What should I expect at my first acupuncture session?
February 18, 2015 6:47 PM   Subscribe

I won't get into the whole story, but a doctor who I trust recommended acupuncture to help with the horrible muscle spasms I'm having in my neck. My first appointment is Friday. I've never had acupuncture before so I'm not really sure what to expect. Can you tell me what it will be like? All I know is that I'll be stuck with needles. I'm not nervous per se, but I would like to feel prepared.
posted by radioamy to Health & Fitness (23 answers total) 4 users marked this as a favorite
 
You will have to answer a lot of questions. Answer truthfully. They will look at your tongue. It's an overall health thing. You will then be put in a quiet room that is the perfect temperature and yes, needles will be stuck in you. Sometimes it doesn't feel like anything until after, when you feel better and sometimes you will actually feel a warm energy. If it hurts or is uncomfortable, they are doing it wrong and you must speak up. Once the needles are in, you will be left alone for about 30 minutes. After the needles are removed, you will get the sales pitch for everything that you must buy to improve your health. You may be offered tea. Don't buy anything right away. You are super relaxed and a hard sell is a dead give-away that you are in a place that you should not return to.
posted by myselfasme at 6:59 PM on February 18, 2015 [2 favorites]


Based on my experience of getting acupuncture for one year:

Wear loose/comfortable clothing. You'll probably lie down (either face down or on your back, or the doctor will have one part of the treatment where you're lying on your back and another where you're face down) in a quiet room. Then the doctor or acupuncturist will put very fine needles on various areas of the body, occasionally twisting the needles after they are inserted. The location of needle placement may not always correlate with where your pain is located in an obvious way, because the goal of acupuncture is to redirect energy flow (through meridians) across the body-- so for example, when I had skin problems, I had acupuncture on my ears.

The needles themselves don't hurt, but I was sometimes sensitive right at the moment they were inserted-- I think it's more of a mental thing than a physical thing, though.

Then the doctor usually leaves the needles in for around 10-20 minutes; sometimes they dim the lights or play very quiet, meditative music. Relax and close your eyes. The doctor will come back in to the room and remove the needles after a bit.

Enjoy, and hope your neck feels better soon!
posted by gemutlichkeit at 7:07 PM on February 18, 2015


I was really skeptical the first time.

Yes, they will ask you questions about physical and mental health, lay you down and make sure you are warm.

When people say 'they stick needles in you' it's not like you are getting big ol' injections everywhere, it feels more like a light flick on your skin from someone's finger more than it does a 'prick', if it feels like anything at all. You more feel the pressure of the acupuncturist's fingers than you do anything else. And this comes from someone with a relatively low pain threshold and a fear of needles. It was no big deal.

You'll have to then lay there for a while after the needles are in (which might take five or ten minutes). You might fall asleep. You might be wired. I actually fuckin' cried, which is so ridiculous, because I am the least woo-woo new age-y person you could ever meet, but it brought something out in me that I still don't understand. It wasn't so much emotional as it was just a release of some kind. Very strange, but not unpleasant.

I have only done it the once, only because I haven't had the time or wherewith all to go again. And I'm not sure it had any real effects, but it certainly had enough of an impact to bring on tears, which leads me to believe that there may be something there there.
posted by greta simone at 7:12 PM on February 18, 2015 [3 favorites]


I had acupuncture for migraines.

I think that it's bullshit, but even thinking that -- I thought it was kind of, well, nice. Apart from the atmosphere designed to be as relaxing and comfortable as possible, the needles are incredibly small, and I even liked the feeling of being pricked with them. It doesn't hurt like a shot, or accidentally poking yourself with a sewing needle. Seriously, they are tiiiiny.

You should definitely be aware that the hard sell is a thing that some places engage in. Not all -- if this place tries to give you the hard sell, you should find another. It's not an inevitable part of the experience.
posted by Kutsuwamushi at 7:22 PM on February 18, 2015 [1 favorite]


I have never had any type of sell, hard or otherwise, at my acupuncturist. I'm not much for alternative medicine in general, but my voice teacher recommended it to help reduce tension in my jaw and neck and it helped a lot for that. It also did a lot of good for my TMJD, not incidentally.

