Optimal Frequency For Acupuncture Treatment

spinal stenosis

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.