What is the best style of acupuncture?
There are many styles of acupuncture – Traditional Chinese Acupuncture, Japanese Acupuncture, 5-element acupuncture, Distal Needling, etc.  Some acupuncturists will try to convince you that their style is superior to every other style, some going to the extent of telling you that other styles simply don’t work (and they may truly believe this), but they don’t understand the other styles well enough to give an accurate comparison of strengths and weaknesses.  Different styles appeal to different practitioners, so of course they are going to be better at the style that they make an effort to learn well because it appeals to them.  As part of my education I received training and clinicals in Japanese acupuncture, 5-element acupuncture, and Distal Needle acupuncture, but the combination of styles I now practice were the ones that appealed to me the most, and therefore became the most effective styles for me.

I practice Traditional Chinese Medicine/Acupuncture, with a history of over 5000 years.  For treating pain, I use trigger point referral patterns (mapped out by John F. Kennedy’s Whitehouse Physician Dr. Janet Travell), and treat the underlying conditions that cause pain with Traditional Chinese Acupuncture and herbs.  Needling trigger points is now being called "Dry Needling" by Physical Therapists, though their technique protocol which is most often practiced uses a lot of needle manipulation and is painful, as opposed to my pain-free technique of inserting and leaving needles in place rather than aggressively manipulating them. 

Trigger points are a symptom, not a cause. Needling or applying pressure to the trigger points treats the acute part of the problem, but does not solve the underlying factors. If you get temporary relief from pain but symptoms quickly recur, then trigger points are definitely a factor, but perpetuating factors need to be addressed in order to gain more lasting relief. Trigger points may form after a sudden trauma or injury, or they may develop gradually. Common initiating and perpetuating factors are mechanical stresses, injuries, nutritional problems, emotional factors, sleep problems, acute or chronic infections, organ dysfunction and disease, and other medical conditions.  To get long-term relief from trigger points, you need to eliminate the perpetuating factors that cause and keep trigger points activated. 

I have my patients fill out a complete medical history and spend on average at least 45 minutes discussing the medical history before reaching a preliminary diagnosis and treatment plan, then do an exam and treatment, and then spend another half hour before the next appointment reviewing and refining my diagnosis and treatment plan.  At the beginning of each subsequent appointment I ask how you responded to the last treatment, and get any new information.  Together we can do the detective work and get to the source of the problem, and I will provide you with literature, advice, and training that includes information on perpetuating factors and how to resolve them, self-help techniques, and dietary advice, in order to get lasting relief.

But pain is only one condition that Traditional Chinese Medicine/Acupuncture treats.  For a list of conditions see http://triggerpointrelief.com/Clinics/AcupunctureConditionsTreated.html.  During the preliminary phone conversation I will give you an honest assessment of whether I think I’ll be able to help you, or I'll tell you if I’m not sure, and that we’ll just need to see how you respond to treatment.  I won’t ever tell you something I think you want to hear just to get you into my clinic (including that my style is superior to another practitioner’s, or that I can treat a condition that I can't or shouldn't treat with acupuncture), or attempt to get you to schedule with me instead of or in addition to, if you have already booked with another acupuncturist (I feel this practice is unethical, and that you should only see one acupuncturist at a time, since it then confounds the results).  If you aren’t getting the results I expect you to have, I will refer you out for imaging and/or lab work for additional information.  I won’t keep treating a patient I’m not helping, and will make every effort to connect you with a Health Care Provider who may be able to help you.  I estimate I have about a 98% rate of effectiveness.

How does acupuncture work?
The answer is: No one knows for sure.  The ancient Chinese theory is that there are meridians throughout the body where "Qi", or energy, flows.  If there is a block in the meridian, disease and pain result.   By inserting an acupuncture needle in the blocked point, the flow of Qi, and therefore health, is restored.