I didn't think it hurt at all. However, I did get a vasovagal response the first time I had it, which would have freaked me out had I not already known I was prone to them anytime I get poked with a needle (I get them when I get tattooed or when I give blood, so I was expecting it). If you get vasovagal responses like I do, that might be something to be aware of. It certainly didn't bother me so much that I didn't go back numerous times.
posted by holborne at 7:41 PM on February 18, 2015


Both of the acupuncturists I have seen structured their appointments exactly the same way. (I think they actually had gone to the same acupuncture school, so your experience may be quite different if you are in a different area.) On the first appointment, they take a long time to discuss your health history, current and past health issues, etc, just like you wish your regular doctor would do if they weren't limited to 10 minute appointments. One of them looked at my tongue, the other one cared more about feeling pulses and checking reflexes -- regardless, I'd expect some gentle poking and prodding of some sort, and then you discuss their diagnosis and treatment approach.

Then for the acupuncture part you are told to lay down either face up or face down, and they poke some very, very thin needles in you. I can barely feel them go in and there is definitely no pain, though sometimes the needle sites get a bit achy or feel hot. Then you lie there for a while, usually with a soothing/annoying new age CD playing, in a dimly lit room until they come back, remove the needles (also no pain) and then you make your next appointment and go home.

Sometimes they suggest herbs and supplements; it's up to your relationship and trust with that person whether you agree that it is a valid part of your treatment or an additional profit center for their practice.
posted by Dip Flash at 7:58 PM on February 18, 2015


I am an acupuncturist, but IANYA:

Of course, you should ask is the acupuncturist who you are seeing, they are used to answering this question and can quickly and reassuringly tell you the plan for the session. You can also ask them about their expectation of results (after you tell them your history and they get a chance to assess you). Some acupuncturists' style allows them to have best results directly after the treatment, some the results are better the next day, and for some everything gets better. Based on the information you provided, so it will likely take several treatments to get the full results.

As for what it could feel like when the needles are in, some people feel each needle go in and some only feel some of them. The first sensation with the needle can vary from a sharp poke to a flick to a pressure but some people cannot feel anything. Then you may feel a zing or a pull or a heaviness or a lightness or a numbness or again nothing. What you don't want is the zing or pain or a nervy sensation to last - most likely if you feel something uncomfortable that does not go away the needle is just near a skin pore or sitting too close to a nerve. Moving the needle even a millimeter can make the difference, so do tell the acupuncturist if something feels wrong after the initial insertion. For most people the needle sensation goes away quickly, sometimes it is reactivated during the treatment because of a movement or sometimes the patient will feel different sensations moving through the body. If you are a person who does not like unexpected body sensations, this can be disconcerting. But now you know that you may feel things (electricity, lightness, heaviness, high) or do things (like laugh or cry or burp or twitch) and that is ok.

There are some minor but real risks: You may get bruised. If they use heat, you may get burned. And like holborne, some people do have a strong response to all needles (again that usually decreases over time). But the amount of sensations or even a bruise you get during a treatment do not necessarily correspond to the effectiveness.

There is nothing you have to do (unless instructed), or think, or believe that will affect the outcome of the treatment. That is why animals and children are able to have acupuncture and have results. (You can even spend the whole time thinking "this is stupid" and you would not "mess up the treatment" or change the results but wouldn't it be nicer to just take a nap.)

Some acupuncturist will ask for feedback and some will not.

- If you are seeing someone one on one, then you will be left laying in a room by yourself after the needles have been placed or the practitioner could stay with you. You may be there for 5-45 minutes.

- If you are in a community clinic, you will likely be sitting in a chair near other people also sitting in chairs, again for 5-30 minutes.

