Hello, I’m Dr. Joseph Kwok, Chief of Chronic Pain at
Kaiser Permanente South San Francisco. You’ve received a referral for
acupuncture at our clinic. Your primary care doctor feels
you may benefit from acupuncture for your chronic pain which
you’ve had for three months or longer or for nausea or
vomiting from chemotherapy or pregnancy. Our mission is to help lessen
your pain and improve your quality of life through
pain management and lifestyle changes. While you might not become
pain free, we hope your pain will be much
more manageable and better tolerated. Many people have questions about
acupuncture, how it works, what to expect,
and how our clinic operates. Let’s have our acupuncturists
answer some of these questions. This video is in chapters. We recommend you watch it all
the way through first. You can revisit a particular
chapter if you want to hear certain information again. Let’s get started! What is acupuncture? Hello, I’m Merissa Tsang, a licensed acupuncturist in the
Chronic Pain Program. Acupuncture is traditional
Chinese medicine that studies have shown can help manage pain
and help with other physical conditions like nausea from
chemotherapy or during early pregnancy. Very thin sterile needles are
inserted into specific acupuncture points on your body. These needles stimulate and
increase blood circulation in areas of pain to promote
healing and pain relief. These needles are inserted
by trained and licensed acupuncturists. We’ll place needles in various
parts of your body, most commonly in the arms,
hands, lower legs, ankles, feet, ears, face
and scalp. The needles stay in your body
for about 20 to 30 minutes. Since the needles are so thin,
they’re usually painless. During your treatment, you may
not even feel them. If you do, you may feel
sensations like a slight throbbing, heaviness, warmth,
coolness, achiness or soreness. If you have any ongoing or
continuous sharp pain different from the sensations
just described, be sure to tell your
acupuncturist. What happens at my first visit? Hello, I’m Diane Au, another one of the
acupuncturists in the Chronic Pain Program at
South San Francisco. Before beginning treatment,
you’ll complete a Pain Level Questionnaire. In fact, you’ll fill one out
before each treatment. We want you to have enough to
time to find parking, check in, use the restroom and
fill out the questionnaire, so you may want to arrive about
20 minutes before your scheduled appointment time. You’ll be in treatment for
about one hour, so be sure you’ve eaten
something light and used the restroom before you check in. If you’re at all fearful of
needles or nervous about treatment, now’s the time to
tell your acupuncturist. For your treatment, you’ll be
seated in a chair or lying down on an exam table. Depending on your medical
condition, you may receive your
acupuncture in a group or in an individual setting. We’ll explain more about the
difference between the two in a moment. Next, the acupuncturist will
clean your skin with an alcohol swab and insert needles
at specific acupuncture points. With the needles in place,
you’ll rest for about 20 to 30 minutes. We may put a heat lamp on your
feet so they don’t get cold. Before the acupuncturist leaves
the room, we’ll hand you a pager which you
can press if you need to call for assistance at any time
during your treatment. What happens during treatment? People feel different sensations
during treatment. You may feel a dull ache,
heaviness, numbness or tingling,
a warm or cool sensation. All these are normal. But if you feel discomfort other
than these, be sure to tell the
acupuncturist. If you’re a candidate for
auricular acupuncture group treatment, you’ll receive
acupuncture with others in a group setting and at
specific points in your ears to help manage pain. One benefit of group treatment
is that it may allow you to get an appointment sooner. In a group treatment session,
there are up to 12 patients sitting in chairs in a circle
formation facing outward and away from each other. To prepare for treatment,
if you have long hair, please tie it back, away from
your ears or you can use a hairnet, which
we will provide. The acupuncturist will swab each
person’s ears with alcohol and places up to 5 needles
into each ear. Then you’ll sit for up to 30
minutes while the lights are dimmed and a guided meditation
plays in the background. An acupuncturist will be in the
room at all times during the treatment. In order for patients to have a
successful and relaxing experience, please be on time
for your appointments. Latecomers will not be
allowed to enter the group treatment room. What should I expect after
my visit? How will you feel after
the needles are removed? Everyone feels differently. Some people don’t feel anything
immediately after treatment, while others experience
sensations that may linger for a few hours, then gradually
go away. Many people feel an increase
in relaxation, so please take caution after
your treatment when driving a car or operating machinery. Try to take it easy and avoid
strenuous activity for the rest of the day. And be sure and drink
lots of water. Numbness, tingling and bruising
following acupuncture may occur, especially if you’re taking an
anticoagulant medication. On occasion, there may be
swelling, itching, bruising, tingling, lingering
soreness, or aching sensations around the acupuncture site that
can last up to 48 hours. For more information about this, please review the chapter
on Side Effects. How will I know if acupuncture
is helping me? At each follow-up visit,
you’ll fill out a Pain Level Questionnaire. This helps us determine if your
