Symptom Responses to Acupuncture

Each person’s body is distinct, and even the same person’s body is different with each passing day. An individual’s response to acupuncture is idiosyncratic, depending on their constitution, any existing patterns of disharmony, and current life circumstances. There are many ways that symptoms respond to an acupuncture treatment:

1) Symptoms improve gradually after each treatment until resolution or plateau.

2) Symptoms improve after treatment, and (gradually) return before the next treatment.

3) Symptoms temporarily intensify following treatment and become less intense overall after several days.

4) Symptoms intensify after treatment and remain more intense until the next visit.

5) Symptoms do not change at all in response to treatment.

6) Symptoms abate after a single treatment and no further treatment is necessary.

Situations 1-3 are the most common, with number 3 being less common in general, though more common in cases of musculoskeletal pain, especially when treatment involves application of acupuncture needles to the affected area. In all three situations, as treatment continues, the overall intensity of the symptoms should decrease, and resilience and the duration of relief should increase.

4) Symptoms intensify after treatment and remain more intense until the next visit.

This situation indicates that something with the treatment was erroneous: the application of needles may have been incorrect, the theoretical understanding of the fundamental pathodynamic may have been incorrect, or the strategy chosen to address the pathodynamic may have been incorrect. Regardless of which error occurred, these reactions provide valuable information to the practitioner and allow them to see more clearly and definitively which course of action is best.

3) Symptoms temporarily intensify following treatment and become less intense overall after several days.

4) Symptoms intensify after treatment and remain more intense until the next visit.

To compare these two situations, let’s look at the example of medial epicondylitis, or golfer’s elbow. Acupuncturists will often needle directly into and around the site of pain when treating golfer’s elbow. Because the body is caught in a cycle of inflammation without healing, the local stimulation can temporarily increase the amount of inflammation in order to break the cycle and allow the body to carry on with healing; this would manifest as a temporary increase in pain for one or two days following treatment, then the pain would reduce and ultimately be less than before treatment. If the pain in the elbow were to increase after local treatment into the site of pain and not reduce after several days, then this would indicate that local treatment directly into the site of pain is no correct for that patient, and changes to treatment strategy would be made accordingly.

5) Symptoms do not change at all in response to treatment.

This situation doesn’t necessarily imply an error in treatment. In fact, it is quite common for an acupuncturist to observe changes upon examination of the tongue, pulse, abdomen, or channels, and for the patient to have not yet experienced a change in symptoms. This is because the changes in observed findings and the changes in symptoms can be related to each other in three different ways:

A) Symptoms and observed findings change simultaneously.

B) Symptoms change before observed findings.

C) Observed findings change before symptoms.

The first of these is the easiest to navigate as both practitioner and patient observe changes occurring at a similar rate. Both B) and C) require the patient to trust the acupuncturist and continue with care. In situation B) the patient is usually inclined to stop treatment once symptoms have improved, but if the practitioner observes that the original findings are still present, they will recommend the patient continue with treatment to prevent relapse of symptoms. In situation C) the patient might be inclined to stop treatment since they are not seeing results in their lived experience, though the practitioner will encourage the patient to stick with the program because the practitioner continues to note changes in observed findings towards what ought to be a change in symptoms.

6) Symptoms abate after a single treatment and no further treatment is necessary.

This situation is quite rare in general, and in particular with cases involving chronic concerns, though it is more common to see this in acute cases such as a cold or the flu where the body can rapidly expel a pathogen. Sometimes the conditions are just right, and the pattern differentiation is spot on, and with a single treatment resolution is resolved in the way described in one of the oldest texts in classical Chinese medicine, the Yellow Emperor’s Inner Classic (黃帝內經 – Huángdì Nèi Jīng):

“The diseases of the five viscera are like thorns, stains, knots, and obstructions. Even though a thorn may have been stuck for a long time, it can be pulled out. Even though stains can persist for a long time, they can be wiped clean as snow. Even though knots can hold tight for a long time, they can be undone. Even though obstructions can block for a long time, they can be drained away.” (Huang Di Nei Jing, Ling Shu Jing, The Nine Needles and Twelve Sources, passage 16)

If you ever have any concern regarding a reaction to treatment, please contact your practitioner directly via email or call the clinic at 312-335-9330.

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