Prescription pain medication “numbs” you out.  Acupuncture works differently.  Acupuncture is more like a crockpot than a microwave - it works slowly through and through rather than heating you up quick and leaving hot spots in the middle.  Sometimes people are unsure if acupuncture is working or not.  Frequently when a person has a chronic pain condition they shut off the connection to their body as a survival mechanism so it can be hard to know! Here’s how to tell the acupuncture is working.

Are you taking less pain medication?
This is a big one. If you are able to drop a dose, wait longer between doses or forget to take it those are all good signs!  You may still be feeling pain however needing less or a less strong medication is a sign your body is healing.

Do you notice a change in the location, frequency and/or intensity of the pain?
Did the area of the pain get smaller?  If your whole back hurt and now its just your upper back that is a sign you are getting better.  Do you get headaches twice a week instead of daily? That is a very good sign.  Has the overall pain level decreased?  Again, good news!

Do you feel relief right after the treatment but then it “wears off”?
This is a good sign. Keep coming back! As you get more acupuncture your body will become more stable and the relief will last longer and longer. This is why we recommend coming more often in the beginning of treatment - an ideal minimum is twice a week for moderate to severe conditions.  Your body is in a habit right now and it’s going to take some time for it to learn how to do something new. Stick with it, it’s working!

Are you able to do more?
Maybe you’re able to forget about your pain sometimes.  Maybe simple things like grocery shopping or going down the stairs is easier.  Can you walk a little farther before having to sit down?  Is getting dressed easier?  Can you get down on the floor and play with your grandkids and be able to get back up again?  Is your pain not interfering with your life as much? Acupuncture is working. Keep going!

Do you feel better overall?
Are you smiling a little bit more? Feel a little more hopeful? Is your anxiety or brain fog better? Living with chronic pain can be exhausting and depressing - sometimes an improved mood is the first sign acupuncture is working.  So if you’re feeling a little less grumpy - keep coming back!

Acupuncture is a great tool to manage chronic pain because it not only helps to reduce pain, it also helps with energy level, mood, sleep and stress which can worsen chronic pain conditions.  It also has no side effects and feels pretty amazing!  A person’s tolerance to pain decreases when they aren’t getting enough sleep and are stressed out for example.  Life seems more overwhelming and we have less ability to manage it when we aren’t feeling well.  Our bodymindspirit is interconnected, what affects one area of us, affects all. 

You walk into the treatment room and see everyone else either asleep with their mouths open or peaceful and still with their eyes closed, maybe listening to their own music on their headphones.  They look so relaxed! You can barely sit still in the chair for 30 minutes and definitely DO NOT feel like sleeping.  Hell, you can barely sleep at night or sit still to watch tv.  There is laundry to be folded, dishes to be washed, homework to be done, emails to be answered, groceries to be shopped for, etc etc etc etc. It doesn't end.  Who has time to relax? That's for lazy people anyway.  Hey you, I totally get it because this is kind of me.

Sometimes people have a hard time relaxing while they get acupuncture treatment. First of all, it's OK. I promise. The acupuncture is still working. Whether you fall asleep or not is zero indication as to efficacy of the treatment.  You are not failing at acupuncture. You do not suck at acupuncture. You are not the 1 special person it's not working for while it works for everyone else.  Your body is just stuck in a habit of go-go-go and its going to take a minute for your body to do something different.  And that is OK.

Sometimes sitting still is scary.  That's OK too. You are not alone.  You are safe here. And we have tissues if you need them. 

Here is my advice. Put your phone away. Put the book or magazine away.  These things just re-stimulate your brain and our goal is to shut your brain off.  Don't keep turning it back on.  Let your mind wander.  Some people find it helpful to focus on their breathing.  You can do that but you don't have to. You can't fail at this.  The success is in taking the time for yourself to coax your bodymindspirit to do something its not used to.  Changing a habit is hard. It takes many intentional acts before momentum kicks in and the cycle starts to build on itself and take over and become a routine to maintain.  This is why it takes "30 days to form a habit".  Us human beings are highly adaptable but it takes a little time for the adaptation to happen and this is a good thing because if it didn't we would be all over the place.

