What to expect at your acupuncture treatment – Before, During and After

Well you’ve done it!  You’ve finally considered acupuncture, or maybe you’ve even booked your first appointment.  Now what?  What is the appointment going to be like?  Will the needles hurt?  Do I just walk in and someone starts poking me??  Every acupuncturist and their office of course will be different, but here are a few things that are likely to happen when you come in for your first appointment:

1) Checking-in & First visit

Really similar to a doctor’s appointment – you arrive 15 minutes early to fill out paperwork, settle in, and let your body calm down after you’ve just sat in traffic or rushed there on the bus.  Your acupuncturist will greet you, take you back to a treatment room that looks similar to a massage therapist’s room or doctor’s office.  You can sit or lie down and the interview process will begin.

2) The Acupuncturist & Interview process

Perhaps similar to your doctor (or not), the acupuncturist will begin a lengthy interview process that may involve things you’ve never been asked before!  Let’s say you’re coming in for back pain – we will ask specific questions about the pain, like when did it start, and how long you’ve been experiencing it, quality of the pain, but then we will ask a series of other questions to get a general idea of your lifestyle and constitution.  Some of these questions will be about sleep, work habits, eating habits, urination, bowel movements, etc.

You might ask, “Why would you be asking me all of these questions if I’m coming into for something completely unrelated?”  In Chinese medicine, we believe that all factors contribute to balancing an issue, so if you have back pain for example, other lifestyle or constitutional factors may play a part in why you are experiencing this pain and it will not heal.

3) Checking the Pulse, Tongue & Palpating

If you come to see an acupuncturist, they will put their fingers on your wrist and feel your pulse, ask to look at your tongue and maybe do some other palpating (which means feeling around your abdomen, limbs, back or anywhere else they feel might need to be checked).  The tongue body, color and quality, similar to the pulse, give us indications of things that are going on inside the body (sooo cool!).  Same with palpation – doctors will sometimes do this if they are feeling for specific organs in your abdomen for example – but we might do this to check for temperature or other qualities that help us figure out your case.

4) Treatment begins!

After we asked you a million questions, checked your tongue & pulse and felt around for anything else that’s important, we will decide what we are going to do, and then begin.  You will be lying on a table, either face up, down or on your side, and the acupuncturist will begin to insert tiny little needles.  40 or so acupuncture needles can fit into the size of a hypodermic needle, pretty cool!!  We might also do a little cupping, massage, gua sha or rub some topical herbs to help you.  We will leave the room and let you rest with the needles in – it may not sound like it, but it’s actually very relaxing!

5) Sensations of acupuncture

Some sensations you might feel as the needles are going in could be a like prick or poking sensation (NOTHING like getting your ears pierced), soreness, itching, aching, or like someone is pulling at a tiny little spot in your skin or muscle – sometimes you even feel nothing at all!  It’s best if you can relax and drift off into a meditative-like state, and if you are unable to, ask your acupuncturist if they can adjust anything.  Hey, it’s your treatment, so you should be able to be comfortable!  The body will heal faster and more proper if you can be at ease.

Sometimes also depending on where you are at that day – let’s say you had too much caffeine, or didn’t sleep well the night before, or for women if you are having a menstrual cycle, you may feel more sensitive that day.  It’s always a good idea to eat a little before the appointment – don’t come in on a completely empty stomach, especially if you have a morning appointment.

Lastly, you may or may not feel some strong or strange emotional sensations.  An acupuncture session can be very vulnerable – you have just told this person you don’t know all these intimate details of your life, and then they poke you!  It’s completely normal to feel like you want to cry or laugh or feel anxious, and perfectly normal if you feel nothing at all!  If anything at all makes you feel uncomfortable, or it’s too much or too fast, please tell them – if the person you are seeing will not adjust the treatment so that you feel good when you leave, maybe think about finding someone else.

6) Length of treatment

You will lay on the table for anywhere from 20-60 minutes, depending on your condition and what your acupuncturist thinks is best for you.  A longer treatment Is not always better, it really varies on a case-by-case basis.

7) What to expect afterwards

After checking to see if you’re ready, we pull the needles out afterwards, and there is usually little to no sensation, but there might be a soreness or itchiness (or some other sensation) afterwards.  It is rare that there is a little bruise or bleeding, but it will go away, and there is nothing to worry about if there is.

