As my readers should know by now, I'm all about promoting maintenance. I often use the analogy of a runner choosing not to stretch and saying, "that's ok, when my muscle gets a tear I'll just go to the doctor to get it fixed." Wouldn't it just be easier to avoid all that pain and inconvenience in the first place? Strengthening the body so that an issue never arises is always better than sitting around waiting to fix it when it does. I'm very honest with my patients. When someone asks how often they should come, I always tell them that they will feel best with weekly treatments...because they absolutely will. However, I never push anyone to follow this schedule. Why? Because I understand that money, time, and obligations are often in the way. Acupuncture is the ultimate de-stresser, but you're not going to enjoy it nearly as much if you are spending your weekly grocery money on it. Nor will you find it as fulfilling if you are lying there on the table, knowing that you are going to be late picking up your kid from school. I try to work around these issues by running discount packages and offering late and weekend office hours, but, well, life happens. I hate feeling pushed into things, even things that I enjoy, so I would never do it to a patient. Weekly sessions are optimal, but monthly sessions will also keep everything in check, and one day a month is usually doable for most people.
So, what about patients who are not coming for maintenance, those that have a specific problem that they want gone, asap? Like Western medicine, the length of treatment is not always easy to predict. There are patients who come for 10 treatments with no change, only to find that they are completely cured during their 11th treatment. Conversely, I have had many patients come for one treatment, walk out pain-free, and never experience the issue again. The length of treatment depends on so many factors: what the problem is, how long it has been going on, how otherwise healthy the patient is...but there is a general guideline that I give my patients when I first access the issue.
Generally speaking, the longer the problem has been going on, the longer it will take to resolve. Someone who wakes up with acute backache is going to resolve much more quickly than someone who has had chronic back pain for the last 20 years. Muscle heals faster than bone; muscular issues resolve more quickly than an issue like arthritis or bone deterioration.
The more healthy qi a person has, the quicker the recovery will be-even for localized pain issues. A young, healthy person who gets regular sleep, has good digestion, and eats well is going to have better quality qi than someone who is older, weaker, and dealing with other health problems.
Other factors in determining prognosis are lifestyle and aggravating factors. Knee, back, and ankle pain will be easier to treat on a person who is not worsening the condition with excess weight. A long-distance runner with plantar fasciitis will take longer to heal than a person who isn't constantly putting strain on the bottom of his feet.
Acute conditions should be treated aggressively with acupuncture. The more times a week the patient can come initially, the faster the resolution. Something like an acute back strain should resolve within a week or two of treatment, with two or three treatments a week. As for chronic conditions, they may take longer, but there should be at least some improvement within 4 treatments. In my experience, about 90% of patients experience some improvement during their first visit. I'm not talking about complete resolution, but a noticeable degree of change. After 4 treatments, we usually see significant results.
The longest I have worked on a patient before seeing any changes was 6 treatments, which was unusual...and very frustrating for me. Although this medicine is about subtle changes, I am not a subtle person, and my focus is on getting the best results in minimal time. In my mind, six weeks without results was far too long. I was ready to completely change the treatment protocol, but a colleague talked me out of it, saying that I should stick with my original plan a little longer. I agreed to continue my protocol for one more treatment...and the 7th time was the charm. The patient had a complete resolution of the problem after the 7th treatment-after not responding at all to the previous six. Acupuncture is funny, isn't it?
But again, the previous case was unusual. I would be very surprised to see a patient who doesn't experience positive changes within 4 weeks, and they usually see these well before the 4th treatment. Acupuncture is a subtle medicine, but don't let this fool you into believing that the results are always subtle.