Western medicine is just beginning to substantiate that indeed, acupuncture does have effects that cannot be explained by what we currently know about human physiology.  When performing a "functional MRI" and needling points in the foot known to affect the eyes, the MRI shows activity in the visual part of the cortex of the brain.  Many people believe acupuncture is a biochemical process -- needling affects the nerve synapses, and therefore the neurotransmitters that transmit information to the brain.  Acupuncture points can be found by measuring the electrical resistance on the skin.

Even though we can't yet entirely explain exactly how acupuncture works, 5000 years of needling acupuncture points has resulted in a vast body of knowledge regarding the effects from needling each of the over 400 acupuncture points.

The first visit includes a comprehensive medical history interview and a full treatment, which takes about 1.5 hours.  All of your symptoms are discussed, even those you may think are unrelated.  I then develop a preliminary Chinese Medicine Diagnosis, which determines acupuncture point selection.  Before your second appointment, I go through your medical history and develop a more detailed diagnosis and treatment plan (about another ½ hour). Subsequent sessions last 50-60 minutes and consist of a brief discussion about the effects of the last treatment, additional recommendations, and a treatment for the present concerns.  It is best to focus on a few priorities at a time rather than jump from treating one issue to another at each appointment, though I will also attempt to select points that treat multiple concerns.

Needles
Acupuncture needles are thin, like a hair.  Usually you will either feel no sensation, or just a sensation that the needle was inserted.  Occasionally, if the needle goes in a hair follicle or blood vessel, there will be a small amount of stinging, which usually goes away almost immediately.  If the stinging does not go away, I move the needle to a slightly different location, or leave it out.  I use only disposable acupuncture needles.  I usually use 14-20 needles per treatment, and needles are typically left in between 20-35 minutes.

How Long Will Therapy Take?
A common question I get in the beginning of therapy is "How long will it take"?  My general rule of thumb is that longer the condition has been going on and the more medical conditions (of any kind) the patient has, the more muscles and organ systems will be involved, and the treatment will be more complicated and take longer.  If a patient is perfectly healthy and has only a recent minor injury, I may only see them a few times.  Patient compliance is a factor -- whether they follow my recommendations and participate in their healing by doing the self-help techniques (patients that follow my recommendations get better about five times faster than those who don’t).  I can usually give the patient a pretty good indication of how many treatments they may need by the end of the second or third treatment, based on their medical condition, their compliance to date, and how much they have improved (or not) within the first few weeks.

Please don’t expect that you will be completely well in one appointment - this is a process, and not a one-time treatment for most patients.  The acupuncture itself is only part of the treatment – I may recommend dietary changes (if you are deficient in a nutrient, acupuncture is not going to replace that nutrient), lifestyle changes, furniture/equipment changes, herbs/homeopathics, and/or self-help techniques as part of your course of treatment.  All of this can’t be done in just one appointment.  For some patients, it is desirable to relax muscles slowly over time, to avoid increasing pain when muscles that are weak (due to splinting by the tight ones) start taking their share of the load again. For most patients, I recommend starting with once per week, and then as a patient improves I start decreasing the treatment frequency.  If you have a disc problem or chronic fatigue syndrome, twice per week may be recommended initially.  Some conditions will take longer to treat, such as gynecological problems.

Sometimes one or more other issues may need to be resolved either first or simultaneously, in order to effectively treat your primary concern.  For example, if a patient isn’t sleeping well or has diarrhea, I may need to treat those also in order to relieve their pain completely. I may recommend supplements if I suspect a nutritional deficiency.

Please plan on giving acupuncture three to five treatments before you decide whether it is working or not.  Sometimes patients forget to put everything on their medical history form that is significant, and it may take some treatments for them to remember that information, or realize it is significant (i.e. all the exercises they are doing, or foods/beverages that are significant).  Sometimes I will ask you to pay attention to certain patterns in the coming weeks, like what you were doing just prior to the symptoms getting re-aggravated, so I can discern what external factors are causing your health issues. 

