What to Expect at Your First Acupuncture Appointment

Trying acupuncture for the first time can be a little nerve-racking. It’s different from going to your regular doctor’s office, but it’s also different from other hands-on appointments you may have experienced, like chiropractic care or massage. You may not know what you’re supposed to wear, whether you’ll need to undress, what the needles will feel like, what on earth your acupuncturist is looking for when they ask to see your tongue, or what you’re supposed to do once you’re lying on the table covered in needles.

These are questions I hear all the time, so I want to walk you through what an acupuncture appointment with me actually looks like.

And perhaps the most important thing to know before we get into any of it is this: you can come as you are.

You Probably Don't Need to Undress

This is one of those worries people don't always ask about, but I think it's important to address.

When I was a teenager, I actually canceled a chiropractic appointment because I was nervous about the possibility of having to undress. I've experienced that same discomfort with massage appointments, especially when I didn't know exactly what to expect. So I understand why someone walking into an acupuncture office for the first time might have the same concern.

For a typical acupuncture treatment, you can stay dressed. Comfortable, loose-fitting clothing is helpful because I may need access to areas around your knees or elbows, but I can work around clothing most of the time.

There are some specific treatments where I need access to other areas of the body. For example, my Internal Dragon protocol uses points on the abdomen and thighs. If I know that's what you're coming in for, I'll try to let you know beforehand. If clothing does need to be moved or removed for a treatment, appropriate draping can be used.

Acupuncture is also not massage. Outside of things like locating a point, cleaning the skin, or inserting and removing needles, I'm not performing the kind of hands-on bodywork you would experience during a massage.

Your comfort matters throughout the entire appointment.

Eat Something, Drink Some Water, and Come As You Are

Please don't come to acupuncture on an empty stomach if you can avoid it. Eat normally that day and make sure you're hydrated.

I also find that people can be more sensitive to acupuncture if they've had a lot of caffeine, are dehydrated, haven't eaten, or perhaps had a little too much to drink the night before. None of those things mean you can't have acupuncture, but you might notice the needles more than you otherwise would.

You don't need to do anything elaborate to prepare. Eat. Drink some water. Wear something comfortable. Show up.

That's really about it.

What Happens When You Arrive?

If you're seeing me at Full Scale Wellness in York, Nebraska, I'll hopefully meet you in the lobby when you arrive. If I'm still finishing with another client, come on in and make yourself comfortable on the green couch in the waiting room. I'll be with you shortly.

At my Lincoln acupuncture location, there is usually someone at the front desk and a lovely waiting area where you can relax until I come get you.

We'll start your first appointment by talking for about 10–15 minutes. This is where your intake paperwork becomes really helpful.

Please complete it ahead of time if you can, because the more information I already have, the less of your appointment we need to spend gathering basic information—and the more time we can spend on your actual treatment.

But here's something I really want new clients to know about that paperwork:

If you only have limited time to fill it out, tell me why you're coming in.

I'd rather read, “I'm stressed all the time,” “my back hurts,” “I've been having migraines,” “my periods are miserable,” or “I have anxiety and can't sleep” than have you spend all your available time trying to remember the name of a doctor you saw five years ago.

Your medications and supplements are helpful for me to know, too, but don't get so caught up trying to make your medical history perfect that you never tell me the thing you actually want help with.

There are certain medications or treatments I particularly need to know about—for example, blood thinners are important when I'm needling, and hormone medications can be relevant if we're specifically addressing hormonal concerns. But acupuncture generally isn't an appointment where I'm going to spend our entire first visit dissecting your supplement list.

Tell me what's bothering you. Tell me what you want to feel different.

We'll start there.

Yes, I'm Going to Look at Your Tongue

After we talk, I'll usually do two traditional Chinese medicine assessments that first-time clients find particularly interesting: pulse and tongue diagnosis.

And no, checking your pulse isn't simply me counting your heart rate.

In Chinese medicine, I feel the pulse at three positions and at different depths on each wrist. I'm paying attention to qualities such as its strength, speed, depth, tension and overall character. Those patterns become one piece of the larger picture I'm putting together about what's happening in your body.

Your tongue gives me another piece.

I'll ask you to stick it out while I look at its shape, size, color, coating, moisture, movement and other characteristics. I may look underneath at the veins as well. Different areas of the tongue are traditionally associated with different organ systems and patterns in Chinese medicine.

Sometimes what I see leads to questions that may seem completely unrelated to your tongue: How are you sleeping? Are you having vivid dreams? Are you anxious? How is your digestion? Have you been feeling unusually frustrated or irritable?