Give it time. Have patience with yourself.  I talk to my kids all the time about working their "patience muscle" when they want me to do the thing RIGHT NOW, usually when I'm driving, wiping the other child's butt or I'm in the shower.  Are we wired this way or is it a result of our society of instant gratification? I don't know but the point is that no one wants to wait.  Our bodies and our lives don't have any light switches though.  You can't turn on the switch to lose 50lbs, get pregnant, go to sleep, meet your soulmate, do 25 pull ups or memorize a piano concerto.  Be easy with yourself and your body.  You are not a failure, you're a work in progress.  What counts is regular practice, regular treatment, being pointed in the general direction of where you want to go and making tiny steps to get there or at least closer.  You might even have some fun and a few surprises along the way.

Progress might be small, regular and incremental or there might be nothing for a while and then suddenly everything at once. Everyone is different.  Context is important too. If you are going through major life stuff it might be unrealistic to expect to be completely zen right in the middle of it all- especially in the beginning. But being able to take a couple of deep breaths, peace out in a chair for 30 minutes with needles once or twice a week and finding the time to take a quick walk can make all the difference. This is the balm to keep you going, to get you through with as few scrapes as possible.  You can do it, I have faith in you. Just keep at it.  It works if you work it, so work it, you're worth it. <3

"But how, mommy, how?"  This is a question I hear at home a lot. Closely followed by "but why, mommy, why??"  I'm going to answer the how here.  As in, how, mommy, how does acupuncture work?

I graduated acupuncture school in 2007, so this is my 13th year of practice.  My understanding as to how acupuncture works exactly has evolved over those years.  In school we learned that energy, qi, moves in pathways around the body on highways called meridians.  If qi flows the wrong way, gets constricted or blocked this leads to symptoms and disease.  Acupuncture gets the qi flowing correctly and in adequate amounts in the right direction.  While this is an accurate explanation from an acupuncture textbook standpoint, I don't think it really gets to what's happening in the human body.

In starting my 13th year of practice I have come to understand that acupuncture works in two main ways.  The first way that acupuncture works is by shutting off the stress response in the body and the second is in the points affecting specific areas of the body through mirroring and fractals.

When humans are under stress there is a physiological response in the body.  Stress is of course a broad term and it affects people in varying degrees.  Stress can come from trauma, dealing with chronic health problems, financial, legal, family, job problems.  All kinds of problems, even being rushed, driving in traffic, having a disagreement with someone.  Most people have stress.  When under stress, the human body goes into "fight-or-flight" mode which is a series of physiological changes driven by hormones in the body.  Heart rate increases, blood rushes to the muscles, pupils dilate - to prepare you for an acute survival situation.  Highly useful when you need to save your own life, not so useful long term.  People can get stuck in fight or flight mode when levels of stress hormones are high in their bodies due to increased stress. 

Acupuncture shuts off that stress response, switching the body into "rest and digest" mode.  This is when the body is relaxed, heart rate slows, muscles relax and the digestive system functions normally again.  This is also when the body heals itself, which primarily happens when a person is sleeping.  Sleep is critical to the healing process in the body.  This also explains why many people fall asleep during acupuncture treatment.

Besides symptom relief, another common thing people notice as a result of long term acupuncture treatment is that they get perspective.  They are able to look at situations and problems in their lives without the same emotional entanglement.  They are able to get done what they need to get done in an easier way.  When you aren't frantic and feeling crazed you make better decisions.  You make calmer decisions. Somehow things don't seem as bad and therefore they aren't as bad.  There is hope.  A sense that somehow, all of this is going to work out.  You got this! This is what I believe is the true gem of what acupuncture does.

Sometimes when people initially get treatment its hard for them to sit still and do nothing.  That is ok.  Just stick with it! Keep coming back!  I plan to address this in a future blog post.

The second way that acupuncture works is by the individual points affecting specific areas of the body through mirroring and fractals (continuously repeating patterns).  This explains how I can treat back pain all day long and never stick a needle in someone's back.  Everything in our bodies is all connected.  There are continuously repeating patterns all over the body.  The entire body can be treated from the ear, for example, just picture an upside down baby on top of the ear and you have a rough idea of where body parts are located.  You can treat wrist pain for example by using points around the elbow (mirror the arm on top of itself) or ankle (the wrist of the leg).  Some points address the opposite side of the body, others on the same side.  Some points treat parts of the body everywhere- for example there is a point on the knee which treats tendons, everywhere in the body. I'll be needling that point on the knee to help someone with tendonitis located anywhere in their body.  There are also specific points that alleviate anxiety, allergies, upset stomach and headaches.  (Unsure what acupuncture can help with?)

