The thought of having needles inserted into the skin often causes anxiety due to previous experiences with medical injections. Acupuncture is an ancient practice that uses fine needles inserted at specific points to promote healing and relieve discomfort. While the procedure involves needles, the actual sensation is generally not painful in the way patients anticipate a shot will be. The design of the tools and the practitioner’s technique create an experience often described as unusual rather than uncomfortable.
The Difference Between Acupuncture Needles and Hypodermics
The primary reason acupuncture does not hurt like an injection is the vast difference in the tools used. Standard hypodermic needles are thick, hollow, and have a beveled, cutting tip designed to slice through tissue for quick fluid transfer. These needles, used for vaccinations or drawing blood, are typically 20–25 gauge (0.5 to 0.8 millimeters in diameter).
Acupuncture needles, known as filiform needles, are solid, thin, and flexible. They are typically 32 to 40 gauge (0.12 to 0.25 millimeters), comparable to a strand of human hair. This means a standard hypodermic needle can be 10 to 50 times thicker than an acupuncture needle.
The filiform needle has a rounded tip, allowing it to glide through the skin and tissue layers instead of cutting them. This solid, non-cutting design, combined with a quick insertion technique, often bypasses the superficial nerve endings responsible for the sharp pinch associated with injections.
What You Actually Feel During Treatment
Once the needle is inserted and gently manipulated, patients frequently experience De Qi (pronounced “duh-chee”). This sensation is a desirable therapeutic response, indicating that the point has been activated and the body is responding to the treatment.
The feelings associated with De Qi are varied. They commonly include:
- A dull ache
- A feeling of heaviness
- Slight numbness
- A tingling sensation radiating from the insertion site
- Pressure or distention in the surrounding area
These unique sensations are evidence of a physiological change occurring at the local level.
Dull pain is sometimes part of the De Qi complex, but it should not be sharp, stinging, or unbearable. If a patient feels a sudden, sharp pain, it usually signals that the needle has hit a superficial nerve ending or a small blood vessel. The practitioner will immediately adjust or remove the needle in this case.
Factors Influencing Sensation
The experience of acupuncture can vary significantly depending on several factors. The skill of the licensed practitioner is a major influence, as a gentle, quick insertion technique minimizes the sensation felt upon entry. Practitioners are trained to insert needles with precision to avoid discomfort.
Anatomical location also plays a role in the intensity of the sensation. Areas with thinner skin, less muscle mass, or a higher concentration of nerve endings, such as the hands, feet, face, and ears, tend to be more sensitive. Conversely, points located in fleshy areas, like the gluteal region or large muscles of the back, are often inserted deeper and felt less acutely.
The depth of insertion is tailored based on the patient’s body composition and the specific point’s location. Deeper needling may be required to reach certain neuroanatomical structures, which can lead to a more intense De Qi sensation. However, any sharp, lasting pain is abnormal and should be immediately communicated to the practitioner so the needle can be adjusted.