Does it hurt?
Acupuncture can elicit a wide range of sensations and generally the insertion and stimulation of the acupuncture needle is not supposed to be painful. Everyone’s body is different however, as is their perception of physical sensations and pain. As acupuncturists, we do our best to make the experience as comfortable as possible, however a person’s experience of pain can depend on their individual pain threshold, what we are treating and in which area. If you have a fear of needles or a very low pain threshold, I make sure to spend the time to guide you through the process with deep breathing, and most of the time, people generally find the experience to be enjoyable after they overcome the fear of the first needle.
The acupuncture needle
Before having acupuncture, a common thing for people to say is that they don’t like needles or they think that it may hurt because they are comparing it to a needle at the doctor’s. The usual gauge of an acupuncture needle is 0.2 – 0.25mm in diameter which is incredibly thin. Compare this to the average gauge of a hypodermic needle generally used to draw blood which is around 0.8mm (aver 3 times the thickness). It may seem small, however this is a big difference when we are talking about piercing the skin.
The other great difference between the two types of needles is that hypodermic needles are hollow so that they can inject or draw out fluids. This means that the needle literally cuts through the flesh and vein walls in order to reach its target. Acupuncture needles are labelled ‘filiform’, meaning thread-like, and have a rocket-tipped point that separates the flesh rather than cutting it. This means that more of the surrounding structures remain in tact and the usual pain response is not elicited.
This is why for most part, the piercing of the acupuncture needle could be compared more to a mosquito bite rather than a needle. This is also why most of the time there can be little to no bleeding when the needle is removed.
What does it feel like?
The sensation of acupuncture may differ for each person, however what we are aiming for at the point of insertion can be dullness, pressure or heaviness; warmth or other changes in temperature; tingling or sensations of numbness. This is the sensation known as the ‘De Qi’ or ‘Qi’ response that we are aiming for and is part of your body’s natural response to the needle.
You may also experience sensations that travel from the point of insertion along the acupuncture meridians to other parts of the body as the channel is activated. These may be electrical in sensation due to activation of the nerves or nervous tissue in the area and is a completely normal and safe response to acupuncture. It is also quite common to feel a sense of calm, relaxation, or even a kind of ‘high’ after a session of acupuncture.
Overall the experience is NOT meant to make you feel too uncomfortable, and if you are experiencing pain or discomfort of any kind during an acupuncture session, you should notify your practitioner straight away so they can adjust or remove the needle. In saying this, we are literally piercing the body’s skin with a sharp object, so of course, a completely pain-free experience can not be entirely guaranteed. Some people are more reactive to this than others and a wide range of sensations may occur from strong stimulation of the point, to feeling nothing at all.
Nerve fibres
After the needle is inserted, acupuncturists stimulate the needle with certain techniques depending on what the condition may require. These techniques usually involve either up and down motions or rotating motions. These motions stimulate the tissues under the skin and activates what we refer to as the ‘De qi’ response which lets us know that the point is ‘activated’. This can be felt as warmth, heaviness, pressure, dullness, or tingling. This response is due to the activation of C fibres beneath the skin which is what is to believed to be one of the mechanisms of action for how acupuncture works.
When your body registers pain or noxious sensations in the external environment, it does so via the use of A-Delta nerve fibres which rapidly transmit localised pain to the brain to make you aware that that part of the body may be in danger. It is the built-in defense mechanism in your skin which covers your entire body. Beyond this protective layer in the muscles and organs, C fibres are then responsible for transmitting sensations. C fibres transmit signals as diffuse, dull pain and they travel at a much slower rate and so our perception of pain in these regions is considerably different to that of the surface of our skin. This is the reason why after the initial prick of the skin, acupuncture does not necessarily hurt so much as it does elicit a dull, heavy, or warm sensation.