We recommend you don’t shower or get into water a few hours afterwards, only because you have been made vulnerable and we want to keep you warm, cozy and safe to keep that healing process going.  This could also include, no major workouts right after, or stressful situations (like don’t head straight back to work and immediately delve into that horrible project your boss has been bugging you about for weeks).  You usually will feel an “acu-buzz” right after, you might just feel a little sleepy or spacey, and that’s pretty normal.

8) Follow-up 

Make a treatment plan with your acupuncturist!  Think of what you want as an end-goal (like “I want to be pain free”, or “I want to be able to sleep through the night”) and talk with your acupuncturist about it so that you both can have clear goals of what you want to see happen.  With chronic conditions, progress can be slower, but that means it will be longer lasting.  Every condition is different, but I think 3-4 visits is usually a good starting point to see if you and the practitioner are a good fit.  If you feel like it is not, ask them for a recommendation for someone else! We usually have a great network of other providers who have specialties, and it’s not offensive to want to get the care you deserve.


Why we do what we do.

The last couple of months have been challenging, both emotionally and physically.  Grad school is definitely a marathon, you do the best you can day by day, and try your best to tell yourself why you are doing things.  I have always been a mover and a shaker; I like to get one project done and move on to the next (so satisfying!) but working on a skill like this really takes a lot of time and practice.  You may not necessarily want to think of all the practice hours your acupuncturist had to put in before they touch you and poke you with needles, but aren’t you glad they did?!  This medicine sometimes reminds me of when I began baking gluten-free goods.  I would try to make everything healthy – take out the sugar, add applesauce.  Take out the flour, add broccoli.  No eggs, make chia seed eggs.  Pretty soon all my sweet friends at every birthday party were wondering if I was going to bring some weird chocolate covered broccoli concoction that tasted… well, let’s be honest, like chocolate broccoli.  But now that I’ve had a few years of experience, my friend’s responses are going from, “Mmm, this tastes healthy,” to, “This is amazing!! What IS this?!”  It took a lot of broccoli cakes to get there.

So, back to my original topic.  A question I ask myself when I feel like I don’t know what the heck or why the heck I’m doing something is, am I doing it because it brings immediate joy?  No way man.  I would say that often I do things because the benefits come later, and it’s difficult to try and remind myself of that, but I need to in order to keep motivation.  I try not to do things because I feel like I should do them, but because I remind myself of the feeling that I know will come later if I am diligent and keep with the process.  Eventually, I began to enjoy the process too.  At one point it was something like, “eat veggies = tastes yucky = feel good”  to now “eat veggies = mmmmmm = feel good!”

With the state of the world right now, the huge amount of stress we put ourselves under as humans, practices such as these (yoga, walking, qi gong) are just constant reminders for us to come back to our body.  We create a quiet space in our day for peace and calm and to REWIRE ourselves.  Meditation, cooking, getting acupuncture, doing tai qi, walking your dog…there are so many ways to get there.  (Heck, even baking gluten-free cake!!  It might not taste as good as your “normal” cupcake, but you can guess that in an hour you won’t feel like crap if you make that decision now).

It’s also funny how we twist ourselves up all day, physically and mentally.  You realize when you’re sitting at work all day, you’re training yourself to stay in this hunched, crunched over position.  You realize that when you’re being negative about your state or talking poorly of your neighbor, that you’re spending all of your energy on that?  Eknath Eswaran said in Words to Live By:, “Destructive desires thrive on talk too; the more we talk about them, the stronger they get.”  The more energy you are putting in your body by external means, means that THAT stays in your body, mind and heart, and it takes just as much time to undo that as it does to do it.

Think about what you can do today for the elongation of feeling GOOD.  I mean, even walking takes practice – think of yourself as a baby, learning to crawl, learning to walk. Practicing that muscle, tendon & sinew memory over and over so that you can actually hold yourself up.

Now, how does this apply to acupuncture?  If you have just been in a car accident or traumatic event – your body is tense and frightened, all the nerves are shot, the sympathetic nervous system – fight or flight – is in full mode.  How can we deprogram this?  With acupuncture, we are using needles to send signals to the body that say, “Hey, everything’s okay, you can relax now.”  After you do that enough times (sometimes even once) the body responds and starts to reprogram itself.  That is why acupuncture can treat SO many different kinds of things: digestive issues, trauma, burns, acne, depression, anxiety, pain, dizziness, and so much more.

