Optimal Frequency For Acupuncture Treatment

How often does one schedule acupuncture appointments? This is a question that comes up very often in my clinic. In fact, the answer is critical to an acupuncture patient’s ability to maximize benefit from any given course of treatment. Bob Flaws in Acupuncture Today writes, “Acupuncturists often say, ‘Acupuncture works!’ I would add, ‘Yes, especially if you do it often enough.'” (“Acupuncture and the 50-Minute Hour,” Acupuncture Today, October, 2007, Vol. 08, Issue 10)

Every week, I teach a 1 hour class for new patients entering our acupuncture program at the HMO I work for. I use a PowerPoint Presentation to share quite a bit of information. I spend a good amount of time during the lecture on this very point: frequency of treatment matters to the outcome. Often Western patients of acupuncture mistakenly believe they can get treatment in a haphazard fashion or infrequently and still reap a great benefit from the therapy. The schedule that is convenient is not always the one that is medically efficacious.

I strongly urge acupuncture patients to get their treatments done as frequently as possible at first, with the possibility of slowing down after a while. What is frequent enough? The standard of care in Chinese hospitals for the treatment of chronic pain conditions (the bulk of what I treat at Kaiser) is daily acupuncture for a course of 10 treatments. On the outside, it’s delivered every other day and in acute cases, up to 3x per day.

The first core idea around doing frequent acupuncture treatments is that the effect of acupuncture can accumulate if it is done frequently enough. We want to engage this accumulative effect in order to render long-lasting results in our acupuncture patients. Many times I have had patients return to my clinic and report that they received 1-2 years of great relief from their chronic pain condition after just 6 acupuncture sessions!

The second core idea is that in order to engage the accumulative effect one must prevent backsliding into pain (or other symptoms). A typical pain-relief result after just one acupuncture treatment is 1-3 days. Who is typical? Nobody! Everyone is a unique individual. Therefore I ask my patients to pay attention to their result so we can figure out their optimal frequency of treatment.

I’ll give an example. “Betty” comes in for a treatment of her chronic lumbar pain due to spinal stenosis. She gets 3 days of relief following her first acupuncture treatment. This means that her optimal frequency of treatment is 2 sessions per week with 3 days in-between treatments. If she adheres to “the standard” weekly treatment schedule, she will get relief for 3 days but for 4 days her pain (or other symptoms) will have a chance to get back up to their original level – or get worse. Then, we must start over again at square one.

Allowing one’s pain to backslide during a course of acupuncture treatment does not allow a patient the opportunity to build up momentum for healing and the optimal result from treatment. It is my belief that failure to achieve results with acupuncture has less to do with the practitioner’s protocols or time spent with each patient and more to do with failure to achieve a proper treatment frequency.

I had an opportunity to study with Dr. Richard Tan while attending the Five Branches University DAOM program. His opinion on this matter is that treatment frequencies are spaced differently depending on how long the patient is undergoing treatment. The first few weeks or the first month of the course may be every-other-day to 2x/week. Then, for weekly treatments for 4 weeks. Then every-other week for 8 weeks, or something along these lines. This makes sense to me because theoretically, we are achieving results for the patient and their interval of relief is getting longer as they move through the course of treatment.

In my clinic I do not have an opportunity to treat patients in an ongoing fashion. I am given a referral or two of 6 sessions of acupuncture for any given patient with any given chronic pain problem. So for my clinical setting it is critical that patients do frequent treatment in order to render rapid and long-lasting relief from my acupuncture treatments.

Acupuncture and Herbs for Heartburn and Indigestion

Many people experience heartburn and acid reflux from time to time. This happens when acid from the stomach washes back into the esophagus. When this tendency to have heartburn becomes chronic, and your doctor finds signs of erosion in the esophagus, this is an indicator of GERD, or gastroesophageal reflux disease. Acupuncture and Chinese herbal medicine can be very useful in addressing GERD and chronic cases of heartburn.

Chronic digestive upset and heartburn are often a result of poor diet, stress, and nervous tension. Acupuncture is very soothing and balancing to the nervous system. Specific meridian systems that are treated are the Liver, Stomach, and Spleen-Pancreas. Points connected to these organs and meridians are used to calm down the production of acid and to make the digestive system function more efficiently. Points that are stress-relieving are also included to address and to heal the nervous system.

Commonly used acupuncture points for treatment of heartburn and acid indigestion are Ren 12, Liver 3, Liver 14, and Pericardium 6. These points can relieve the stress and the sensation of stuffiness that are associated with GERD.

In terms of Chinese medicine, chronic heartburn is frequently a result of the Liver overacting on the Spleen and Stomach, which can produce Heat (acidity and inflammation). One commonly used formula for this disharmony is Free and Easy Wanderer Plus (Jia Wei Xiao Yao San). This remedy has the potential to relieve digestive discomfort while also addressing anxiety, stress, and nervous tension. It is a very commonly used remedy and it can address a whole host of complaints at once, if the formula is indicated based on a person’s tongue and pulse.

Another good remedy for acid indigestion and heartburn is homeopathic nux vomica 200c. Homeopathy works well in conjunction with acupuncture and herbs, for those who are open to it.

If you have chronic heartburn, it is also important to take a look at your diet and lifestyle. Really rich, fatty foods that are difficult to digest can aggravate the condition. In Chinese medicine, we also suggest reducing your intake of milk and dairy products. While milk may temporarily relieve symptoms of heartburn, in the long run we believe dairy products clog the digestive system, and cause more problems than they solve. Drinking coffee or an excessive amount of alcohol can also aggravate GERD. Spicy food can also be a problem for people who tend to have a great deal of heartburn.

Usually, with acupuncture and Chinese herbal medicine, people see a significant and satisfactory improvement in their tendency to have heartburn and acid indigestion within four to six weekly sessions.

Yintang – The Most Requested Acupuncture Point

Yintang is the most requested acupuncture point and is found in the middle of the forehead. It is an “extra point,” a class of points that are mapped but do not fall on a specific acupuncture channel. This point has a few different indications but the most common reason it is requested is because it calms shen. Shen is a term used in Chinese medicine that doesn’t really have an exact translation in English. Basically it refers to the aspect of us that is not physical, like consciousness and thought, and our emotional and spiritual being. There are many points that calm shen and they are used in a wide variety of conditions like anxiety, depression, and insomnia, even pain and shock.

Most acupuncture points have more than one indication and yintang is no exception. Like all acupuncture points it is valuable for treating local conditions such as frontal headaches. It also benefits the nose and can help when there is nasal congestion and discharge or sinus pain. I use it a lot in my practice, especially for stress and sinus allergies and infections.

The location of this acupuncture point corresponds to the third eye, a metaphoric eye in Hinduism and Buddhism that opens as our consciousness expands and we become enlightened. It is the location of the brow chakra, the 6th of 7 major energy vortexes that exist in our bodies, which has to do with inner guidance, mental clarity, and intuition. Even in western medicine this is an anatomically important location, where light enters the skull to activate the pineal gland. As darkness increases in the evening, the pineal gland is stimulated to secrete the hormone melatonin, which makes us sleepy. As the sun comes up and light increases, the pineal gland stops producing this hormone and we wake up.