An article by Warwick Poon

Here are some insights into why Acupuncture might hurt…

Position on the Body

Pain can be a function of geography. There are areas on the body that feel pain more than others.  Acupuncture points are located all over the body, and some points are on areas that don’t feel a lot of pain, and other areas are attuned to feel sensations more. From a Western Point of view, these areas of skin are more endowed with nerve endings, and have be plotted for many years.  Some areas like the back are not as sensitive, so feel much less needle sensation, whereas the palms of the hands are designed to feel a lot, and will be much more reactive to needle insertion.

Practitioner Experience

Pain can be a function of the technique of the practitioner.  Some methods of insertion require speed, some need twisting, and some are a function of a bent needle. There are points that require two fingers on the needle, some use a tube, some require fingers close to the point of the needle, and sometimes the shaft rests on the adjacent finger.

With practice, the practitioner will get better at causing less pain with every insertion.  Most practitioners will use one or two techniques only, and not practice the others, so when needed, they can be a little less than perfect.  A well practiced technique will have the needle slide into the point with minimal pain, regardless of the point location.

Needle Quality

It may be a surprise for patients, but there are myriad qualities of needle, and needle points. The old style of acupuncture needle was honoured with a diamond cut. That is, it was a straight cut diagonally along the shaft, creating an almond shape, and then the needle was revolved 90 degrees, and cut again. The needle with this type of point, went into the flesh at an angle, not straight. This type of point made sure that the needle did not pierce any tendon sheaths or blood vessels.  To manufacture these type of needles, the price made it necessary to use them multiple times, as we did on the old days.  Now, machines make needles, and they are packed in sterile single use packets, and the points are simple cones. Cheap needles bite when they are pushed into the flesh, and well made needles insert smoothly with little or no effort.  These type of needles are less effective therapeutically, so it is up to the acupuncturist to choose which needle is best for them, as it will always be a compromise. Less pain on needle entry, giving less therapeutic effect, or a little more bite on the needle, but a much better strike rate.  This is for filiform needles with wound copper handles. Many practitioners now try to use plastic handle, thin, extremely sharp needles, as they are cheap and easy. I reject plastic myself, as the plastic handle does not allow me to manipulate the qi with my fingers, as the qi does not run through plastic as well as it does through metal.

Point Needs

The specific point is also a reason for less or more pain on insertion.  Some points are stuck, and full of qi pressure, like a garden hose that is twisted.  On the application of the needle, the qi will surge, and this can be translated in the brain as pain.  Not all points that need to be needled will do this, but the points with stagnant qi certainly will.  The most common time for this to be felt is when a cold or flu is being treated, as there will be at least one point relieving  stagnation.

Patient Stress

Finally, pain can be a function of the stress of the client themselves.  When the patient has had a stressful drive to the clinic, or they have been working feverishly all day, or simply physically stressed by their medical problem, then their qi is equally as stressed.  The qi is inside pushing out, in an effort to protect them from their environment, and the qi is also tight and thick. Trying to insert a needle into this arrangement can be hard, and for the patient, sometimes painful. On the other hand, when the practitioner is calm, and willing to sit and chat about things, and calmly discuss life in general, then the qi calms down by association, and the needles slip into the skin with a lot less resistance.