How do I know if acupuncture is working?

Sleep, energy and mood often improve first, within 2-3 sessions. Symptom-specific improvements build over 4-12 sessions depending on the condition.

What to Expect from Acupuncture

Name: Dr (TCM) Attilio D'Alberto
Brand: Dr (TCM) Attilio D'Alberto
SKU: hd-local-wokingham-rg-40
Rating: 5 (227 reviews)

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

If you have never had acupuncture before, the prospect of someone putting needles into you is — quite reasonably — a bit unnerving. Most patients tell me afterwards that the experience was nothing like they expected: it didn't hurt, they felt deeply relaxed, and they couldn't believe how quickly the time passed. Knowing what to expect makes the first session much more comfortable and helps you get the most from it. This page walks you through everything — booking, what to wear, what happens during the consultation, what the needling feels like, common reactions afterwards, how many sessions you'll need, and the realistic timeline of results.

On this page

Booking and what to bring
What to wear
The first consultation
Tongue, pulse and pattern diagnosis
The needling itself — does it hurt?
What it feels like
After the session
How many sessions you'll need
When you'll see results
Possible side effects
Combining with other treatment
Is acupuncture safe?
FAQs

Booking and what to bring

Bring a list of any medications and supplements you take.
Bring any recent test results — blood tests, scans, fertility investigations — that are relevant.
Eat something light beforehand. Don't come on an empty stomach (you can feel light-headed) or immediately after a heavy meal.
Avoid alcohol on the day of treatment.
Allow time afterwards — don't book a high-pressure meeting straight after; many patients feel deeply relaxed and prefer to ease back into the day.
Arrive a few minutes early to settle.

What to wear

Comfortable, loose clothing that can be easily moved or rolled up. Many fertility, abdominal and back treatments require access to the lower abdomen, lower back, arms and lower legs — clothing that allows the practitioner to reach these areas without you having to undress fully is ideal. A blanket and modesty drape are always provided in clinic. If a particular treatment requires more access (cupping for back pain, for example), you will be asked to undress to underwear in privacy and remain covered with a sheet apart from the area being worked on.

The first consultation

The first session is longer than subsequent ones — typically 60-75 minutes. About a third of that is the consultation. I will ask about:

Your main reason for coming and how it has developed.
Sleep — how easily you fall asleep, whether you wake in the night, dreams.
Energy and fatigue patterns through the day.
Digestion — appetite, bowel habit, bloating, food triggers.
For women — menstrual cycle: length, flow, pain, PMS, fertility history.
For men — libido, erectile function, semen analysis if relevant.
Temperature regulation — whether you tend to feel hot or cold, sweating patterns.
Mood, stress and emotional state.
Past medical history, surgery, hospitalisations.
Current medications and supplements.
Family medical history.
Diet, exercise, alcohol, smoking, recreational drugs.

Some questions may seem unrelated to your presenting complaint — they are not. In Chinese medicine, the body is treated as a system, and details about sleep, digestion or temperature regulation reveal which patterns are at work behind a presenting symptom.

Tongue, pulse and pattern diagnosis

Two diagnostic methods are unique to TCM:

Tongue diagnosis — I will ask you to put out your tongue. The colour, shape, coating, and any cracks or marks all give information about your internal state. Avoid eating brightly coloured food (curry, beetroot) immediately before your session as it stains the tongue. Don't scrape or brush your tongue that morning.
Pulse diagnosis — I will feel three positions on each wrist with three fingers, at three depths, listening to the qualities of the pulse. This takes a minute or two on each side and is also surprisingly informative.

From the consultation plus tongue and pulse, I form a diagnosis in TCM terms — naming the pattern (for example, "Liver qi stagnation with Kidney yin deficiency and blood stasis") — and from this diagnosis comes the treatment plan, point selection, and any herbal formula prescribed.

The needling itself — does it hurt?

The honest answer for most people is: no, not really. Acupuncture needles are very fine — typically 0.20-0.25 mm diameter, around eight times thinner than a standard hypodermic needle, with a tapered (not cutting) tip. Insertion is usually felt as a small prickle, sometimes nothing at all. Once the needle is in place, most patients feel a dull, slightly heavy or tingling sensation around the point, which is called de qi ("arrival of qi") in TCM and indicates the needle has connected with the right area. De qi is not painful — it is a deep, slightly weighty sensation, sometimes spreading along the limb.

Some points are more sensitive than others — points on the hands, feet and face can feel a sharper prickle, while points on the abdomen, back and legs are usually barely felt. If a needle does feel uncomfortable, tell your practitioner — it is easily adjusted or removed. Pain on insertion that doesn't ease in a few seconds is not the goal and not normal.

What it feels like

Insertion — small prickle or nothing.
De qi — dull, heavy, tingling sensation around the point.
During retention (20-30 minutes) — most patients feel deeply relaxed; many fall asleep. Some feel warm, some feel sensations travelling along channels. All normal.
Removal — usually unfelt.
Immediately after — varies enormously: some patients feel energised and clear; others feel pleasantly tired.