Some patients get a little worse before they get better, and if I think that will happen, I will let them know, but I can’t always anticipate that.  Please don’t stop coming if you feel worse after a treatment!  Sometimes getting a little worse, or no change, is good diagnostic information in itself.  It could be good information about what is aggravating your problem.  Sometimes patients will start to feel better and overdo it, but that does not mean the treatment made you worse or didn’t work.  Sometimes it takes trying different treatments to get to the root of the problem.  If someone hasn’t improved at all in three to five treatments, I will send that patient to get imaging (MRI, X-ray, CT scan) and/or blood work, or other diagnostic testing through another type of provider.  Once that is done, I can decide if acupuncture is still appropriate, and how to change subsequent treatments based on the test results.  If I think you need to seek care from another type of provider at that point, I will make a recommendation.

Sometimes a patient will come in and tell me “there was no change,” but upon further questioning, the condition really has improved, it’s just that it’s not all gone.  Any change for the better in symptom intensity, frequency, duration of symptoms, amount of affected area, and a shorter length of time before the symptoms decrease once re-aggravated, are all signs of improvement.  It also makes it easier for you to discern the pertinent external aggravating factors when you don’t have symptoms 100% of the time any more.  This does not mean you won’t relapse, particularly if you overdo it, but what is significant is how you felt within the first few days of the treatment, and I will ask you for that information at the start of each session.  Ideally you will get relief for longer and longer periods of time if you don’t re-aggravate it.

Why is Acupuncture Growing So Rapidly in the U.S.?
- It puts people back in control of their bodies and health care.
- It works on many health problems for which Western medicine is less effective.
- It is safe, effective, and has virtually no side effects.
- It treats the whole person and not just the disease.
- It uses the body's natural healing process to effect relief.

Herbs
Herbs in pill form may be prescribed to help support your treatments.  The formula will be based on your individual Chinese diagnosis, including your signs and symptoms, and your underlying constitutional pattern.

Please let me know if you have additional questions.  I look forward to working with you to improve your health and quality of life!

Sincerely,

Valerie DeLaune, LAc

About Valerie DeLaune

Valerie DeLaune is a licensed acupuncturist and certified neuromuscular-trigger point/myofascial release massage therapist, with a Masters Degree in Acupuncture from the Northwest Institute of Acupuncture and Oriental Medicine and certificates from Heartwood Institute and Brenneke School of Massage.  She has been in practice since 1989, and has seen patients from all over the world. 

 She has written eleven trigger point books:  Pain Relief with Trigger Point Self Help (book-on-CD ROM, 2004), Trigger Point Therapy for Headaches and Migraines:  Your Self-Treatment Workbook for Pain Relief  (paperback, 2008), Trigger Point Therapy for Foot, Ankle, Knee, and Leg Pain (paperback and e-book, 2010), Pain Relief with Trigger Point Self-Help (paperback, 2011), Trigger Point Therapy for Repetitive Strain Injuries (paperback, 2012), Trigger Point Therapy Workbook for Shoulder Pain including Frozen Shoulder (e-book, 2^nd Ed. 2013), Trigger Point Therapy Workbook for Upper Back and Neck Pain (e-book, 2^nd Ed. 2013), Trigger Point Therapy Workbook for Lower Back and Gluteal Pain (e-book, 2^nd Ed. 2013), Trigger Point Therapy Workbook for Chest and Abdominal Pain (e-book, 2013), Trigger Point Therapy for Headaches and Migraines including TMJ Pain (e-book, 2013), and Trigger Point Therapy for Lower Arm Pain including Elbow, Wrist, Hand & Finger Pain (e-book, 2013).  She has written articles for ADVANCE for Physical Therapists, Massage World magazine, Fibromyalgia Magazine, Yoga Magazine, and the International Journal of Therapy and Rehabilitation on trigger point topics, and has written several articles for the Juneau Empire on acupuncture topics.

Valerie teaches trigger point continuing education workshops in the U.S., and currently resides in Palmer, Alaska.   www.triggerpointrelief.com