If you have had acupuncture, you may have felt that deep relaxing mediative feeling during the treatment. Your body seems to adjust to just what it needs because sometimes you need a little energy boost, and you leave feeling more alive and vibrant. Other times you are on overdrive, your mind goes a mile a minute, and then you leave feeling relaxed, and calm. The treatment forces you to conserve the energy you need.
When your stomach makes a noise or quiets down when I insert a needle on the stomach channel this is a clue it is working. If you feel an itch on your nose when I insert a needle on the liver channel it is working. If you feel a needle in your shoulder, but is in your hand, it is working. If you yawn, let out a deep breath, breath deeper, let your shoulders drop, fall asleep, feel a deep ache at the points, that feeling dissipates, then a feeling of heaviness comes over you. It is working.
These are signs that the treatment is working. There is a certain sensation with acupuncture a kind of heaviness, like water flowing, or a small tug like a fish biting a hook.
Because you feel good after acupuncture, and it seems to last a few days you are wondering whether the results are permanent or temporary.
They are cumulative. Perhaps you have less pain afterwards, and then it seems to creep back in, or come and go. There might be counteractive forces interfering with the therapeutic effect such as you are doing something that is continuing to irritate the painful area.
Sometimes we are just not sure because we have become so used to the pain that we don’t recognize it when it is changing. Others may notice that you don’t complain as much, and that you can do more before getting tired.
Here are some objective ways you can measure your progress.
The efficacy of acupuncture is measured by the number treatments needed for maximum pain relief, and the duration of pain relief. It depends on the interaction between a patient’s self-healing potential, the severity and nature of the symptoms, or whether the symptoms or disease is healable. (1).
Track your progress: This is how you will know that you are improving. A few people like to say that it is not helping at all. They feel the same. It is usually not true. When you know what positive results to look for you can stop focusing on the negative, and you will decide to see the positive. It becomes a snowball effect in the right direction from there.
- Before you begin treatment. Rate your pain on a scale, and problem occurrence frequency (how often you experience it). Rate yourself again after a series of treatments.
- Rate your ability to recover after an aggravation, set-back, or activity that usually causes problems. Does it usually take you 3-5 days to recover? After a series of treatments are you noticing you bounce back quicker?
- Note what activities you are not able to do, and which ones cause you pain, before beginning treatment? After a series of treatments, are you able to do things that you weren’t before treatment? Like tie your shoes, take your jacket on and off, walk to the back of the grocery store, get in and out of your chair, get in and out of bed, brush your teeth, your hair? This in and of itself tracks mobility, range of motion, and muscle strength. The things the doctor objectively rates while you are in the office. You might still experience pain, but you are able to do more, longer, and better. The pain will gradually dissipate as you heal, and as you get back into normal daily life.
- Check other health problems. Are they improving? Things like sleep, mood, bowel movements, appetite, energy levels, strength, breathing, abdominal bloating, gas, pain, discomfort? How’s your skin, complexion? Has it become smoother, better color, temperature? How do you feel within yourself after acupuncture? Are you complaining less?
- Your basic labs. Have you seen improvement in blood work, cholesterol, blood sugar, blood pressure after treatment versus before treatments?
- Are you taking less medication, or less pain relievers?
Rate your pain or problem on a scale of 0 no symptoms to 10 worst possible debilitating pain, or emotional affect.
- Severe is subjectively scored at 8, 9, or 10 worst possible pain or symptoms. This is debilitating pain. You can’t take care of yourself. You need help. You can’t drive. If it is a 10, You may be experiencing an emergency or urgent care. You are typically not in an acupuncturist’s office or other doctor’s office. The problem is constant.
- Less Severe is scored at 7, 8. You might wear a brace, crutch, not use the body part. Your gait is changing. Perhaps you are limping. You feel the need to take stronger pain relievers. It affects your sleep. It affects some or all your daily activities. The pain or discomfort is frequent or constant.
- Moderate is subjectively scored at 4, 5 or 6. It’s on top of your mind. You might need to change position, move, favor the body part, change how you do something, compensate using the other good side too much, take an over the counter or analgesic remedy. The problem is frequent, intermittent, or occasional.
- Mild is subjectively scored at 1, 2, or 3. The problem is mildly annoying, but it doesn’t interfere with your life. Usually, mild pain is felt only intermittently, or occasional. You don’t need to take any pain relievers for it. If you do take any pain relievers they work effectively, quickly, and you don’t need to take very often.
