A common worry for people considering acupuncture for the first time is whether the needle insertion will be painful. Most people associate needles with the unpleasant sting of a vaccine or blood draw. However, the experience of acupuncture is markedly different from conventional medical injections. While you may feel a sensation, the sharp, piercing pain often feared is typically not part of the process.
Describing the Initial Sensation
The needles used in acupuncture are substantially finer than the hollow hypodermic needles used for injections. Standard acupuncture needles are hair-thin, measuring between 0.12 and 0.35 millimeters in diameter. This minute size allows the practitioner to insert the needle quickly and gently through the skin surface, often resulting in no feeling or just a brief, mild pinch.
The sensation following insertion is known as De Qi, which translates to “the arrival of energy” in Traditional Chinese Medicine. This feeling is not pain but unique physical sensations signaling the needle has engaged the intended point. Patients commonly describe De Qi as a dull ache, slight tingling, heaviness, or localized pressure.
This desired feeling should never be a sharp or stabbing pain. If a sharp sensation occurs, it suggests the needle has hit a superficial nerve ending or capillary. A skilled practitioner will immediately adjust the placement. A dull ache is considered beneficial, signaling the activation of the physiological response needed for therapeutic effect.
Why Comfort Levels Vary
The comfort of a first session is influenced by factors beyond the needle, with practitioner skill being the most significant variable. A gentle and rapid needling technique is necessary, as a skilled acupuncturist minimizes the sensation felt upon initial skin penetration. Correctly locating the point and maintaining a steady hand contribute directly to a comfortable experience.
The anatomical location of the points also impacts the intensity of the sensation. Points on the extremities, such as the hands and feet, or near joints tend to be more sensitive. This is because they have a higher concentration of nerve endings and less muscle tissue. Conversely, points on the back or abdomen, which have more muscle mass, are often much less perceptible.
Patient factors, particularly anxiety and muscle tension, also play a substantial role in comfort. When a patient is tense, their muscles tighten, making the insertion feel more noticeable and sometimes uncomfortable. Acupuncture encourages the body to shift from the “fight or flight” response to the “rest and digest” state. A relaxed patient generally has a better experience.
The Remainder of the First Session
Once all the needles are inserted, the patient enters the retention period. Needles are typically left in place for 15 to 30 minutes. During this time, most people report sinking into a state of deep relaxation. This response results from the treatment stimulating the release of endorphins and other neurochemicals that promote calm.
Many first-time patients become so relaxed they may fall asleep, often referred to as an “acu-nap.” While the needles are retained, the body regulates its internal systems and energy flow. This process should be completely passive for the patient. When the treatment time is complete, the needles are removed quickly and painlessly.
Immediately after the session, the resulting feelings can vary. Some people feel calm and energized, while others experience lethargy or drowsiness. This fatigue is a normal sign that the body is processing the treatment and shifting energy toward healing. Taking it easy and staying well-hydrated after the first session helps maximize the therapeutic benefits.