I'm not diagnosing a medical condition by looking at your tongue or magically reading your entire medical history through your wrist. Tongue and pulse diagnosis are traditional assessment tools that I combine with what you've told me, what I'm observing, and the rest of your clinical picture to help determine your Chinese medicine pattern and choose your acupuncture points.

Once You're on the Table, I Want You Comfortable

This is a big one for me.

Please tell me what you need to be comfortable.

You are not being difficult. You are not being “the princess and the pea.” If you need another pillow, ask for one. If your shoulder hurts in a certain position, tell me. If we need to prop something up, adjust your position, add warmth, remove warmth or make another reasonable accommodation, I want to know.

My York office has a massage table that allows us to treat you face-up or face-down, and I also have a rocking chair that works beautifully for certain treatments. My Lincoln treatment table is highly adjustable, including the head and knees, so we have lots of options for positioning you comfortably.

Once you're settled, I'll clean the areas I'm going to needle with alcohol and begin placing the acupuncture needles.

You may feel the needle go in. You may feel a brief pinch, ache, heaviness, itching, tingling or another strange little sensation around a point. Those sensations can happen with acupuncture.

What I don't want is a sensation that prevents you from relaxing.

People fall asleep during acupuncture all the time. I don't expect you to fall asleep during your very first treatment—your nervous system may still be thinking, Excuse me, what exactly are we doing here?—but I do want you comfortable enough that you can settle.

If something hurts enough that you can't relax, tell me. I can adjust it.

What Happens While the Needles Are In?

Once all the needles are placed, you'll usually rest for about 25–30 minutes. Lights off, music on, and quiet time.

Typically, I'll leave the room so you can relax quietly. You'll have a call button if you need me. And if being alone with the needles makes you uncomfortable, please tell me. If you need someone to stay in the room with you, I'm happy to accommodate that.

Around the halfway point, I'll come back in to check on you and make sure you're still comfortable. I may also stimulate some of the needles by gently manipulating them.

This is part of the treatment and, again, shouldn't be unbearably painful.

One funny thing about acupuncture is that everyone's sensitivity is different. Sometimes I'll warn someone, “This point might be a little spicy,” and they don't feel it at all. Then a point I expect them barely to notice gets a very enthusiastic response.

Bodies are weird. That's okay.

I'll communicate with you, and you can communicate with me.

And Then…We Take Them All Back Out

At the end of your treatment, I'll remove all of the needles and check each point. I may hold a cotton ball or Q-tip over a spot if there's a tiny amount of bleeding.

I always warn first-time clients that minor bleeding or bruising can happen with acupuncture. Most of the time it doesn't, but you're having tiny needles inserted through the skin, so it is possible.

Taking a blood thinner doesn't automatically mean you can't receive acupuncture, either. I simply need to know about it so I can take the appropriate precautions.

For most people, there aren't major restrictions after an ordinary acupuncture treatment. Eat, hydrate, and pay attention to how you feel.

If you came in because something hurt and suddenly feel fantastic, however, please don't immediately go test your limits. I've had people feel dramatically better after treatment, go home and overdo it because they finally could, and then wonder why they're achy again the next day.

Enjoy feeling better. Just give your body a little time.

Occasionally people also feel very relaxed, tired, hungry or a little depleted afterward. If you need some water, electrolytes or a small snack before leaving, let me know. I often have something around the office that can help.

How Often Will I Need Acupuncture?

This is one of the hardest questions to answer before I've actually met you because treatment frequency depends on why you're coming in and how your body responds.

For many new clients, I recommend starting with another appointment about a week later. If we're dealing with something acute or particularly intense, I may suggest seeing you again sooner. If you're coming in primarily for general wellness or maintenance, we may be able to space appointments farther apart.

My goal isn't to keep you coming in as frequently as possible forever. It's to figure out what frequency makes sense for what we're actually trying to accomplish and adjust as your symptoms change.

Still Nervous? Ask Me.

There are no bonus points for pretending you're not nervous about your first acupuncture appointment.

Tell me you're nervous. Tell me you've never had acupuncture. Tell me you're scared of needles. Ask me what I'm doing. Ask me why I'm putting a needle somewhere that seems completely unrelated to the symptom you came in with.

I'd much rather you ask than spend the entire treatment quietly worrying.

If you're considering acupuncture in York or Lincoln, Nebraska, you can learn more about acupuncture at Full Scale Wellness and schedule your first appointment through my website.

And if I didn't answer your question here, visit my FAQ page. Still can't find what you're wondering about? Reach out. I'm happy to answer questions before you decide whether acupuncture feels right for you.