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.


What is “normal”?

The word “normal” is a funny word in the English language – in the dictionary, it actually has multiple meanings.  The first definition states:

“conforming to the standard or the common type; usual; not abnormal; regular; natural”

I have my own opinions, of course, about how this word delineates a moral right and wrong, and can make people feel pretty crummy when used in a certain way, but my point here is to get how it relates to Western & Chinese medicine.  Another definition, which declares its definition for Biology & Medicine states:

free from any infection or other form of disease or malformation, or from experimental therapy or manipulation; of natural occurrence.” 

If you think about what that means in terms of medicine, a lot of people might not know.  It basically means that you’re not sick and in relatively good health.  And I feel when it comes to people’s health, this is a commonly unasked question by folks seeking healthcare advice.  For example one might ask, “is it normal that my knees are popping all the time?”  Or they’ll say, “It’s pretty normal that I get headaches all the time.”  Or maybe your shoulder pain has been there for so long, it seems “normal” now.

Look at these sweet little mushrooms doing their thing in the forest in Mindo, Ecuador!  Ok, sidetracked…but we were talking about what natural is!!  

“What’s it like for other people?” is another common one that I see people hesitantly ask, and also interesting, because we all want to know what other people are experiencing because we want a baseline for what we think our bodies should be doing.  A “norm”, a “natural state” of health – but what is that? One thing is that we are all different, and our norms and baselines can all be different.

I bring it up today because I think it’s a question that many adults are afraid to ask whoever they are receiving care from, because as an adult, you’d think we know all the answers by now, right?!?  WRONG.  And let me tell you why.

Here’s  a story of how we grow up with different “norms”:  Sally’s “normal” was being the only female in a family full of boys – mother passed away and her dad never taught her about shaving her armpits or legs, fart jokes were pretty common, and there was no shortage of diarrhea jokes from her brothers (you remember the diarrhea song, right?).  At a certain point, Sally starting getting stomach cramps, she just assumed this was “normal” because all the boys in the house were constantly farting and laughing and it seemed like it was funny and enjoyable to them, even though it wasn’t for her, so why ask?!  She ate what a lot of kids ate, or so she thought – chips, lunch meat sandwiches and Root Beer and would usually get stomach aches after meals that got worse throughout the day – she knew her dad was allergic to nuts, because he would break out in a rash on his arms every time he had them, and that was all she knew about allergies.  She never said anything to anyone because she just assumed having tummy aches and gas was “normal”.

Some of these “normal” things are influenced by society, culture and religion, and now of course, media.  But when it comes to this – what I ask for myself is, “What is a natural standard of health for my body that suits me at this time?”  I have conversations like this with my patients all the time, and it’s a conversation you shouldn’t be afraid to ask your health care provider.

Look at these natural little mushrooms 🙂

To me, a standard of good health or “natural” state of health is to NOT have headaches, to NOT be constipated or have daily loose stools, to NOT be bloated all the time, to NOT be moody, crashing daily and exhausted, and so on.  These are great things to consider in your life – does this resonate with you?  Are there a list of things you’ve always thought to be “normal” health-wise because a lot of people you know experience them and are just dealing with them or medicating them?  I have good news – this is something acupuncture and herbs can treat!!  Your body is an amazing machine that just needs slight tweaks to keep it running optimally and to support all of its other symptoms, and sometimes it just needs a little help to do so.

And now, one last cute little mushroom to get you thinking about nature some more…

**Please note: as with anything written in this blog, I am not a doctor, but am a student and write my observations based on my clinical training.  Always talk with your health care provider and decide for yourself what is best – I do not give out medical advice on this blog, only opinion.