Think of acupuncture as a part of your routine to keep your life going optimally.  It's a low -tech, inexpensive and safe tool in the box to maximize quality of life.  We have our sliding scale and flexible scheduling system to make getting acupuncture as easy as possible.

The irony of starting this blogpost about sleep today, when I slept terribly last night at an Airbnb in Boston, finally getting out of bed at 4:50am to catch a plane flight home.  As I go through my day zombie-like I’m reminded of the fact that I used to feel this way fairly often, and how refreshing it is that this feeling has become mostly a memory.  Or, an unpleasant reminder when traveling.  

Back before I had children, one million, I mean six years ago, I was one of those people that needed her sleep.  After I had kids I got a clue as to how adaptable humans truly are.  Once my first was born my anxiety and restless anticipation would start to set in around sunset, because that’s when he would start crying and it wouldn’t stop until the wee hours of the morning. The longest it lasted was until 4am, and pacing the house with a crying baby I would chant to myself 4am, 4am I just have to make it until 4… and somehow we always did.

My second child, a daughter born 3 years later, slept beautifully as a newborn.  Unfortunately that is when my terrible insomnia started and I would lay awake next to her, staring at a peacefully sleeping baby, angry as hell that I finally had the opportunity to sleep but my body wouldn’t let me.  

Insomnia is a complicated thing and it affects every area of a person’s life.  Lack of sleep affects the immune system, leaving a person more prone to catching a cold or the flu.  Cognitive function is affected and thus its hard to think clearly.  Hormones in the body which influence hunger are affected which lead people to crave quick food energy in the form of sugar.  Chronic lack of sleep is linked to an increased risk of multiple health conditions such as heart disease, high blood pressure and diabetes.  

Why people don’t get enough sleep varies from person to person. Reasons include job schedules, lack of time to unwind, inability to relax, hot flashes, too much coffee, mental health conditions and chronic pain plus many others.  There will always be factors outside of our control.  For our purposes here we are going to focus on what we can control (ex. limiting caffeine and alcohol intake) and decrease the effects of the factors that we can’t (ex. crying baby) as much as possible.  Take what you need and leave the rest.

Make your environment work for you

Make your bedroom as dark as possible.  The first order of business is your windows.  Wake up when you want to, not when the sun rises.  The phases of the moon need not affect your sleep, or street lamps, motion lights or flashlight tag. There are many options for solutions here.  Room darkening curtains are worth their weight in gold.  There is also blackout film that you can apply directly to windows, the disadvantage being that you won’t ever see sunlight in your bedroom.  Blackout shadesor blinds are fantastic although rather pricey.  After you tackle your windows see where else there is extraneous light in your room.  Its best to keep electronic devices out of your bedroom but if they must stay, cover any tiny lights with black tape.  If you use an alarm clock, pick one that doesn’t have numbers that light up, cover it with tape or put it facing the wall.  The last thing that jives with a good night of sleep is an electronic light shining in your face.  Do you wear a fitbit to bed? Turn off the function that makes it light up if you turn your wrist.  I have been woken up many times by simply rolling over and fitbit light shines right in my eye.  Eye masks are also an option, however downsides include the fact that humans can perceive light through other cells in our bodies so a dark room is best for sleep.

Make your bedroom as quiet as possible.  I highly recommend the Marpac Dohm white noise machine to drown out ambient noise.  Alternatives include a multitude of smart phone apps or sleep sound machines, however the marpac is king. We use them in the clinic and I use them at home, in my room and my kids rooms.  Ear plugs are also an option however they tend to fall out and if you need an alarm to wake up at a certain time you may not be able to hear it.  They are the best choice if you share a bed with someone that snores.

Keep tv and work out of your bedroom.  The idea here is to associate your bedroom as a place to rest and relax. Work is definitely neither so don’t bring it to bed.  Watching TV in the bedroom is not advisable either, keep it on the couch.

Keep pets out of the bedroom.  Pet lovers, don’t hate me.  Also, this really refers to dogs, because who has had success keeping a cat from doing what it wants?  After night duties for 2 children who still sometimes wake up at 6 and 3 years old, I have zero patience for an animal interrupting my sleep.  However I barely slept last night and got up at 4:50am so I’m cranky today.  If your dog sleeps like a perfect angel more power to you!  

