Another common misconception is that patients must 'believe' in acupuncture to enable it to work. This is similar to the idea that acupuncture is a complex form of suggestibility, but this is quite wrong. Like any other type of medicine acupuncture works on those who believe in it and those who do not. The mechanism of acupuncture is not clearly understood but, as has already been mentioned, it is quite clear that reproducible biological changes occur when an acupuncture needle penetrates the skin. Whilst accepting that all medical treatment is more effective if the doctor is trusted by the patient, this trust is not a prerequisite for the physiological changes that occur during and after acupuncture.
Will I Get Better?
No medical treatment works all the time, and acupuncture is no exception to this rule. There are many problems in assessing acupuncture as a form of treatment for any disease. First of all the doctor must have a clear idea of the natural history of the disease; if the disease is going to get better anyway, it is a little presumptuous to claim that the cure is due to acupuncture, just because the patient has received acupuncture. Furthermore vast number of statistics must be collected and analyzed before any treatment can be adequately assessed, and in the field of acupuncture the research has not yet been satisfactorily completed. This makes the question 'What chance of improvement do I have?' a very difficult one to answer exactly for specific condition.
In the West, the condition that is most commonly treated is by acupuncture is pain and, in general, acupuncture has a significant effect in about seventy per cent of painful diseases. The results and data available about 'success rates' will be discuss in detail in later sections.
Response to Treatment
It is very difficult to be dogmatic about how a patient will respond to acupuncture. Occasionally, one treatment is all that is required, whilst other people may need a number of treatments to gain the same result for the same disease. In general most people, and their problems, do not respond magically to one treatment, and between four and eight treatment sessions may be required in order to obtain the best results from acupuncture.
Acupuncture usually works in stages. The first two or three treatments represent a process of 'understanding the needs of the patient', and are therefore a sort of experiment designed to assess the specific requirements for that person in that particular condition. Some people respond to classical Chinese body at puncture, whilst others respond better to ear acupuncture. This partially reflects the skill of the acupuncturist in the use specific techniques, but it also represents the fact that the body responds in a slightly different way to slightly different stimuli. Some people seem to respond to a particular acupuncture technique for one condition, whilst requiring a completely different technique for another complaint. A patient may even respond to a particular approach for a specific condition and then stop improving half way through treatment, thus necessitating an alternative approach to that condition.
If a patient experiences some symptomatic improvement at the first consultation, then they often gain considerable relief from a course of acupuncture; equally, many people who do not obtain symptomatic improvement at the first consultation may also gain a great deal from acupuncture. It is a good prognostic sign if there is some instant improvement, although the improvement gained at the first consultation rarely lasts longer than a few hours, and may last only a few minutes. Each subsequent treatment should then give a better and more prolonged result and, as shown on the graph, the symptoms should gradually disappear as the treatment becomes effective.