*Knowing that your problem is not severe, nor is it less severe should help you feel better about the outlook of your condition, and the heal ability. This often reduces the pain by reducing the emotional component. If you are hypersensitive to pain, and your subjective pain score of 8, 10, or “My pain is off the charts a 15!”, and it doesn’t match the definition of pain severity scale consider the possibility that your pain is coming from the memory-emotional part of your brain. You might be attached to your disease or pain. You may have some depression or anxiety.
Defining how often you have the symptoms or pain occurrence:
Occurrence of pain, symptoms or emotional affect are determined by how often you experience them.
Constant symptoms occur without relief up to 100% of the time.
Frequent symptoms occur up to 75% of the time.
Intermittent symptoms occur around 50% of the time.
Occasional symptoms occur 25% or less of the time.
How Long Should It Take to Heal Your Condition?
This can depend upon normal body Tissue Healing Timelines, your individual factors mentioned earlier. This is that it depends on the interaction between a patient’s self-healing potential, the severity and nature of the symptoms, or whether the symptoms or disease is healable. Understanding this can help you have reasonable expectations for how many treatments, and for how long it will take to reach your therapeutic goals.
The right expectations will help you stay on track with your treatment plan to heal your pain, and to reach your health goals. Number one rule is don’t be too impatient!
However, this doesn’t mean keep doing therapy, and continue with tons of acupuncture without having any benefit. That is why I posted some ideas on how to track your progress. Also, the treatment plan formula will give you a pretty good idea of how many visits you might need, and when to know that it isn’t working for you at this time for this problem.
Healing is a process. Even if there is instant pain relief your body is still recovering. I often like to point out that when you are doing good things for your body good things are happening behind the scenes that you may not see yet. Don’t give up if results aren’t immediate. It is just same as when bad things are happening behind the scenes that you don’t know about until you feel or see the disease. The disease may have been building up over time. If you can catch it in time, you may be able to reverse the damage. Reversing the damage is all about cellular renewal. Your body heals by making new healthy cells while dissolving and excreting the old defective cells.
Different body tissues have different healing times. Tissue regeneration can vary. This is very important to understand so that you can have the right expectations, and not become too impatient when you think your body isn’t healing quick enough.
Keep in mind that a red blood corpuscle (RBC) has a life cycle of 120 days that is 4 months. This is also a general timeline that it takes people on average to develop and stick to a new healthy habit. We don’t get rid of the old unhealthy habit. We start a new one instead! This is from, “The Power of Habit”, by Charles Duhigg. So, think about if you started a new exercise routine then naturally you begin to eat healthier foods. After four months these have become good habits that are now part of your regular routine. Your blood has recycled, and it is cleaner, healthier as are you! To change your health will take time at least 4 months. The results will begin to show. It is not overnight. Four months is not that long either. Some people that are in worse shape, it may take one year, some two years to experience significant long-lasting results.
Let’s look at this tissue healing timeline below and here we can see an average of somewhere between 3-4 weeks and 3-6 months to heal.
Tissue Healing Timeline with respect to Musculoskeletal injuries | ||||||||
0-3 days | 4-14 days | 3-4 weeks | 5-7 weeks | 2-3 months | 3-6 months | 6 mo.-1 year | 2 years | |
Tendon | ||||||||
Tenonitis
Rupture/full tear |
TTTTTT | TTTTTT | ||||||
RRRRR | RRRRR | RRRRR | ||||||
Muscle strain | Exercise Induced | |||||||
Grade I
Grade II Grade III |
I | I | I | |||||
II | II | II | ||||||
III | III | III | ||||||
Ligament | ||||||||
Grade I
Grade II Grade III |
L-I | L-I | ||||||
L-II | L-II | L-II | L-II | |||||
L-III | L-III | L-III | L-III | |||||
Ligament
graft |
Graft | Graft | Graft | Graft | ||||
Bone | Bone | Bone | ||||||
Nerve 6-12wks | N | N | ||||||
Disc 8-12wks | D | D | D | Full rupture 1-year | ||||
Meniscus | M | M |
Have the right expectations to treatment.