pain has decreased since starting acupuncture and if you
should continue it. Since the goal of acupuncture
treatment is to achieve significant and sustained
pain relief, we want to hear if you’ve had
pain relief after your first, second or third treatment. You can document this on your
Pain Level Questionnaire, and we’ll check in with you by
email or phone. After your initial treatment,
typically you’ll be scheduled for two additional treatments. After your third treatment,
we’ll reevaluate to see if you should continue
acupuncture treatment. If you’ve experienced
significant and sustained pain relief with treatment,
that’s great! Your acupuncturist will then
determine if a plateau has been reached and if you’ve
experienced maximum benefit. But if you have pain relief
that’s short-lived with pain quickly returning to its
original base level, that indicates that acupuncture
isn’t significantly beneficial for you. We’ll then discharge you and
have you follow up with your referring doctor for other
possible medical interventions. So, pay attention to your pain
and how it may change. While your pain may never go
away completely, our goal is to lessen your pain
so you can better manage your pain and improve your
quality of life. When you reach a plateau in
treatment, when you’ve experienced the
maximum benefit of pain control, you’ll be discharged from the
acupuncture clinic with the option to call us for a
flare-up treatment. A flare-up is increased pain in
the same body part where you previously had pain, has a moderate to high level
of severity and doesn’t resolve on its own
within three to four days. If you have a new injury or
trauma in the same pain region or pain in a different area,
you’ll need to be re-evaluated by your primary care doctor. Are there any side effects? Sometimes increased pain in your
original affected body part can occur during and after
acupuncture treatment. This is known as a pain crisis. While painful, a pain crisis
frequently results in a decrease from your original baseline
level of pain. An increase of pain lasting up
to 72 hours after the procedure is common in up to 20 to 30
percent of patients. Increased pain in your original
affected body part lasting up to a week or more only occurs in
about 5 percent of patients. Warm compresses, a heating pad
or hot soaks with Epsom salts on the affected area can be helpful
to reduce discomfort – just follow directions on the
Epsom salts container. If you have increased pain
lasting longer than 3 days, with increasing intensity or
new pain you feel is related to acupuncture, please call the
acupuncture department. If you feel it’s a
life-threatening condition, call 911 or go to the nearest
Emergency department. What else can I do to help
manage my pain? Acupuncture’s not generally used
as a long-term therapy. We encourage you to participate
in self-care to better manage your pain. Activities such as stretching,
exercise, stress management, self-massage,
self-acupressure, and dietary changes may enhance
your acupuncture treatment results and increase the
potential for long-term benefit. Staying hydrated,
getting sufficient sleep, and resting your area of pain
may also help you feel better. We suggest eating an
alkaline diet. This is a balanced diet with
lots of fruits and vegetables, with less red meat, dairy
products, wheat and sugars. If you have arthritis, try to
avoid foods in the nightshade family, such as
tomatoes, potatoes, eggplant and all peppers. Turmeric supplements of 1,000 to
1,500 milligrams a day may be helpful for those suffering from
pain by reducing inflammation. And incorporate lemon into
your diet, as lemon is an alkaline super
food when taken internally. A good way to do this is to
drink lemon water, which is water with lemon slices
or lemon juice in it. What else should I know before I
come to acupuncture? Remember to arrive early enough
before your appointment to allow time to check-in
and fill out a Pain Level Questionnaire. Late patients will not be
allowed to enter the group treatment room. We prefer that you refrain from
taking any prescription or over-the-counter pain medication
on the day of your appointment so that we can better gauge how
the acupuncture is affecting your pain. After your acupuncture
treatment, if you experience ongoing pain, you may resume taking pain
medication as needed. Please take all other
medications as prescribed by your doctor. If you’ve had a steroid
injection, you must wait at least two weeks
after the steroid injection before starting acupuncture. If you’re scheduled for physical
therapy on the same day as your acupuncture treatment,
we recommend going to physical therapy first. Wear comfortable,
loose-fitting clothes, especially pants that can be
pulled up over the knee or shirts with sleeves that can
be pushed up over the elbow. Use the restroom before each
treatment. Make sure your hair is away
from your ears. Please don’t come to your
appointment hungry, after a rigorous workout or
under the influence of alcohol, drugs or caffeine. It’s best not to consume
any caffeine on the day of treatment. And please avoid wearing
perfume, cologne or strongly scented products. Our contact information. Please call our department to
let us know if you’re running late, unable
to keep your appointment or have questions. If you have to cancel your
appointment, we appreciate 24-hours notice
if possible. We look forward to helping you
better manage your chronic pain condition through
acupuncture and lifestyle changes. Thank you.

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