It is very likely that you will be offered some herbal medicine as well. Treating pain with just acupuncture is unusual and not as efficient or effective as adding in herbs. It is a 2000 year old medicine and the tradition is varied. You may be offered some additional treatments for pain that include patches or liniments or something that you take internally. Tooth from the Tiger's Mouth by Bisio is my favorite book for both learning how to treat injuries and for patients that are more interested. You do not have to do anything, including the herbal medicine, but it will likely speed the process and help the pain between treatments. If money is a concern, you just need to explain that and the practitioner will recommend something in your budget or help to prioritize.

Afterwords, most folks are calmer but some do get a lot of energy after the treatment. So be prepared to move slower and drive slower and maybe even feel a little high. If you need to rest a little after, that is ok, too. Drinking water and sitting can help with this. But if you do not have that experience, that does not mean your neck will not have improved.

Do let your acupuncturist and us know how it went.
posted by mutt.cyberspace at 8:56 PM on February 18, 2015 [4 favorites]


I've had acupuncture from multiple practitioners. In terms of preparation, I would say that the biggest thing is to be ready to not to be able to move very much while the needles are in - have kleenex ready if you have a runny nose, for example.

I'm not sure if this is uncommon, based on other reponses, but all the actupuncture I've had involved the needles being hooked up to wires that created electrical pulses. It was occationally uncomfortable when I was being treated for muscular problems, but it shouldn't be painful.

The issue I had when I first started was extreme fear of having needles inserted in my head, but it turned out to be fine, and not painful at all or as strange as I thought it would be.
posted by delezzo at 9:03 PM on February 18, 2015


These are great answers so far, thanks!

So after he puts the needles in and leave then room, I just...lie there? I'm pretty bad at doing *nothing.* Am I allowed to listen to a podcast or something? Or am I supposed to meditate? Is it okay to fall asleep?

For those of you who have had acupuncture for muscle pain and felt it was successful, how long after treatment did you feel like it took to take effect? I think he said he's probably see me for 4-6 sessions. Should I expect relief after the first session?

How common is it to get an upsell for herbs or whatever? I come from a heavily scientific background (my dad's a doctor) and I am only trying acupuncture because I am out of other options and it was recommended by my neurosurgeon. I'm not sure I can handle the upsell.
posted by radioamy at 9:19 PM on February 18, 2015


For me, the needles sometimes hurt when first put in, but it soon fades.

The first acupuncturist I saw would first give me a massage if she was doing my back.
posted by brujita at 9:24 PM on February 18, 2015


So after he puts the needles in and leave then room, I just...lie there? I'm pretty bad at doing *nothing.* Am I allowed to listen to a podcast or something? Or am I supposed to meditate? Is it okay to fall asleep?

They may put on music, you can also ask to listen to a podcast. I've done both. Honestly though I'm terrible at doing nothing, and that is why I love it - it forces me to sit still for 30 minutes. It is awesome. Falling asleep is fine - go for it.

For those of you who have had acupuncture for muscle pain and felt it was successful, how long after treatment did you feel like it took to take effect? I think he said he's probably see me for 4-6 sessions. Should I expect relief after the first session?

I felt drugged after my first session. I tried to go back to work - terrible idea. Plan to go home and relax after the first session. I'd plan to go see the acupuncturist not as a cure-all, but as a way to maintain health - so maybe plan to go indefinitely.


How common is it to get an upsell for herbs or whatever? I come from a heavily scientific background (my dad's a doctor) and I am only trying acupuncture because I am out of other options and it was recommended by my neurosurgeon. I'm not sure I can handle the upsell.


It could happen, just politely say 'no thanks.' You don't need to explain why.
posted by Toddles at 9:28 PM on February 18, 2015


I've had acupuncture for a spasming piriformis muscle causing sciatica problems. For me the first treatment probably halved the pain/spasms, second treatment cleared up most of the rest, and a third treatment finished it off. (I've also had acupuncture for tendonitis).