Having the right expectations can help you heal. I hate to break it to you, but healing doesn’t always mean 100% pain free. Most people really do hate pain. We don’t like anything that hurts. So, if you go into any kind of therapy, and expect to be 100% pain free within an unreasonable amount of time you will be dissatisfied. You will think it is not working and stop short of reaping any benefits. Then you move on to a different therapy. You might be doing too many things at the same time. You don’t stick to one thing to let it work for you. Eventually you move on to more drastic measures. All without any positive results. Let’s manage those expectations because if you expect too much too soon then you worry and worry and constantly focus on the problem. You think about it all the time. You worry, worry, worry that something is really WRONG! You lose trust in your own body’s healing capabilities. Any attention paid to these brain circuits reinforces them, “Where the mind goes the Qi goes”!
In his book, “Do You Really Need Spine Surgery? Take Control with a Surgeon’s Advice”, David Hanscom, an orthopedic surgeon, writes, “Most pain arises from irritation and inflammation of soft tissue surrounding and supporting your skeletal system. Since there are over a million pain receptors per square foot of soft tissue, the discomfort is often quite severe.” The source of pain usually cannot be found on an imaging test. He explains how pain from structural sources can only be identified for sure 5-15% of the time that match the symptoms. He states, “Your surgeon is guessing 85% of the time.” Even with structural sources of pain that are amenable to surgery, they may be resolvable by non-surgical means. If an anatomical abnormality shows up on an imaging study, it does not mean that it is the source of your pain. Quite often they are not. (4.)
Alas, this knowledge doesn’t often make you feel better. We often hope for a definitive answer where there is a quick fix like a medication, procedure, or surgery. You get discouraged that there is not a real definitive structural abnormality that will respond favorably to surgery. That it will be worth the recovery time, and the rehabilitation time. Change your perspective to see this as good news! Nothing is structurally wrong with you. You are not injuring yourself by following dynamic moving exercises, heat therapy, gentle stretches, meditation, acupuncture, or whatever your condition calls for. You can take control of your healthcare. Perhaps it will help bring awareness of what it is in your life that is the cause of your pain or discomfort.
Types of Pain Relief to Expect from Acupuncture
- Immediate Relief. This can be expected in young, healthy individuals with a simple acute problem.
- Cumulative Effects and Relief. Most patients feel some relief after each treatment, but the majority see major lasting effects after a series of treatments.
- Delayed Relief. No relief for the first few visits. Then, may suddenly experience relief 2-3 weeks after the initial visits, or series of treatments.
- No Relief. When this happens a break between treatments can trigger a reaction in the right direction. For healthy individuals if there is no change after 4-6 visits take a break for 1-3 weeks then resume. For elderly people, or those with multiple health problems after 5-8 visits without a change take a break for 1-3 weeks, then resume. The break in between may help the patient to conserve the necessary energy for healing the tiny holed micro-traumas created by the needling.
In a nutshell, to measure your progress start by rating at the beginning of treatment against measurements taken after six visits. The measurements include rating your pain on a pain scale, determining how frequently you feel it, your range of motion, mobility, sleep, mood, digestion, appetite, recovery, and pain medications.
With the treatment plan, and good mindset, I expect you to be feeling better in no time!
To schedule your appointment today give us a call now!
Office call: (858) 613-0792. I love texts too. Text (858) 613-0793. I won’t receive the text if you text the office number!
Best in Health,
Dr. Michele Arnold
REFERENCES
- Ma, Yun-tao; Cho, Zang Hee. Biomedical Acupuncture for Pain Management – E-Book. 2005. Elsevier Health Sciences. Kindle Edition.
- Dharmananda, Subhuti, “Restructuring American Acupuncture Practices”, May 2003. http://www.itmonline.org/arts/restructure.htm
- Duhigg, Charles. The Power of Habit: Why we do what we do in life and business. Random House. 2012. NY.
- Hanscom, David. Do You Really Need Spine Surgery? Take Control with a Surgeon’s Advice. 2019. Vertus Press: Oakland, CA.
- Bernard, Rick. Orthopedic Electroacupuncture. eBook edition.
- Wong, Joseph Y. A Manual of Neuro-Anatomical Acupuncture, Vol I: Musculo-Skeletal Disorders. 1999. The Toronto Pain and Stress Clinic, Inc. Toronto, Ontario, Canada.
- Shu Hongwen, Clinical observation on acupuncture treatment of piriformis syndrome, Journal of Traditional Chinese Medicine 2003; 23(1): 38-39.
- Zhao Jianping, Acupuncture treatment of facial paralysis caused by craniocerebral trauma in 50 cases, Journal of Traditional Chinese Medicine 2003; 23(1): 47-48.