Keep your bedroom on the cool side.  A small fan to circulate air or an open window if you live in a quiet area can do wonders to keep your bedroom cool which is good for sleep.  Keeping the heat down a few degrees at night in the warmer months saves energy and improves sleep too. 

Weighted blanket. A few of my patients swear by a weighted blanket to help with sleep and nighttime anxiety.

Daily routine

Go to bed and wake up as close to the same time every day as possible.  This helps to establish a rhythm for your body, making getting up and going to sleep easier.  Aim for within 30 minutes of wake up and bedtime.  

Turn off electronics 1-2 hours before bed.  This one is huge.  Remember regular ol’ books? Yeah I forgot about those too because I’m addicted to audiobooks and podcasts.  Cracking a book, some journaling or conversation with your partner or a friend on the phone are great low-tech activities to wind down in the evening.

Avoid caffeine after noon and limit caffeinated beverages to 1-2 cups/day.  Everyone knows that caffeine is in coffee, however it shows up in various other foods and beverages as well.  Some soda contains caffeine (some root beer and orange soda- weird, right?), watch out for caffeine in tea, juice and chocolate.  Some medications contain caffeine.  Decaf coffee and tea also contain trace amounts of caffeine.  Caffeine gives you false energy and while it gives an initial lift it ends up robbing you of valuable rest later.  First become aware of how much caffeine you are consuming and then slowly cut down or even wean yourself off.  

Avoid high carbohydrate and sugary foods right before bedtime.  Dessert, I’m talking to you.  A blood sugar crash does not a restful night of sleep make.  I would also put alcohol in this category too.  Alcohol contains a ton of sugar and while initially it might help you go to sleep, frequently it will make you wake up.  Many of my patients report difficulty sleeping after a night of even moderate drinking.  And after a night of excessive drinking, you know what happens the next day.  If you are having serious sleeping problems, you may want to consider abstaining from alcohol for a while.  

Reduce Stress

Sleep requires laying relatively still, closing your eyes and relaxing. Our bodies don’t function like light switches, on and off.  If your day has been stressful and chaotic, it’s unreasonable to expect your body to just be able to shut itself down and sleep simply because it’s bedtime.  Racing thoughts, tossing and turning and waking up in the middle of the night are common occurrences when stress levels are just too high.  Incorporate some stress relief into your daily and weekly routine to help your body to rest when it’s time for bed.  

Acupuncture Acupuncture is the best way to manage stress.  Usually people feel much better after just one treatment, sometimes it takes a few.  Acupuncture is a great tool to manage ongoing stressful situations, people feel better able to cope and deal with what’s going on when they are getting regular treatment.  With chronic stress and trauma the physiological stress response of the body can get stuck “on”.  Acupuncture shuts it off so that people’s minds and bodies can rest and relax.  Acupuncture also helps with hot flashes and night sweats too.

Exercise Getting your body moving is essential to managing stress and improving sleep.  Some people feel too revved up when exercising in the evening. If that is you, switch your workout to the morning or afternoon.  It doesn’t have to be bootcamp or crossfit, a nice walk outside counts!  Yoga is also a great choice because it helps to relax your mind too.  

Meditation, progressive relaxation These are techniques to help relax your mind.  There are many guided meditations on youtube and various smartphone apps.  Personally, I use the Calm app, however Headspace is also popular.

Take a bath This is a nice thing to do in the evening after the kids are asleep.  You can just close your eyes and relax, catch up on a book or magazine, listen to some music or chat with your partner.

Supplements - CBD, Melatonin, Magnesium  Some people find a sedating supplement before bed helps.  Sometimes sleep issues are so bad that a prescription is necessary and that is ok. You have to sleep in order to function. However these supports do not have to be a long term solution, I encourage you to do what you need to in order to rely on these measures as little as possible.

Give it Time

You might be tired initially.  Especially if you are coming off caffeine for example, you might just be now aware of how tired you really are.  If you are finally tired, let yourself rest. Go to bed a little earlier for a while to allow your body to catch up.  Be easy with yourself. If you have had life long sleep problems it may take awhile to get better.  

Consider this a starting point to figure out what works for you.  If you are still not sleeping well and have other health concerns you may consider a sleep study. Sometimes people need to use a small machine (CPAP) to help their breathing while they are sleeping.  Don’t be afraid to ask your doctor her opinion.