As far as these other practices go – yoga, Qi Gong and walking for me in particular – I do these because they help me to deprogram from so many things that I get knotted up over during the day.  From sitting too long, from driving too much, from hearing too many bad things on the news and not breathing enough, to stress.  When I feel overwhelmed and don’t want to do them, I remind myself of why I’m doing them, to reap the goodness I feel physically and emotionally, to send that energy out into my community that hopefully emanates peace and love.  I practice for myself and for you!  I challenge you to do the same.

xo, WD


When to see an acupuncturist.

I hear this all the time – “What do I even go see an acupuncturist for?”  Acupuncture can help with a long list of things that ail you – as you probably noticed if you’ve gone to an acupuncturist’s website (like my friend Ryan) and they’ll tell you they can treat anything from:

  • Acne
  • Depression and anxiety
  • Musculoskeletal pain, such as hip, low-back, or ankle pain
  • Traumatic injuries or post-surgery healing
  • Headaches
  • Menstrual issues and PMS

And this is just a fraction of them!  How is this possible?  Do you feel overwhelmed and confused yet?

I like what Michael Max said in one of his Everyday Acupuncture podcasts, “You can’t touch one thing without touching everything.”  What does that mean in terms of acupuncture and herbal medicine?   Craig Mitchell, the Dean of the Seattle Institute of Oriental Medicine (also an acupuncturist & herbalist) gave a great example in this podcast of a patient he was seeing who was coming in for chronic headaches.  The patient says to him after a couple visits, “Well you didn’t help my headaches, but I didn’t realize I was having frequent abdominal pain and now that’s gone.”

It’s like peeling an onion (excuse my poor metaphor!) for your body on its healing journey – you peel off one layer and another appears, and you just keep peeling!  This doesn’t mean it’s endless, it just means we might hit a few layers before we get to the good stuff.

Let me get real with you here for a minute and tell you a story:

This year I was having a really odd stabbing pain on my left side.  It would come on at the weirdest times: when I was lying flat on my stomach, if I was sitting in a chair for too long, and it eventually got so bad that when I was walking, with each step I took, it was another stab into the front of my abdominal wall.  If you looked real close, a rib seemed like it was poking forward a bit… did I break it during a massage training class??  Was I really pushed so hard in the mosh pit the week before and didn’t notice it (this actually happened)?!  Injuries like this can sometimes actually be very subtlety acquired.

I didn’t know what to do, so I saw a Naturopath, a massage therapist, and talked with various people about it.  The consensus was that I either had a rib or vertebrae out of place, that I had a hairline fracture on my rib, that my spleen was enlarged somehow, maybe it was the Copper IUD… the list was too long and I had no idea who to see!  So?  I turned to acupuncture, because that’s what I do!

Without going into too much detail, my acupuncturist narrowed it down to a few things – I likely didn’t have a fracture, but my vertebrae and rib were out of place, but we couldn’t adjust them because there was too much pain.  She noticed my belly was very tight and she started working there.  After a couple of sessions and some herbs, she was able to ease up the tension in my abdomen so that I could finally lay on my stomach, and then she kindly put everything all the bones back in place using a cupping method.  CUPS!!  (I will write more on this later, because cupping is REALLY cool).  Suffering over!!

Acupuncturists will get a ‘full picture’ on your first visit, asking all kinds of questions that seem unrelated to what you’re experiencing like your menstrual cycle, what your bowel movements are like, how you sleep, if you’re sensitive to hot or cold and more.  You’ll think it’s irrelevant, oh but it’s not!  In fact, we are like Sherlock Holmes – the tiniest detail could help us solve the puzzle of your case!  It’s fascinating (and really fun for us too!)

Craig, in that particular podcast also asks about how many treatments are appropriate for a person.  Are 1 or 2 treatments enough?  “It’s a conversation you have to have with the practitioner,” he says.  Example could be chronic low back pain you’ve had for 20 years.  Craig says 4-6 treatments within a month, the back pain might not be resolved, but by that point both of you should get a sense of whether it will be able to help or not.  If you come in with a respiratory infection (something acute), it should clear up sooner.  “Healing from a longer term illness is a process.”

Lastly, TALK TO YOUR ACUPUNCTURIST.  Come on folks, if you haven’t figured this out yet, I’m ALL about communication!  TELL them if you liked it or didn’t and what your hopes and fears are.  Are you feeling skeptical that it’s not working?  It doesn’t really help us as healers much if you bail after a couple sessions and we have no idea why.  We usually guess that everything cleared up, or that you didn’t like it, but if we have a conversation about it, maybe we can adjust things for you.

Check out the Everyday Acupuncture podcast here for more topics related to acupuncture.  Also, comment below if you have any thoughts or additions to this post!