This is perhaps the most common question that I get asked by the uninitiated.  

The answer?  Well, it depends.  

For the majority of points, there may be a slight discomfort first when the needle is tapped into the point and second when the needle is inserted to the proper depth.

For a small number of points, there will be a sharpness when the needle is tapped in and any further manipulation of the needle will perpetuate the sharp sensation.

 

The discomfort that one feels when the needle is tapped in feels like someone yanking on a single hair but not nearly as bad.  From what I have been told, the nerves that sense pain are concentrated in the skin.  once the needle penetrates the skin, the pain should stop.  if the insertion is quick enough, you may not even know that the needle has been tapped in.  however, if the insertion is slow or if the needle is a heavier gauge there is a much greater chance of feeling the sharpness of the needle and with greater severity.

on rare occasions, a needle is tapped in and the patient reports feeling sharpness, even after the needle has penetrated the skin.  in these cases, i find that if i remove the needle and insert it again one or two millimeters away the patient usually doesn’t feel the same discomfort.

 

once the needle has penetrated the skin, the next step is to get the needle to the proper depth.  the depth a needle gets inserted depends on the point being stimulated.  some points only need a millimeter or two, while others need a couple of inches.

when the needle has reached the appropriate depth, there is a sensation that is called ‘de qi’ (duh chee) that translates into ‘the arrival of qi’.  it is described as anything from local heat, throbbiness, distending, numb, tingling, achey, or nervy.  in Chinese medicine, the arrival of qi is important to achieve good treatment results.

i find that most westerners neither welcome not want the de qi sensation, so i end up merely inserting the needles to the proper depth without much stimulation to achieve de qi.  my feeling is that japanese acupuncture uses much thinner needles than chinese acupuncture and with shallow insertion and no de qi sensation and still has good results, so if a patient wants to experience de qi, i’ll stimulate the needles to obtain qi but otherwise not.

 

the more sensitive areas include the fingers and toes near the nails, anywhere near the palms of the hands or soles of the feet.  sometimes people feel scalp points are uncomfortable.  i find that it feels like someone is pulling a clump of hair.

 

sometimes, a point that is normally not sensitive is suddenly very sensitive and the patient feels a sharp pain either upon tapping the needle in or with needle insertion.  in my experience, a patient shouldn’t feel any sharp pain (besides when tapping the needle in) and if they do, it usually means that i have accidently hit a blood vessel.  this is no cause for concern or alarm.  in these rare cases, i merely pull the needle out slightly until the discomfort subsides and maybe try to reinsert the needle but at a slightly different angle.  otherwise, i will remove the needle completely and reinsert it a few millimeters in either direction.  this has always taken care of the patients’ discomfort.

 

but let’s not talk about pain or discomfort because the majority of the time the patient doesn’t even feel the needles penetrate the skin, nor when the needle is inserted to the proper depth.

 

 

thanks!