After the session

Drink water; have a light meal if you haven't eaten recently.
Avoid alcohol and intense exercise for the rest of the day.
Allow gentle movement — a walk in the fresh air is ideal.
Many patients sleep deeply that night — keep the evening calm.
If you are receiving treatment for pain, expect the area to feel different — sometimes briefly more achy before improving.
If you are receiving fertility treatment, follow any specific advice given (timing of intercourse, supplements).
Note any changes in symptoms over the following days — this informs the next session.

How many sessions you'll need

This varies enormously by condition:

Acute conditions (a recent muscle strain, a cold, mild acute pain) — 2-4 sessions.
Chronic pain (back pain, sciatica, headaches, frozen shoulder) — 6-12 weekly sessions, then monthly maintenance.
Migraine prophylaxis — 8-12 weekly sessions, then monthly maintenance. See: acupuncture for migraines.
Hot flushes / perimenopause — 8-12 weekly sessions, then monthly maintenance. See: acupuncture for menopausal symptoms.
Insomnia and anxiety — 8-12 weekly sessions.
Fertility (preconception) — 3 months minimum (12 weekly sessions) before a conception attempt or IVF cycle.
IVF support — sessions through stimulation, the day of transfer (or day before/after), and into early pregnancy.
Cycle regulation / PCOS — 3-6 months of weekly treatment for full regulation.
Pregnancy support — fortnightly through the second and third trimesters as needed.
Pre-birth acupuncture — weekly from 35-36 weeks until birth.
Cosmetic / facial — typically a course of 10 sessions twice weekly.

Consistency matters more than total number. A weekly course of 8 sessions consistently outperforms 8 sessions spread over 6 months.

When you'll see results

Sleep, energy and stress often improve within 2-3 sessions — these are the "system" effects of acupuncture.
Pain typically reduces by 30-50% within 4-6 sessions.
Cycle regulation usually shows by cycle 2-3.
Migraine frequency reduces by week 6-8.
Hot flush frequency and intensity typically halves by week 6-8.
Fertility outcomes are judged over 3-6 months, since egg and sperm maturation take 90 days.

Possible side effects

Acupuncture is one of the safest medical treatments when performed by a qualified practitioner. Possible reactions:

Mild bruising at needle sites — uncommon, harmless, settles in days.
A drop of blood on needle removal — occasionally; wiped away.
Brief light-headedness — uncommon; usually if you are tired, hungry or anxious. Tell your practitioner.
Temporary tiredness or emotional release after the session — particularly common in the first few sessions.
Mild temporary worsening of symptoms for 24-48 hours — uncommon; sometimes precedes improvement.
Local muscle soreness after deeper needling.

Serious adverse events (pneumothorax, infection, organ injury) are extremely rare in qualified practice — published rates are much lower than for conventional medical treatments.

Combining with other treatment

Acupuncture combines well with:

Conventional medicine — including most prescription drugs; always tell both your GP and your acupuncturist what you are taking.
Chinese herbal medicine — often the synergistic pair with acupuncture in TCM practice.
Physiotherapy and osteopathy — particularly for musculoskeletal pain.
Massage and reflexology.
IVF and assisted conception — there is an established sub-speciality of fertility acupuncture.
Counselling and psychotherapy — for stress, depression, anxiety.

Is acupuncture safe?

Yes — when practised by a qualified practitioner using sterile single-use needles. I am a member of the British Acupuncture Council (BAcC) and the Register of Chinese Herbal Medicine (RCHM), with over 25 years of clinical experience. All needles are single-use, sterile, individually packaged, and disposed of immediately after use in a sharps bin. Standard hygiene and clean-needle protocols are followed throughout.

Frequently asked questions

Does acupuncture hurt?

Most patients feel only a small prickle on insertion, often nothing at all. Once in place, the needles produce a dull, heavy or tingling sensation that is not painful. If anything is uncomfortable, tell your practitioner.

How long does a session last?

The first session is 60-75 minutes including consultation. Follow-up sessions are typically 45-60 minutes.

How many needles will be used?

Typically 8-15 needles per session; sometimes more, sometimes fewer depending on the treatment. Less is often more in skilled hands.

How do I know if it's working?

Sleep, energy and mood often improve first — within 2-3 sessions. Symptom-specific improvements (pain reduction, cycle regularity, hot flush reduction) build over 4-12 sessions depending on the condition.

Is acupuncture safe in pregnancy?

Yes — when performed by a pregnancy-trained acupuncturist who knows which points to avoid. Acupuncture is widely used safely throughout pregnancy for nausea, back and pelvic pain, anxiety, and birth preparation.

Will my health insurance cover acupuncture?

Many UK private health insurers cover acupuncture provided by registered practitioners (BAcC, BMAS). Check with your insurer; I can provide invoices for reimbursement.

Can I have acupuncture if I'm afraid of needles?

Yes. Acupuncture needles are nothing like the needles people associate with injections or blood tests — they are eight times thinner. Most needle-phobic patients tolerate acupuncture well. If you are very anxious, tell me and we can start with a small number of points.