The following article was published by our friends at Guelph Community Acupuncture in Ontario, Canada on their website.

We're taking the opportunity to re-post Stef & Lisa's writing here in order to open this common clinical topic up.  No one can tell you about the pain or illness you experience.  Likewise, no one can tell you if you are feeling better.  However, this post offers examples of changes that typically show through that are good signs of a shift in the right direction, even if you're not where you'd ultimately like to be, quite yet.

We hope it's useful to you.

 - MAS Staff
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How to Tell That Acupuncture Is Working Even Though You’re Still in Pain

We see many people in intense, long-term chronic pain. Some of these people get immediate and dramatic relief, but it's much more common for regular treatment to slowly chip away at an issues that are chronic. (That's why we do our best to make acupuncture as accessible as possible; it may not work if you can't get enough treatment.) And sometimes progress is less straightforward. How do you tell if acupuncture is working even though you're still in pain? Here are some questions to ask yourself:

Am I taking less pain meds?

It is surprisingly common for someone to arrive for their second visit, say there's no improvement, that the pain is just as bad ... and then, when we ask about medication it turns out they forgot or didn't need to take it. We get that it may feel the same in your body, but that's still progress!

Has the pain changed?

Sometimes acupuncture shrinks the area of the pain before it changes the intensity of the pain. Was the original pain covering a postcard-sized area? Did it shrink to the size of an egg after you started treatment? That's progress, even if that egg-sized area is still very painful. Likewise, if the pain was very intense all day every day and now you are getting small windows of only milder pain, that's progress as well.

Am I able to walk further/do more physical activity?

Chronic pain can make our lives a lot smaller, can make going out to the car a struggle or doing the dishes a seemingly impossible task. We frequently see people doing more in their lives, sometimes before we even see the pain itself decrease.

On a related note: did you feel so good after your treatment that you overdid it and re-injured yourself?

We get it, you were in pain for so long and now there's so many errands and things to do around the house, nevermind the other things you've been waiting to do for so long. It's common for people to get really excited when they feel better, overdo it, and then have the pain set in again. If that happened, and you're feeling worse now, we wouldn't necessarily call that "progress" ... but it is a sign that the acupuncture helped. Try to take it easy after the next treatment!

Are you sleeping better or longer?

Chronic pain often interferes with sleep. If you're still in just as much pain during the day, but your sleep is better, then the acupuncture is most likely helping. Keep at it, and hopefully you'll experience daytime relief too.

Is your mood and focus better?

Chronic pain demands a lot of our brains' "bandwidth". Another great thing about acupuncture is that it can help clear up mental fog, forgetfulness, anxiety, or a low mood. It may be, especially at the beginning of treatment, that your mood or focus improves before your pain does.

Lots of folks have been kindly asking how they may help MAS with the upcoming move in Manchester. 

We do appreciate this.

Here are three ways:

1) Continue to get acupuncture treatments in Manchester & Nashua, and to refer your friends, family & co-workers to do the same.

2) Show up out back at 813 Canal Street in Manchester at 9am on Saturday, June 22nd with a pickup truck or car, ready to make a trip or two over to the new space.

3) Offer a tax-deductible donation to MAS to help offset costs of relocation. All amounts are appreciated.

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Similar to how CBD has very recently captured the collective imagination, Dry Needling (DN) has made a dent in the collective cultural awareness over the past few years, mostly via adoption into physical therapy and chiropractic practices.

Nowadays, the staff at MAS is asked fairly frequently about dry needling, so we've put together a small amount of information about it from our collective perspective. We offer this as experienced licensed acupuncturists, who've both employed and received dry needling, and from our experience from speaking to dozens of people who've also received DN, mainly outside of MAS.

Our definition: Dry needling involves repeated needling directly into knotted muscle fibers, each time causing a twitch in said knot, for the purpose of ultimately coaxing it to become exhausted and release.

A few things we'd like to get out of the way, up front.

First things, first: dry needling is an acupuncture technique, called 'trigger point' needling in different circles. The term 'dry' was apparently attached to the technique when adopted by medical professionals to distinguish it from a prevailing needling technique performed with a hollow hypodermic that would be used to inject various substances into the flesh.

First things, second: At MAS, we want lots of people to get acupuncture. In light of this, we support people getting acupuncture in all forms - including dry needling - as readily and affordably as is possible for them. We understand this is not a popular opinion in our profession, but we stand by it.

...and third: We have not and likely will not offer dry needle/trigger point needling at MAS. There are several reasons for this, one of which is we normally don't find the technique any more effective than the distal-needling we primarily employ. Also, more than any particular technique, receiving treatment as often as is appropriate clinically, is the factor most closely related to feeling better in our experience.

You may have heard Maslow's Law of the Instrument: if the only tool you have is a hammer, you'll see the world like a nail.  DN reminds us of this notion. Repeatedly and directly needling into a muscle knot is one way of approaching helping to resolve the knot via acupuncture needle, but it certainly isn't the only one. 

Alternately, one could choose to stimulate strategically connected acupuncture points further away from the muscle knot. These can be effectively employed like the light switch on the wall controls the lights on the ceiling. In addition, this approach will eliminate the likelihood of the great soreness after a treatment as compared to the DN approach. It's also our preference to do so as a tremendously more gentle means to an end.

Just like the piano is a tool that can played in many ways, the acupuncture needle can be employed in distinctive ways as well. You wouldn't expect all pianists to tickle keys in the style of Fats Domino, right? In the same way, MAS acupuncturists aren't limited to a heavy-handed direct-needling techniques either.  While these can be effective, no doubt, they simply aren't always going to be the best choice across a broad array of clinic situations, from our perspective.

A few other thoughts to share...

Dry needling is normally felt much more intensely than most other acupuncture techniques. So if you've had DN done in past and are thinking, "that's what acupuncture feels like", hold that thought. You may surprised at how softer different approaches can feel, while providing good results.

To the folks who have been left to wonder if they can receive acupuncture at MAS when they've had DN alongside at their PTs office, Yes, please come on in and grab acupuncture treatments. As we normally aren't directly needling locally (ie. where the target pain is located), treatments at MAS will not further test the area needled with DN. Just the opposite, in fact, where a reduction in inflammation via movement of blood and body fluids aims to ease local soreness and pain.

Not all approaches will hit the spot for every person. If distal acupuncture techniques haven't done the trick after a course of treatment, DN may be a good choice. Some folks do well with a more passive approach, others more direct. For our part, we never want to see you stuck on a hamster wheel, just spinning in place. Any referral that we feel would be of benefit for you in your goals, we are most happy to make. This happens regularly at MAS, where we are grateful for many outstanding providers of many stripes, in and around southern NH.

It's a long-held truism in the realm of Chinese medicine, that Springtime is a favorable time of year to include natural sour-flavored foods to one's plate in small amounts at each meal.

The thinking here is it's an advantage to do so for the parts of our system that are involved in clearing the heavier residues of the winter diet and assisting getting things moving anew upward and outward. 

Read more about recommendations the Chinese medical classics make for us down below.   

Aside from citrus juices like lemons and grapefruit, a number of natural sour-flavored foods can be found among those that are fermented.  Fermented foods are produced or preserved by the action of microorganisms.

Think pickles or sauerkraut or kimchi as common examples. 

Adding to the case for fermented foods in the Springtime, or any time of year for that matter, is information like this that comes out of modern research. This research from the National Institute of Health suggests fermented foods have the measurable effect of aiding the beneficial bacteria in the lower digestive system, but also improves our ability to perform various mental processes such as memory recall, orientation to the outside world, learning and furthering language skills.