As others have said there might be a momentary discomfort when the needles are inserted. I barely feel most of them, though some of them feel a little weird, but not painful, while I'm resting. I frequently fall asleep before the acupuncturist comes back to remove the needles. The first time I had acupunture I fell asleep for 6 hours after I got home, but I've been less tired each time after.
posted by kbuxton at 10:34 PM on February 18, 2015 [1 favorite]


I don't know how useful it is to frame herbs as an upsell. Herbs are part of traditional Chinese medicine, which is the acupuncturist's treatment domain. It's like saying "sure, go to the MD, but beware the antibiotics upsell." If you don't want herbs, that's fine, but being offered some is just a part of traditional Chinese medicine, and thinking about it like its an opportunistic thing might unnecessarily color your perception of the experience.

I've had acupuncture a few times and always declined the herbs, for what it's worth, and the practitioner never made me feel uncomfortable about it. And I think listening to a podcast would be fine. Falling asleep is great too.

I hope this experience helps with your pain; it might help relax you a bit to check out the World Health Organization's pdf about acupuncture; they say that it is a very effective analgesic, better than placebo when treating most kinda of pain, and nearly equivalent to morphine when treating chronic pain:http://apps.who.int/medicinedocs/pdf/s4926e/s4926e.pdf
posted by feets at 12:44 AM on February 19, 2015 [2 favorites]


I am not an acupuncturist, but I am an osteopath who sometimes uses dry needling to reduce muscle tone and pain. This means I don't know anything about meridians, but I have some idea about the neurological effects that take place when we put long thin spikes of metal in people.

Because pain is incredibly complicated, this is an oversimplification, but here is my usual quick intro into what happens.

Locally, the needles trigger a histamine reaction, which is often visible as little red wheals. These are due to the increase in local inflammation.

The next most obvious effect is on the nerves that carry nociceptive stimulus, one thing that can be interpreted as pain in the brain. These respond broadly to tissue damage, and there are two main types of nerve fibre, one thick and one narrow. Have you ever trodden on some logo in the middle of the night? First you get a sharp searing, shooting pain, followed by a slow creeping, sickening pain spreading up your leg. These correspond to the signals carried by the thin nerve fibres (which carry messages relating to sharp trauma) and the thick fibres (which carry messages relating to dill trauma).

We are hardwired to override the dull sensation with the sharp sensation. The dull sensation is that produced by tight muscles, as well as all sorts of other things. This means that by putting in the needles, the muscle pain is temporarily blocked. Often, the muscle tightness/pain cycle is self-reinforcing, as muscles tend to tighten in response to painful stimulus

So taking away the pain, can relax the muscles, but interrupting this cycle can lead to lasting, relaxed muscles.

There are other effects, but these are to do with effects in the peri-acquaeductal grey matter and down going pain pathways, and since all of these effects are post hoc ergo proper hoc, I won't go into them for now.

Finally, using dry needling is frustrating for me as there is a strong divide between 'good responders' and poor responders'. This means that people who have had previous good responses, probably will again. And those who haven't probably won't. So the first time to try it can be a let down. I will say that the times it appears to have a better chance of being effective is in real tight muscles, spasm and protective alike.
posted by fizban at 2:00 AM on February 19, 2015 [4 favorites]


I don't know how useful it is to frame herbs as an upsell. Herbs are part of traditional Chinese medicine, which is the acupuncturist's treatment domain. It's like saying "sure, go to the MD, but beware the antibiotics upsell." If you don't want herbs, that's fine, but being offered some is just a part of traditional Chinese medicine, and thinking about it like its an opportunistic thing might unnecessarily color your perception of the experience.

The first acupuncturist I saw made the herbs feel like a clear upsell rather than an integral part of the treatment so I said no; my current person does not and if they suggest herbs at some point I would be inclined to say yes. I've said no to drugs at the doctor's office before as well; not everything is as clear as antibiotics, unfortunately.
posted by Dip Flash at 4:37 AM on February 19, 2015


You should plan to take a nap or listen to music with no words. Usually the music is provided. If you are having trouble relaxing or feel fidgety tell the acupuncturist and he/she will tell you what to do (breathe in and out slowly or focus on something or count).

