I have decided to provide this section for those of you who are new to my acupuncture style with the hopes that you can get a sense of what to expect during a typical treatment session.  While the details of a treatment session differ depending on the nature of the condition, general health, age, and even time of the day or season, the sequence of events during the treatment remain fairly the same; diagnosis, treatment, and homework.  Briefly, they are:

• Diagnosis – finding relevant facts through guided dialogue and hands-on palpation with the belief that a malfunctioning area is tender upon pressure.
• Treatment – inserting needles where they relieve the tenderness found during the diagnosis.
• Homework – incorporating life style changes and exercises for owning better health and eventually becoming independent of me.

Let us imagine two fictitious cases to describe what a typical treatment session may look like.  Patient Jane is in her early 30s with Premenstrual Symptoms (PMS) that consist of abdominal cramps, breast tenderness, and moodiness.  She also has a hard time falling asleep, but is otherwise healthy.  Patient John is in his mid 50s with a frozen shoulder problem in his right side, and is also concerned that his neck and hip joints are beginning to feel stiff in recent years.

Diagnosis

The beginning of a session is devoted to finding relevant facts to figure out what is causing the condition through physical tests and dialogue guided by me.  I use hands-on palpation extensively to gather diagnostic data with the belief that a malfunctioning area is tender upon pressure.  With Jane’s condition, because PMS is most likely caused by a hormonal imbalance, I may start my diagnosis by examining organs that are engaged in menstruation, such as hypothalamus, pituitary gland, thyroid, or ovaries, by palpating their reflex areas.  If the two acupuncture points on the eye brows are tender, then I suspect that there could be a degree of malfunctioning in the pituitary gland, for example.

Another area that I would also check for Jane’s condition is the spine, as the nerve impulses from the brain through the spine to body parts are often impeded in the joints of the spine.  For example, breasts are innervated by the nerve roots that come out around 4^th and 5^th thoracic vertebrae, and when the tissue in the lamina groove is tight, the nerve impulses can be impeded, resulting in improper innervation of the breasts and possibly undue tenderness.  For similar reasons, abnormal curvature of the lumbar area is often seen in women suffering from excessive abdominal cramps.  On a side note, having successfully treated patients with Premenstrual Dysphoric Disorder (PMDD), which is basically a severe form of PMS, I personally do not believe that suffering from PMS is natural; the human body is more elegantly designed than that.

For orthopedic conditions, such as frozen shoulder, it is necessary to pinpoint what tissues are causing the problem.  Is it the labrum in the shoulder joint not having enough lubricant?  Or, is it one of the rotator cuff muscles shortened, causing an imbalance of the shoulder joint?  It could be the shoulder blade not moving smoothly on the ribs, or a superiorly rotated clavicle jamming into the supraclavicular region.  As wacky as it might sound, a shoulder problem can even come from an uneven pelvis, or an old ankle injury.  Of course, an energy blockage in an acupuncture meridian can be the culprit.  More often than not, because the human body wonderfully compensates the malfunctioning of a body part by tweaking an adjacent body part, multiple malfunctioning body parts are present by the time I see a patient.  I borrow concepts and techniques from Western healing modalities to perform orthopedic assessment and to understand my palpatory findings because Eastern medicine simply lacks enough knowledge in this area.

Not all diagnostic discoveries are done with palpation alone, however.  A guided dialogue plays a critical role in fact finding.  We might discover that Jane always eats some ice cream before going to bed at night, and this creates an excessive amount of sugar in the blood, making her unable to relax enough to fall asleep quickly.  In John’s case, we might discover that his neck stiffness becomes worse whenever he sleeps with the windows open, or his hip condition can be improved faster by doing a qigong exercise everyday at home than with a weekly acupuncture treatment.

Treatment

Once the condition is correctly diagnosed, treating it becomes rather straightforward and fun; insert needles where they relieve the tenderness found during the diagnosis.  I lightly press acupuncture points that could relieve the tenderness with my finger, and insert needles at only the points that do indeed relieve the tenderness.  The location, direction, angle, and depth of the needle insertion are determined in this way using the degree of relief of the tenderness as a feedback measure before the actual insertion.  I do not guess where and how to insert needles.

After inserting the needles, typically between 1 and 20, I leave the patient alone in the treatment room for 20 – 25 minutes for the body to interpret the instructions dictated by the needles and react to them.  During this time, the body relaxes and the mind rests.  Most patients report of having either a floating or a sinking sensation.  It is not unusual for patients to fall asleep during this time.

The single most frequently asked question about acupuncture I receive is whether the needles hurt.  Well, the answer is yes.  After all, a sharp foreign object is going into the body.  But, because the needles are hair-thin and insertion past the skin nerves is so fast, the pain is either not experienced at all, or is nothing more than a very short-lived pinch.  That is why many patients fall asleep with the needles in.

After having the patient rest with the needles for 20 – 25 minutes, I will return to the treatment room to remove the needles and give tuina massage if necessary.  The type of tuina I do is similar to deep tissue massage; I locate where the energy blockages are, and penetrate my thumbs into the layers of tissues to reach the blockages and apply various techniques to remove the blockages.  While the acupuncture needles are wonderful at removing the blockages, I find that some types of blockages respond better to human touch; nothing can replace human hands.

While giving tuina, I will also assess the effect of the acupuncture treatment; reduced tension and tenderness in the previously discovered tender spots indicates that a healing effect has taken place.  I confirm this assessment with the patient’s report; Jane’s abdominal cramps may have subsided and John’s shoulder has a greater range of motion.  This gives me confirmation that my diagnosis and treatment approach are on the right track.

Homework

The second most frequently asked question about acupuncture I receive is how many treatment sessions will be necessary, followed by how often the treatments should be received.  This can only be intelligently answered after seeing how the patient responds to the first treatment.  If, for example, the condition improves by 30% with the first treatment, then a few more treatments may clear the condition.  If the condition stays better for 4 days, but starts to decline on the 5^th day, receiving treatment every 5 days would be the most economical way of maintaining the healing momentum.  For this reason, I ask my patients to make a mental, or better yet, a written note of how the body reacts to the treatment and how long the treatment effect lasts in measurable terms.  This serves as valuable feedback for fine tuning the current approach, or choosing a new approach.

While it is my responsibility to guide the patients into health, it is the patients’ responsibility to own their health.  The treatment does not end when the patients leave the clinic.  For Jane, she needs to be watchful of eating ice cream before going to bed, and massaging acupuncture points I showed her whenever she can.  For John, it is closing the windows before bedtime, and doing the qigong exercise I showed him.  Such participation and ownership is of paramount importance in owning one’s health and eventually becoming independent of me.

In Closing

I hope that I have given you enough description of how I treat my patients to put you at ease.  To summarize, I emphasize hands-on palpation for diagnosis, treatment, and assessment of the treatment, tuina massage for deeper release of energy blockages, and patient education for ownership of their health.  If you get a sense that I may be of help for your health concerns, please feel free to contact me.  I will be glad to provide my services to you.