Most patients that come in for acupuncture or herbal medicine do so because they are seeking treatment for a specific health issue – they are seeking relief from chronic headaches, treatment for a rotator cuff injury, a targeted approach to managing symptoms of menopause, treatment for unexplained infertility, etc. We focus the initial treatment phase on alleviating these symptoms and diseases for which the patient is seeking care. As symptoms start to improve, we gradually space out acupuncture visits until the symptoms are completely resolved or at a manageable level.
Some chronic or degenerative conditions, such as osteoarthritis, require that patients come in regularly for maintenance care to prevent flare-ups of the disease or symptoms. For example, after pain and stiffness have been brought down to a low and manageable level, we may recommend that the patient return once every 8 weeks for a tune-up, or plan to do another intensive course of weekly treatments after 6 months. For these chronic conditions that have underlying changes to anatomy, it is easy to understand why maintenance care is important.
For other conditions, however, it is not always as clear. Why should you come in for acupuncture when your symptoms are gone?
The reason is that TCM, like many traditional medical systems, focuses on health rather than disease. It can be used as a truly preventative medicine. Many traditional medical systems have focused for thousands of years on the promotion of health and wellness, and what you can do every day to PREVENT disease. It has been said that physicians in ancient China were paid as long as the patient was healthy – if the patient became sick, the doctor was no longer paid. Our Western medical system, in a large part, is designed to focus on disease. It diagnoses a problem, and treatment is aimed at fixing that problem. We have remarkable scientific understanding of the human body, and these “solutions” are incredibly complex – the advancements of Western medicine provide essential tools in our arsenal for taking care of ourselves. However, in most cases, once that particular issue is dealt with (ie, the swelling has gone down, the cancer is gone, the wound has healed), the treatment period is over, until something else happens to bring you in to a specialist's office. In most cases, you see your doctor for your yearly physical, your annual exam, your follow-up appointments to make sure that everything is ok, to make sure no old diseases have returned and no new ones have arisen. And this is great – this is a huge step within the realm of Western Medicine in understanding the power of health management. And more and more, doctors are recommending lifestyle changes to their patients during these visits, lifestyle changes that are now understood to prevent future disease (diet, exercise, stress management, etc.)
This idea that your actions now prevent health issues later is at the core of TCM and many other traditional health systems. Acupuncture views health as a state of being in its own right, not merely the absence of disease or symptoms. And the more that we can stay in this state of health and balance, the less our body’s systems are stressed and wounded and hurt in those tiny little ways that we don’t notice until they come crashing down around us.
So what is maintenance care?
Maintenance care is treatment to maintain a state of health. Acupuncture and TCM view the body as a complex system of energy systems. Sickness, disease, pain, emotional disturbance, and all health problems occur when there is too much energy in a certain system, too little energy in a certain system, or the energy is stuck. Based on asking questions, looking at the patient, palpating acupuncture points, looking at the patient’s tongue, and feeling the patient’s pulse (our diagnostic methods), we determine what energetic systems need to be worked on in a particular patient.
Some of these diagnostic tools can pick up changes in a person’s energy before symptoms appear. For instance, we can tell from the pulse if a person is coming down with a cold or the flu, often before any symptoms have shown themselves. The pulse can tell us whether or not a patient in pregnant, whether the patient is stressed, and if there is a flare-up of pain. The tongue can tell us if work needs to be done for cardiovascular health and stroke prevention. The tongue and pulse together tell us what energetic systems are affected at that moment…for instance, we may feel from the pulse that the digestive energy may be weak, before any issues with digestion manifest. So through the acupuncture treatment, we can boost the body’s digestive energy and prevent these symptoms from occurring. As mentioned before, pain and dis-ease are taxing to the body’s systems, so even preventing a week of stomach cramping may actually have greater ramification later in life, beyond preventing an unpleasant week.
Patients all have a certain way of being – in TCM, we refer to the body’s “constitution” – the characteristics of your body’s energy that are innate to you. For instance, just as you have brown eyes or tend to carry weight in your hips, you also have certain patterns of energy in the body that are innate to who you are. Through the diagnostic methods mentioned above and understanding what health issues you have had in the past, we can attune your acupuncture treatments to strengthen the systems that have a tendency to be weak in your unique energy make-up. Many women come to us for painful or irregular menstrual cycles. After a series of treatments (usually weekly), we can almost always get the menstrual cycles back on track and mitigate pain substantially. We then recommend that women come in for maintenance acupuncture treatments – depending on the person, this could be as little as 4 times per year…just to maintain the regular and painless cycles. We do this by focusing those treatments on the energetic systems that have been out of balance before and in which that patient has a tendency towards pathology.
In writing this, I began searching for research articles on preventative acupuncture, and was reminded that studying preventative medicine is incredibly challenging. You can read this post for more about the general issues with acupuncture research – but in this case, it is a problem that in studying how an intervention prevents a disease down the road, it is incredibly hard to control for all the other factors that may also prevent the disease. And studying health? Well that is near impossible within mainstream scientific research systems.
However, there are a few symptom-specific studies: Research has shown that acupuncture before and/or after surgery can preventpost-operative nausea. Other studies have shown that acupuncture may reduce high blood pressure, which obviously has been shown to prevent cardiac complications down the road. Perhaps more telling is the research currently underway to understand why acupuncture is an effective treatment for so many diseases and symptoms – what is mechanisms are, from a scientific perspective. I won’t summarize them all here, but scientific studies have shown that acupuncture may exert its effects on the peripheral nervous system, the brain and spinal cord, hormone regulation, connective tissue, and the muscles. These mechanisms have been shown to affect pain management, inflammatory response, endocrine regulation, and cardiovascular, gastrointestinal, and gynecological systems. For all the reasons mentioned above, it is easy to understand how a homeostatic treatment (one that brings the body into balance) would have health-promoting effects when its actions can reach all of these systems.
So the short version is, maintenance acupuncture can help you stay healthy. It can avert symptoms of pain and disease before they actually appear, and can keep you living in a state of health. If nothing else, the relaxation effects of acupuncture are well documented. And the positive effects of relaxing your body, your mind, and your spirit are enough in and of themselves to warrant occasional acupuncture care. A basic maintenance care recommendation is to come in for a “tune-up” visit once per season. If you have questions about what kind of maintenance is right for you, give us a call and we will happily discuss your unique situation with you.
Living your life with a goal of health, as opposed to a goal of avoiding issues, is actually a revolutionary idea, and we congratulate you. You deserve to take care of yourself. You do.