Acupuncture Session: First Appointment, Sensations, Frequency and Preparing

First appointment

Expect conversation first. At a hospital pain clinic described by University College London Hospitals (UCLH), the clinician explains the procedure, asks if you want treatment, asks about your pain and general health, and examines you to find tender areas. [1] Cleveland Clinic similarly says the acupuncturist talks with you about your condition and then examines your body for areas that will respond. [2] For consultations in the traditional Chinese medicine style, see TCM consultation.

Be ready to say whether you take blood-thinning medicine such as aspirin or warfarin, have a pacemaker or other implant, may be pregnant, or have had a change in your health. [1] The NHS adds that acupuncture may not be safe with blood thinners, a raised risk of bleeding, or a skin condition or infection. [3]

Sensations and comfort

• Insertion. UCLH says the needles are very fine and most patients are surprised how little they feel; slight discomfort is possible, but acupuncture is rarely very painful. [1] Cleveland Clinic describes a small prick, less painful than a vaccine. [2]
• After placement. A warm, heavy sensation around the needle is common and is usually quite pleasant. [1] Traditional practice calls a composite of such sensations "deqi" and treats it as meaningful; whether it affects results is still being studied. [4]
• Needles. They are sterile, disposable and as thin as a human hair, and stay in for a few minutes up to about 20 minutes. [2]
• Speak up. Tell the practitioner if something hurts, you feel faint, or you want to stop. This follows from the risk of fainting, which UCLH lists as rare, most likely at a first treatment. [1]

Allow between half an hour and an hour for the whole treatment, according to UCLH. [1]

Treatment frequency

There is no single correct number. Cleveland Clinic says the number depends on your condition, how severe it is and how you respond, and that most people are seen once a week. [2] UCLH says treatments are normally weekly, that you may not notice any change until two or three treatments, and that most people need a course. [1] In one large trial of women with joint pain from breast cancer drugs, treatment was twice a week for 6 weeks. [5] NICE suggests up to 10 sessions over 5 to 8 weeks for headache prevention, if acupuncture is considered. [6] Those are examples, not a plan for you. Be wary of any practitioner who promises an outcome or a fixed number of sessions up front.

Preparing for a session

• Wear loose clothing, as you may be asked to expose the painful area or wear a gown. [1]
• Consider having someone with you after the first treatment, since you may feel sleepy; if drowsy, do not drive yourself home. [1]
• Bring a list of your medicines, and check insurance, since coverage varies. [2]

Discussing results and expectations

Ask what the practitioner is trying to change, how you will both judge progress, and when to stop if there is no benefit. Keep taking prescribed medicines, no matter how good acupuncture makes you feel. [2] Some people have a short increase in pain after a session, which UCLH says usually settles in a couple of days. [1] If you feel very unwell afterward, contact the clinic, your own doctor or emergency services. [1]

See also questions to ask before a session, what is acupuncture and licensing and training.