The length and success of Acupuncture treatment is dependant upon the commitment of the client that is seeking the treatment, the practitioner, the type of medicine being used and the relationship or “teamwork” that is built from the patient and practitioner
Many clients that ring up for an Acupuncture appointment (at my Hobart clinic) have often tried every other therapy before hearing about it from a friend. Often there is the preconceived notion that it’s some sort of “magic bullet”, where we place the Acupuncture needle at the exact position on the body, releasing the person immediately from pain or illness.
But is this perspective the case for Doctors and the western medical framework?
With the amount of respect that most GP’s, Doctors and Surgical Specialists receive from the community of patients that seek their help, how often is there a moment where 1 x visit to the GP cures a chronic condition?
Under the direction of a doctor, the appropriate prescription for any number of chronic conditions might involve a lifetime of pharmaceuticals, or a complicated regime of rehabilitation and lifestyle change, physiotherapy. Which most informed patients are willing to agree to, or spend considerable time committing to.
In considering this, I think it’s important to discuss what treatment is, what it involves and how the body responds to Acupuncture or Chinese Medicine.
To briefly summarise some points which this article will dive into:
People respond to Acupuncture in different ways. Pain relief from treatment accumulates over time and with each treatment the idea is to increase the period of time that pain relief is observed. It’s important to note that for some people, pain may initially decrease after treatment but return prior to the follow up treatment. And there is a very small percentage of people that have symptoms initially get worse, but then begin to improve. This has sometimes been referred to as the “healing crisis” (read more).
For example, some cases in the clinic might only see 1 x day of pain relief after the first treatment. The pain might return but be less intense. After the 2nd treatment, there might be 3 x days pain relief.
So gradually, depending on how people respond, we should hope to get an accumulation of response to Acupuncture. This is why it’s important to see Acupuncture as a course of treatment and not 1 x single treatment.
First discussion point:
Acupuncture and Chinese Medicine stimulates the body in a certain way, to increase the bodies own capacity to balance itself.
There are many ways to talk about physiological responses of the body…and this includes a multitude of modalities including the action of pharmaceuticals.
We could talk about Neuroplasticity (read more) and the brain’s ability to rewire itself. The theory is that repeated stimulation of the body or repeated actions lead to changes to the neural networks of the brain.
For example, a piano player has a drastically larger number of neural networks allocated to the fingers responsible for the playing of more and more complex pieces of music, because of repeated action.
So…in that sense. If Acupuncture is indeed affecting neuroplasticity, how can 1 x treatment be considered to fix an issue when it takes weeks or months for a piano player to learn the skills necessary for a complex piece of music?
Another example or theory of how Acupuncture might work relates to the stimulation of proprioceptors and nociceptors and that relationship to the stimulation of the bodies own release of enkephalins from the brain stem.
Chronic pain is sometimes a pain that has no known cause or serves no purpose. So the increased stimulation of proprioceptors and nociceptors with Acupuncture needles leads to an increased nerve receptor input which eventually forces the brain stem to release the body’s own natural pain killers (so the theory goes).
However in chronic pain that “serves no purpose”, or where all the necessary tests and x-rays find no abnormalities, the pain might have lasted years before they seek treatment.
How can the stimulation of the body’s own painkillers in one treatment treat a problem that has lasted for years?
As we can see from these 2 x examples, if we think about the physiological theories around neuroplasticity, when the body responds to a stimulus, that 1 single stimulus does not necessarily equal an ever perpetuating stimulus.
In other words, one gym session doesn’t give us a year’s worth of bench presses and squats making us walk out looking like Mark Wahlberg, just as much as one piano lesson doesn’t give us the skills to play Bach with impeccability on the second session.
Acupuncture and Chinese Medicine is a physiological medicine that provides the body with an input, which over time leads to physiological changes in the psychosomatic system.
At a very basic level, from a Chinese Medicine theory perspective, all we are doing is moving Qi (oxygen or vital air) and xue (blood) and moving that through the Jing Luo (highways of blood vessels, capillaries and lymphatic networks of the body). (Read more on Qi, Blood, Merdians). Occasionally there are anecdotal stories of patients having miraculous responses to Acupuncture, but that is an exception and not the rule.
As a majority rule, Acupuncture is a course of treatment, not 1 x single treatment.
Usually in the clinic I mention to patients that the first 1-4 treatments are an observational and response phase. This is where we look at how each individual is responding to Acupuncture. From this we can work out how to structure the course of treatment, or when someone needs each session. In the beginning phases, people might need to get Acupuncture once a week or twice a week, depending on how severe the symptoms are.
The length of time people require treatment is also largely related to how long the type of imbalance has been going on for.
As a general rule, if we are talking about back pain, the less time that patient has had that pain, the quicker the patient should see results. But it is still based on each individual’s response to the treatment.
So lets break that down into a simple formula:
Length of treatment = How long the disorder has been going on for + Type of disorder + Individual response from each patient + limiting factors such as re injury or emotional stress and work.
These factors will greatly influence how the Acupuncture works.
So in essence, as far as I’m aware, we have a “response and observation phase”.
And then a second treatment phase where we provide a “prescription” of treatment, which usually centres around how many treatments per week there will be and when the reassessment point is, in regards to the goals which are set (eg less pain and more mobility).
That doesn’t mean we don’t have some immediate observations in the clinic. Some patients might report immediate subjective changes to their pain levels and well being during and following treatment.
But these are only some factors that should be considered whilst considering treatment phases of Acupuncture.
Another important aspect of Acupuncture as far as the treatment phases are concerned is client/patient commitment to the prescription.
A large aspect of reaching the desired end points of treatment is that the patient understands the limitation of Acupuncture if they don’t receive an appropriate amount of Acupuncture treatments (remember that repeated stimulus = physiological changes).
Think of it as a sort of team work.
The practitioner has the training and skills to provide the insight into what might be needed and provide the application of Acupuncture techniques based on years of training and continued professional development. The patient also provides the commitment that they will commit to treatment that either proves or disproves whether Acupuncture is right for them.
As Acupuncturists, we have a duty of care to be honest and transparent to patients about what we understand to be the appropriate treatment schedule, which is based on the current scientific evidence available and the clinical experience of each practitioner.
We have to be upfront to clients and patients if we feel like we have reached our limitations with what Acupuncture and Chinese Medicine is capable of, or if we are not seeing the desired effects. In that case, we need to refer to another specialist.
So, in conclusion, Acupuncture and the results we might see in Acupuncture are not just dependant on the experience and skill of the practitioner, they are reliant on both practitioner and client working together, in a goal to reach the desired end point.
Acupuncture and Chinese Medicine is a marvelous framework handed down to us over thousands of years through clinical trial and error.
But it takes time, patience and teamwork to find whatever benefits await at the lighter end of the tunnel.
There’s an African Proverb that says it well:
Thanks for reading.
Acupuncturist and Chinese Medicine Practitioner in Hobart Tasmania