- Wang Caiyun, Ma Jinghua, Xiao Li, Treatment of 50 cases of sciatica by needling zanzhu and fengchi, Journal of Traditional Chinese Medicine 2003; 23(1): 51-52.
- Yang Tao, Liu Zhishun, and Liu Yuanshi, Electroacupuncture at ciliao and huiyang for treating neuropathic incontinence of defecation and urination in 30 cases, Journal of Traditional Chinese Medicine 2003; 23(1): 53-54.
- Zhang Hong, Zeng Zheng, and Deng Hong, Acupuncture treatment of 157 cases of anxiety neurosis, Journal of Traditional Chinese Medicine 2003; 23(1): 55-56.
- Cui Rui and Zhou Dean, Treatment of phlegm- and heat-induced insomnia by acupuncture in 120 cases, Journal of Traditional Chinese Medicine 2003; 23(1): 57-58.
- Wang Hairong, Acupuncture treatment of depressive syndrome after cerebral vascular accidents, Journal of Traditional Chinese Medicine 2002; 22(4): 274-275.
- Sun Jianhua, Warm needling and bloodletting for treatment of gonitis, Journal of Traditional Chinese Medicine 2002; 22(4): 278-279.
- Xiang Dongfang, et al., Ear acupuncture therapy for 37 cases of dysmenorrhea due to endometriosis, Journal of Traditional Chinese Medicine 2002; 22(4): 282-285.
- Wang Hongyu, Observation on the therapeutic effects of acupuncture for 60 cases of simple obesity, Journal of Traditional Chinese Medicine 2002; 22(3): 187-189.
- Tang Wenzhong, Clinical observation of scalp acupuncture treatment in 50 cases of headache, Journal of Traditional Chinese Medicine 2002; 22(3): 190-192.
- Lu Zeqiang, Scalp and body acupuncture for treatment of senile insomnia, Journal of Traditional Chinese Medicine 2002; 22(3): 193-194.
- Li Baomin, Chai Fuming, and Gao Hongming, Cervical spondylopathy involving the vertebral arteries treated by body acupuncture combined with scalp acupuncture in 72 cases, Journal of Traditional Chinese Medicine 2002; 22(3): 197-199.
- Song Jianqiao, Ischemic apoplexy-induced sequelae treated by penetrating puncture with long needles, Journal of Traditional Chinese Medicine 2002; 22(3): 200-202.
References for tissue Healing Timelines
Lifecare Kingsway Physiotherapy. “How Long Will This Take? Timeframes of Tissue Healing”. Dec. 22, 2017. https://www.lifecare.com.au/blog/how-long-will-this-take-time-frames-of-tissue-healing/
References from the article, “Tissue Healing Times, and What it Means for You”, Evolve Flagstaff. Brian Kinslow. Feb. 08, 2018. https://www.evolveflg.com/articles/tissue-healing
Muscle Strains:
- MR observations of long-term musculotendon remodeling following a hamstring strain injury https://link.springer.com/article/10.1007/s00256-008-0546-0
- Clinical Orthopaedic Rehabilitation, 2nd Edition by Brotzman and Wilk http://a.co/d0Zkzhp
Ligament Sprains:
- Ligament Injury and Healing: An Overview of Current Clinical Concepts http://journalofprolotherapy.com/ligament-injury-and-healing-an-overview-of-current-clinical-concepts/
- Ligament Healing: A Review of Some Current Clinical and Experimental Concepts https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2328751/pdf/iowaorthj00022-0022.pdf
- Ankle Ligament Healing After an Acute Ankle Sprain: An Evidence-Based Approach https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2547872/
- Nonoperative treatment of Grade II and III sprains of the lateral ligament compartment of the knee http://journals.sagepub.com/doi/abs/10.1177/036354658901700114
Tendons:
- Painful, overuse tendon conditions have a non-inflammatory pathology http://www.bmj.com/content/324/7338/626.full
- Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matter https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/
- Clinical Orthopaedic Rehabilitation, 2nd Edition by Brotzman and WilkArticular Cartilage, Meniscus, and Labrum. http://a.co/d0Zkzhp
- New perspectives for articular cartilage repair treatment through tissue engineering: A contemporary review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017310/
- The meniscal healing process https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666493/
- Labral reconstruction with tendon allograft: histological findings show revascularization at 8 weeks from implantation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467408/