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How many session of acupuncture required?

Q: I have pcos and persistent rhinitis. I have had acupuncture by two practitioners. One hurt me, I  lost sensation in my head and collapsed when i got off the couch. The other was much kinder, helpful and caring but I felt that i wasn't getting any benefit after 4 months of weekly treatments. How many treatments should I require to notice some difference? I know it depends on the condition and severity but 16 sessions and no difference?

A:As you say, this is getting to be a substantial investment in time and money, and you need to know whether this is actually heading somewhere or has just become a kind of 'treatment habit.'

As you say, these can both be very stubborn conditions. With long term chronic problems it is often quite difficult to establish an analogue scale of improvement. With acutes it is far easier: 'how many out of 10 is your pain now?' With chronic conditions this is often trickier. One of our Japanese colleagues once remarked that if someone tells you they are 10% better, they're just telling you that you are a nice person and keep trying.

The best that one can do is to maintain a regular review, usually every four or five sessions, and to share with a patient the findings from a Chinese medicine perspective. There are a number of occasions where changes in the tongue and pulse can be quite radical without having yet filtered through into changes in the main conditions. If a practitioner is sure that there is progress they need to share this with the patient. It is also important to try to set measurable outcomes, difficult as this can sometimes be. It is very easy to be unable to say what happened last week, and with both problems there are usually some symptoms whose appearance can be charted. This can help to establish just how many episodes there have been and whether there has been a change.

If nothing happens, then there are a number of options. One is for the practitioner to seek a consultation with a colleague present or refer to someone else just to have a fresh pair of eyes looking at the case. Occasionally, though, it just has to be agreed that treatment isn't working, and the practitioner is usually in a good position to suggest alternative treatments which may help. Chinese Herbal medicine is often used alongside acupuncture to good effect, and although homeopathy has had a run of really bad press in recent years, this expert has several patients who have used homeopathy to treat both acute and chronic rhinitis when acupuncture hasn't done the trick (and stayed with acupuncture for other conditions).

The best person to address your concerns is your practitioner, however. None of us minds being asked about the benefits of treatment when results are slow in coming, and sometimes it marks a good time to call it a day. Good communication sidesteps many of the problems which can otherwise emerge.

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