Acupuncturists frequently check for feedback in patients. This doesn’t necessarily mean that the acupuncturist is not confident, but this can be startling to patients because many have the idea that you simply place needles in certain places and it can fix the area. Patients can be easily confused when the acupuncturist checks in with patients for feedback after needling them. Here are three reasons why acupuncturists check for feedback in the patients.

1. One needle doesn’t always do the job. When I was treating a woman for shingles pain, she didn’t understand why I was asking her questions. She had lingering shingles pain for over six years and was at her wits’ end. She suffered shingle pain to her left thigh, which circled around her back. She would have trouble wearing clothes or putting any pressure on it. She was 78 years old and she was chronically depressed. I was placing needles on her opposite shoulder. In one style of acupuncture, you treat the opposite side when the nerves at the affected site are causing pain, because the body is confused already, and is jolting the body with excess nerve stimulation, which causes pain. I was trying to cover an area on her shoulder to cover the area of the thigh and the lower back area. So I had to use enough needles in the vicinity to make sure I was going to cover this area properly and get a result. As a result, I asked her if she could move the affected body part, and tell me if the pain was less. It was less.

One thing people don’t know about acupuncture is that you don’t need to needle directly into the painful spot. You see, signals from the needles are circulated via nerves that go to the brain and direct the brain to affect other areas. So yes, we can treat one area to treat another. To make sure that we are affecting the area properly, we can use many needles to treat a specific area far away on the body.

2. Secondary pain shows up once the original pain goes away. Many times the pain that someone feels is so severe that they don’t realize that other muscles in the vicinity of pain are also tight, sore and painful. Frequently, when treating, we can reduce the pain in one area, only to find that the pain “moves” to another area. This isn’t because it is something “new,” but rather because you just weren’t aware of that pain because the original pain was prominent.

I recently was treating an overworked female financial planner. She was stressed and fatigued and came to me for crippling pain in her neck. She told me that her pain was so intense, that she couldn’t think of anything else but alleviating the pain. Poor person! We did a first set of needles on her wrists and ankles to treat her neck pain. (She was in so much pain she couldn’t deal with needles in her neck.) She started to feel better in the back of her head. She said she now felt a “new” pain. This pain was situated on the sides of her neck. In the initial evaluation, I was feeling for tender spots in her neck. I found ropey, hard muscles in the sides of her neck. It wasn’t that her neck pain had “moved,” but rather, she had experienced relief in the worst part of her neck pain and now we had “discovered” that the sides of her neck were affected as well. Needling some other areas to mirror this area helped her reduce the pain in those areas.

The reason we put needles in faraway places is because we can ask the patient to move the affected part and find where the secondary areas of pain have surfaced. It’s all about strategy when it comes to treating pain effectively.

3. In some cases acupuncturists must use different points at different visits. Many times we see that the same acupuncture treatment selection stops working! I was once treating a woman for headaches. I placed the needles in the sides of her thigh and her opposite wrist along with some other points in her body, yet I did not see any change happening with her. So we started to alternate different selected areas at future visits. We started to get “back on track” because of this strategy. It is not for lack of consistency that we were not making progress but rather it highlights a point that we acupuncturists have to be aware of. When we place needles into the body, we are sending a stimulus to the body to evoke a change. In order to do this consistently and regularly, so we can see a resolution to a problem, we sometimes need to “shake up the body” by placing needles into different places to keep the body from getting used to a stimulus and not responding. In this woman’s case of headaches, I alternated points in the thigh and upper legs and arms with points in the wrists and fingers, and ankles and toes. This helped keep the “signals” fresh and the body was stimulated to respond. As a result, her body was able to reduce the headaches to a 2 or 3. She only comes in now for some maintenance visits to prevent the headache from getting worse. The acupuncture also helps her reduce her stress, which has a positive impact on preventing her headaches.

Learning why acupuncturists look for feedback helps many to peer into the actual treatment of acupuncture, which is still enshrouded in mystery for many people. I hope you found this article informative and helpful in peering into what happens in an acupuncture session. As you can see, treatment is not a “cookie cutter,” one-size-fits-all approach. There is always a difference between “book” knowledge and live, “breathing” patients who have unique bodies that respond differently than others. Knowing to keep that in mind as a practitioner of acupuncture can make the difference between getting and not getting results for our patients.

By Joshua Goldstein

 Joshua Goldstein is a licensed acupuncturist who studied at the Pacific College of Oriental Medicine earning his Master’s degree in Oriental Medicine. He has studied with master practitioners in California and New York, has been a past secretary of the New Jersey Acupuncture Society and has taught in the Swedish School of Acupuncture and Eastern Acupuncture School programs. He works in Ridgewood, New Jersey and can be reached at 201-444-7150 or contacted via email at [email protected].