Ask the Acupuncturist

For over two thousand years, acupuncture has successfully treated everything from cancer to mental illness to infertility to chronic pain with alternative medicine in patients both from the east and west.

What should I expect during my first acupuncture treatment?

Acupuncture is an ancient Oriental healing system that stimulates the body's ability to balance its “qi” and heal itself by the insertion of thin, sterile needles at specific points along the body's meridian system. Qi is the life force that flows along the meridians between these points, which are located within cell groups that have been shown to have especially permeable cell membranes. In biomedical terms, this means that chemical messages (qi) travel faster through those cells. Good health results when qi flows freely along the meridians; disease develops where qi is deficient or blocked.

An acupuncturist will form a diagnosis by taking a health history, including asking why you are there, looking at your tongue, taking your six pulses, and maybe pressing on your abdomen. After that she will swab with alcohol the spots where she’s going to insert the sterile, disposable needles and insert them. Then depending on what method she practices and the disorder being treated, she will either leave the needles in or not; manipulate the needles, or not, burn moxa (a healing herb) or not, leave the room or not. The depth of the insertion and how long the needles are left in place, if at all, depends on the method of acupuncture being used. Sometimes the process is repeated with the patient laying on the stomach, sometimes not. The same is true for adding any adjunct natural healing modalities of acupuncture such as cupping, gwa sha, herbal teas, nutritional supplements, bodywork, healing touch, moxa, etc. Some practitioners use them, some do not.

One of the reasons acupuncturists vary so greatly in how they practice is because Asia is big. China, Japan and Korea all have their own distinct methods and it is very common to find variations within those methods based on who’s teaching it. Add to that the fact that the practice of acupuncture is at least 2,000 years old, and you get even more variation. Some schools, and thus some practitioners, will encompass more or fewer biomedical ideas/techniques, and more or fewer adjunct modalities.

There are, however, some similarities between forms of acupuncture. All insert needles and all attempt to summon qi. It is the needling techniques that distinguish the skill of one practitioner from another: how a practitioner obtains qi, whether he can or cannot do so, whether he or the patient senses the qi, what the practitioner does with the qi. An acupuncturist senses the qi coming to the needle as a tug on the needle. Some acupuncturists twirl (manipulate) the needle until they feel the qi sensation, others simply leave the needles in place until the qi, in its normal cycle through the meridians, comes to the needle. Some people can actually feel a mild sensation traveling along the course of the meridian when a needle is inserted. Not everyone feels it, and everyone doesn’t have to, but the qi must travel if the treatment is to be effective.

The length of time needles are retained varies between practitioners. It can be from between 20 minutes to an hour. During that time many acupuncturists turn on some soft music and leave the room to treat another patient. When the qi does arrive patients usually feel extremely relaxed. This is the “acupuncture nap” that patients look forward to, from which they awake feeling refreshed and invigorated. If knotted, their qi has become smooth; if deficient, it has become ample and good health will follow. Some acupuncturists, however, do not retain the needles in the body. They simply obtain the qi by manipulating the needle and then remove it, moving on to needling the next point.

If you can’t feel the qi, how can you tell if the treatment is working? The treatment is working if you get better, ie, your symptoms subside either within 24 hours or within a reasonable time period relative to the length of time you’ve had the disorder and relative to your general health. For instance, if you’ve had back pain for over five years, one treatment is not going to do it. Yes, energy can do anything, but energy (yang) has to move flesh (yin) and flesh is a lot less flexible than qi.

Generally speaking you should evaluate your rate of progress using your common sense. Depending upon the seriousness of your condition — acute or chronic — for the best and longest lasting results, expect to return for a series of visits. One or two treatments per week is optimal to start, although even a single treatment will provide benefit. Some patients opt for regular maintenance visits weekly, monthly, or seasonally for system “tune-ups.”

What should I look for when choosing an acupuncturist?

In some ways choosing an acupuncturist is just like choosing any kind of holistic health practitioner. You should feel immediately comfortable with whomever you are entrusting your most prized possession: your body and all its baggage. Since your first interaction will probably be over the phone, look for respect. Is your phone called returned promptly? Does the practitioner or receptionist give you her full attention? Are your questions answered well?

The Buddha said that the right answer depends on asking the right question. So ask yourself: beyond effectiveness, what am I really looking for in a practitioner? The best acupuncturist for you is the person who is effective and meets your needs in the present moment. Are you looking for someone with whom you feel you can really connect? Or do you prefer a little more professional distance? Do you want someone who can speak from a western medical perspective? Do you want someone who can explain Traditional Chinese Medicine (TCM) to you in detail? Or advise about lifestyle? Most importantly, wait to make a decision about your practitioner until after your first visit.

Look for a licensed acupuncturist. All six New England states require acupuncturists to pass the National Certification Commission for Acupuncture and Oriental Medicine examination in acupuncture in order to become a licensed acupuncturist. Some medical practitioners, such as MD, DO, chiropractors and others, are not required to fulfill the complete educational and clinical requirements of a licensed acupuncturist, yet they may still be allowed to practice acupuncture. Check your practitioner’s credentials to ensure he or she is a licensed acupuncturist.

Consider the length of time in practice. The longer a practitioner has been practicing, the better. Generally speaking five years guarantees that the training wheels are off. This does not mean you should never schedule with someone less experienced, especially if they come well-recommended or are very accessible, but give new practitioners extra scrutiny.

Acupuncturists often treat more than one person at a time, using several rooms so they can interview one person while another patient “cooks.” An experienced practitioner can handle two, even three rooms. Beyond that you have to ask yourself how much individualized attention you’re really going to get. Community style acupuncture is a new style of practice where several people are treated together in one room while laying in reclining chairs. Treatments focus mainly on points above the neck and below the elbows and knees so no clothing removal is required. While this type of treatment is very economical, there are trade-offs in privacy and individualized attention.

The patient-practitioner relationship is an extremely subtle thing and all practitioners are responsible for creating a relationship that promotes healing. Your practitioner should never seem to be in hurry or to have anything on his mind other than your well-being. Hopefully this acupuncture information is helpful in guiding you along the next steps of your holistic healing journey.

Daria Casinelli, Lic. Ac., graduated from the New England School of Acupuncture in 2002 and maintains a private practice in Milton, MA. Her website is: She can be reached at or 617-312-7650.