And, until you are assessed no one can say how long this is going to take. It could take one treatment or it could take 6 months. You won't ask the car mechanic to make an estimate without seeing the car.
posted by mutt.cyberspace at 9:34 AM on February 19, 2015


There are a few different types of acupuncture, and the styles bring variations on technique. Traditional Chinese acupuncture (tcm) practitioners will leave the needles in for 20-60 minutes. I brought headphones and asked to turn the lights down to help me relax. 5 element practitioners are more present in the session, and it's just a quick prick. I've tried both for long term medical treatment and have had more success with 5 element, though both were effective.
posted by Kestrelxo at 1:22 PM on February 19, 2015


Interesting. The acupuncturist I saw was a MD/PhD (who was Chinese, but not exclusively educated in China), so even though I suppose acupuncture is relegated to the realm of "wooo!" and "new age" treatments, I think it works often enough to give it a shot (I guess this is why the US has established the National Center for Complementary and Integrative Health... these things are, at minimum, worth researching, it seems). Then again, I grew up with Chinese medicine in the household and so I didn't regard acupuncture and the rest of TCM as something entirely foreign until I entered medical school, where it was presented in the curriculum as a more of a "new age" sort of thing.

Anyway: I believe that my doctor ended up suggesting that I modify my diet a bit, but in general I didn't feel too pressured to buy any of his herbs. Maybe if he ends up encouraging you to purchase herbs, you can instead ask about any dietary or lifestyle modifications he would suggest you try out first? Diet is a big part of TCM as well.
posted by gemutlichkeit at 1:39 PM on February 19, 2015


For those of you who have had acupuncture for muscle pain and felt it was successful, how long after treatment did you feel like it took to take effect?

I had acupuncture for a soft-tissue injury that was causing chronic low-level pain. I could deal with the pain OK except that I couldn't sleep with it, I'd have to take painkillers at night. I don't know if this is in any way similar to your muscle pain.

I was skeptical as hell, but went along after a musculo-skeletal specialist essentially told me he had no idea what the actual problem was and had no way to treat it.

I found the acupuncture produced almost immediate relief, which would last ~1-2 weeks. Then on the 6th or 7th session when the acupuncturist was 'twirling' the needles, one of them produced a sudden twinge, almost like a very mild electric shock. That session produced a permanent fix.
posted by HiroProtagonist at 6:03 PM on February 19, 2015


Yes, bring your phone pre-loaded with podcasts of your choice and listen away. No point lying there uncomfortably undistracted if it doesn't work for you!
posted by bluebelle at 7:55 PM on February 19, 2015


I've had it on and off over the years for upper back tension and one thing: don't be surprised if it hurts MORE the day after. Ask specifically about after care (hydration, exercise, nutrition) and what you can expect afterwards. More sensitivity is par for the course after the first few visits.
posted by kinetic at 5:49 AM on February 21, 2015


Thanks for all the info everyone, I definitely went in feeling prepared!

He had told me to wear whatever I wanted as long as he could access my hands and feet, but since I was working from home in comfy clothes I just wore that, which was good because it can be a little uncomfortable to lie down in jeans for 30+ minutes.

This guy seemed very low on the woo-scale. Explained things in very scientific terms, didn't push any herbs beyond recommending I pick up one supplement at the drugstore. Said he has helped a lot of patients like me (many who were recommended by my neurosurgeon), and that we'd know in 4-6 treatments if it was working.

I had my phone and earbuds and asked if I could listen to a white noise app and he said that was fine. It definitely helped relax me, I think I would have been too anxious without it.

A few of the needles were painful but the pain subsided pretty quickly.

I felt a little light/floaty afterwards. He said that I should feel changes in my pain over the next few days, which I have - some better, some worse, some moving into new places.

Here's to hoping that the next few sessions produce significant results!
posted by radioamy at 10:57 AM on February 22, 2015


Just wanted to give another follow-up. After about 5 sessions I noticed significant improvement! This was in line with his estimate at the first session of 4-6 sessions. Still going to acupuncture and still improving. Thanks again for all your reassurance.
posted by radioamy at 10:36 AM on March 22, 2015 [1 favorite]


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