitioners suggest in order to get the best results. Your acupuncturist can help you get on track with many of these things. It is the combination of things you do that will work together to tonify the underlying deficiencies, strengthen the body and facilitate the recovery from chronic pain. It is also important to understand that some types of pain, which are chronic in nature, degenerative, or from terminal illness, may only be managed rather than fully corrected.

Some underlying causes of your pain might include: repetitive motion injuries, physical trauma, emotional trauma, environmental factors (like wind, cold, damp and heat), age related degeneration, job or family stress, structural misalignments, poor quality sleep, poor circulation and malnutrition, just to name a few. Some underlying hindrances to the healing process might also include these same factors.

Listen to what your body is trying to tell you. It is essential for you to determine what the causes of your pain are and then, with the help of your practitioner, develop some coping strategies to directly address these issues.

Here is a list of some coping strategies that may help you. In order to most effectively manage your pain and get the most out of your experience with acupuncture you should make a commitment to doing a minimum of two things on this list that you are not currently doing.

Nutritional suggestions

• When pain medications are taken on a long term basis or misused by patients, side effects, nutritional imbalances and serious health problems can occur. That is why it is very important to eat a well-balanced diet with a wide variety of vegetables, fruits, proteins, whole grains and nuts in order to give your body all the nutrients it requires for bone, muscle, and nerve health. Most of us are simply are not getting enough vitamins and minerals in our diet no matter how hard we try. Your body needs the essential nutrients or ‘raw materials’ for maintenance work and repairs. If it doesn’t have these things, how can it do its job? In particular, calcium and magnesium are especially important nutrients used in the repair and rebuilding of bones, tendons, cartilage, and connective tissues. Deficiencies in these minerals can lead to spasms, cramps, and tense muscles. To relieve cramps and spasms, drink adequate amounts of warm water and eat plenty of fruits and vegetables, which will supply your body with the calcium, magnesium, and potassium it may be lacking.

• You may want to talk to your acupuncturist to find out ways that you can enhance your body’s own healing capabilities, fight inflammation, enhance tissue repair and increase bone density through diet and nutritional supplements.

• Avoid cold drinks, caffeine, dairy products, sugar, peanut butter, white and wheat flour products, excess tomatoes consumption, excess citrus and banana consumption, and above all ice cream, as all these things tend to create inflammation, muscle constriction, and stagnation in the body. You will feel a big difference in your health if you can just follow this.

• Cut down on your intake of red meats and seafood’s as they contain high levels of uric acid, which put strain on the kidneys and can be a factor in conditions like gout.

• Try adding the herb turmeric to your daily diet. Turmeric is a health-enhancing herb that, among other things, has anti-inflammatory properties that can help with a variety of aches and pains. I recommend simply sprinkling a generous amount of turmeric on your food once or twice a day and see what happens. (Add a little black pepper to help increase its absorption). This is the safest and most cost-effective way to take this herb on an ongoing basis.

• Ask me about what kind of herbs you can take for your particular health care needs. There are traditional herbal formulas that can be used to target very specific areas of your body in need. For example, if you have neck pain – you will be given a formula that guides the herbs to that part of your body. If you have lower back or knee pain, you will be given herbs that target that area of your body. Chinese herbal medicine is a very complex art and science that is extremely effective in treating almost any kind of imbalance and it is not a ‘one size fits all’ approach. You will be given herbs that help to balance your exact imbalance. If you are already on medications, you will not be given herbs if herb-drug interactions would be a potential problem.

Lifestyle Suggestions

• Mild exercise such as walking, swimming, yoga, Tai Chi or Qi Gong on a regular basis is recommended.

• For those who are overweight, weight loss will help to decrease pressure on the joints and relieve pain.

• Hot baths with Epsom salts help to relax muscles and draw toxins from the tissues. Rest for about 30 minutes, being sure to avoid becoming over-tired from the heat. Hot compresses over painful areas may also help to increase circulation, alleviate pain (especially pain aggravated by the cold), and speed healing. Short periods of time in a sauna can be helpful too.

• Topical applications of pain relieving ointments, liniments and creams can be extremely helpful in alleviating pain. Look for creams that do not only mask the pain (like “BenGay” or “Icy Hot”), but also help to treat the underlying problem. Products like Traumeel, Topricin and various Chinese liniments and pain patches contain herbs that have anti-inflammatory, anti-spasmodic, analgesic, and circulation – enhancing effects. They also help to reduce swelling, stiffness, numbness, tingling, burning pain and bruising. These products are a very useful adjunct in treating repetitive motion injuries like carpel tunnel syndrome, sports injuries, nerve pain, arthritis and other joint diseases.

• Keep your muscles and joints from becoming too stiff by doing gentle stretches daily even if only for a few minutes.

• For those with low back pain or weakness, strengthening the abdominal muscles helps to reduce strain on the low back. I can show you a very simple and effective exercise that anyone can do standing up.

• Find a balance between rest and work and make sure you get enough sleep. Most healing takes place while you relax and sleep. If you are having sleeping difficulties, then it is important to let me know about it so we can work together to address this.

• Drink plenty of water, especially if you consume caffeinated, carbonated or alcoholic drinks. Part of your pain can be due in part to dehydration.

• Massage can be a soothing way to help your muscles to relax, and it can have a calming (and almost sedative) effect in some cases. If you accept the belief that our body, mind, and spirit are all one, than you will agree that it is impossible to affect one of those things without affecting the other. It is very common for several types of pain to coexist, so even the temporary relief you get from massage can have a profound impact on your outlook and the pain cycle itself. There have also been numerous other health benefits associated with massage, including increased relaxation, circulation and detoxification which can assist in the management of pain.

• Chiropractic manipulation and Rolfing (also known as Structural Integration) combine really well with acupuncture treatments and can help to address any underlying structural issues your body may have.

• Social support, whether it be through friends, family, or the help of a professional can be helpful for anyone. Everyone appreciates being understood and listened to. “Getting things off our chest” can be so freeing when we have someone or a variety of people to talk to about what we are going through. And lending a caring ear to someone else can be therapeutic for us too. Through the sharing of experiences, one can sometimes find enjoyment, hope, and inspiration.

• Laughter is the best medicine! Try to find as many things as you can to laugh about, including yourself! If you can have a great laugh with someone, all the better. It has been said that 20 seconds of laughter gets as much oxygen circulating throughout the body as 20 minutes of exercise. This may or may not be true, but we certainly all know people who have triumphed over something very difficult, and have said that a positive attitude was the key ingredient. And if none of these other things work for you, find a good, healthy distraction that keeps you entertained, engaged and feeling alive.

• If you can think of something else that has worked for you or that I should add to this list, please let me know!