People with rheumatoid arthritis (RA) who are looking to manage and relieve their pain may not realize acupuncture is an option to consider. Rooted in Traditional Chinese Medicine, the general goal of acupuncture is to resolve energy imbalances within the body that can cause pain and inflammation. In the case of RA specifically, acupuncture can also address the immunological components of the disease. Your acupuncturist will determine the best way to treat you based on your diagnosed condition and specific symptoms. For example, acupuncture for someone with RA will differ from acupuncture for someone with insomnia. But even between two people with RA, the treatment will vary depending on which specific joints are bothering you and what kind of pain you’re experiencing. Let me assure you from the start the needle pricks are not painful. Still, I know acupuncture can be intimidating for some and you may feel hesitant to try it. Before Your Visit It’s a good idea to have a light meal before your visit, and to avoid drinking coffee just prior. As far as clothing, just dress comfortably. Consider bringing any recent blood work (some people will even bring X-Rays). These records will help give us a complete picture of what’s going on inside your body. Plan to set aside between an hour and 90 minutes for your first appointment—and make sure you use the restroom beforehand. Meeting Your Acupuncturist Just like with any doctor’s visit, your appointment will start off with a discussion about your symptoms. You’ll fill out some paperwork and your acupuncturist will ask you a variety of different questions to gather information. Some questions may strike you as odd; they may not seem relevant to your symptoms or condition. For example, even if you come in with RA, we may ask about your digestion and your sleep. For women, we may ask about where you are in your menstrual cycle. In Traditional Chinese Medicine, these factors and systems are interconnected and help us diagnose and determine the best course of action. Physical Assessment When a patient comes in and tells us they have an autoimmune disorder like RA, then we know straightaway we need to address the immune system. But there are different patterns people with RA present and we treat each in specific ways. Traditional Chinese Medicine teaches that pain brought on by cold temperatures or damp climate is related to the spleen. So when RA patients come to us with cold, stiff joints, we insert needles into points on their bodies that correspond to the spleen’s energy channel, which lie on the inside of the lower legs. Your acupuncturist will also measure your pulse on both wrists. We do this because each pulse point corresponds to a different organ system; so a weak pulse in your right wrist doesn’t mean the same thing as a weak pulse in your left wrist. Your acupuncturist will likely examine your tongue as well, noting color, thickness of the coating, fluid level, and any cracks, swelling or teeth marks. In Traditional Chinese Medicine, different parts of the tongue correspond to different organ systems and all of these characteristics help us assess where there are imbalances within your body. The Needling Process You will most likely be lying down for the actual needling process—either face-down or on your back. Some centers may also have massage chairs available if that would be more comfortable for you (often the case for pregnant women). The needles we use are always sterile and one-time-use only. They range in size, but all of them are much smaller than any needle that would be used for injections. They’re also flexible, kind of like a cat’s whiskers. Depending on your condition, your acupuncturist will likely insert between 16 and 20 needles at various points on your body. Some needles are inserted about half an inch deep, while others—in areas where there’s thicker body tissue—may be inserted a few inches deep. You may feel a dull or achy sensation from the needles, but you shouldn’t feel pain. If you do feel pain, you should definitely tell your acupuncturist so they can address the issue. The needles will stay in for about 25 minutes, during which your acupuncturist will leave the room and allow you to relax. She may set up a heat lamp in the room beforehand. Generally she will check-in about halfway through to make sure everything is fine. After the 25 minutes, the needles are removed and discarded into a biohazard sharps container. You may feel as if you’ve just received a massage and your acupuncturist may in fact massage your neck and face to get your blood flowing again. Follow-up and Payment Once you’re dressed and fully alert, your acupuncturist will want to discuss and schedule your next visit. For new patients and for those with more acute issues, it’s usually recommended you come in twice a week. Eventually, with an ongoing condition like RA, we would scale back your visits to once a month. Your initial treatment will usually cost about $90 and for follow-up visits, $75 is pretty standard. In addition to the actual treatment, we may recommend certain herbal supplements or probiotics that we sell at the center. These come in a variety of forms like tablets and powders you mix with water; some centers may even sell raw herbs you need to cook. If you decide to purchase any herbs and depending on which ones, these could end up costing you another $30 or so. But of course you can always say thanks, but no thanks. Insurance may cover your acupuncture expenses, depending largely on which state you live in. Expectations for Pain Relief After your first few visits, you may notice pain relief, reduced inflammation and greater joint flexibility, lasting for about three days. But as your body adjusts to the treatment, the effects will become longer-lasting. It may take about six appointments to get to that point. Side effects are minor and uncommon—you may continue to feel a dull sensation where the needles were inserted for a bit after your treatment. You may also feel dehydrated afterwards. For this reason, it’s a good idea to drink more water than usual before and especially after your visit. Our goal, through acupuncture, is to enable our RA patients to live comfortably without any prescription medication. However, this may take time and will depend in part on the patient’s doctor and the doctor’s view of acupuncture as a viable alternative for the patient. I can’t speak for all acupuncturists, but for myself and those that I know, I can say we’ll be very upfront with you about what kind of results we think you can expect from the treatment. Then, after about three treatments, we’ll reassess and determine with you if acupuncture is a good fit for your needs. Mariah Van Horn is a licensed acupuncturist and board certified herbalist practicing at Acupuncture Atlanta.