Scared of Needles?

This video demonstrating an acupuncture needle is too fine to burst a balloon is great fun!  Today I’d like to talk a little bit about needling, the central skill and art an acupuncturist spends their life developing.

New patients come to an acupuncture clinic wondering, or worrying, what the needling will feel like… will it hurt, will you be able to relax, what will it feel like having needles stuck into you and left.  So, when people ask, I tell them they are unlikely to feel what they do expect – ie the sharpness of the needle as it goes through the skin – this is because acupuncture needles are very fine – as in the video above.  They are filaments, not tubes, because there is nothing being injected through them.  Inserting them into the skin is seldom something people feel, usually to their great surprise on a first visit.

However, I also tell people that they MAY feel things they didn’t expect.  The most common is the development of a sense of fullness or very slight achiness around the needling site.  Sometimes there is a buzzing type feeling, as if something is on the move, perhaps a tingle or an electric feeling.  Occasionally, a strong sensation is felt in a completely different part of the body from the needling site… Acupuncture does approach treatment through the pathways provided by the electrically charged, insterstitial fluids, which make the entire body a single connected whole.  I do tend to be suspicious if someone says they got acupuncture and “didn’t feel a thing.”  Something should be happening during a session, and that should be tangible for the patient.

I do ask people to let me know instantly if anything they experience is uncomfortable.  I want them to expect unusual sensations, but not pain or discomfort, which, in my experience, are signs of an incorrect needle insertion or position.  In general, the feedback from people about what they feel while being needled is very positive.  It’s not painful, with very few exceptions.  It does produce interesting effects and sensations.  And in the vast majority of cases, it produces a very deep sense of relaxation, sometimes even sleep.

Some patients develop an interest in what needling is like for the practitioner, and this, too is different to what people expect.  As students, before we went near a human being (usually one of our fellow students) with an actual needle, we were encouraged to practice with an orange.  Such practice may give you a steady hand, but, I later discovered, it in no way prepares you for what it is like to interact with your patient’s body via your needle.  Because that is what happens.  Various living responses from a patient’s body arrive back at your fingertips via the needle.

It helped my understanding enormously to discover that the Chinese word for acupuncture point, “xue”, means “hole” or “cave”.  With this understanding I learned to find the points in a very precise way, by seeking subtle depressions or hollows with my fingers & an increasingly practiced sensitivity.  It also helped to understand that the needle would only ever be inserted into a space.  We do not needle into muscles or tendons or other structures, but into the fluid-filled spaces between them.

So what does that feel like for the practitioner?  It’s like a two-way conversation.  The initial insertion through the skin requires a certain skill, and some of us use an insertion tube, to ensure it is painless.  The skin offers the most resistance, and is really quite tough.  Once through the skin, and into the fluid-filled space underneath, sometimes there can still be a feeling of resistance.  To me this indicates that the patient’s body is not quite ready to invite the needle in.  In almost every case, though, waiting patiently, with the needle firmly, but gently grasped for 30-40 seconds max will produce such an invitation – this feels to the practitioner as if a doorway has just opened up, smoothing the pathway of the needle.  Ideally the very slightest pressure will now result in the needle finding its own smooth path to descend to exactly the right level, where it will once again stop.  Almost as if the needle is leading the fingers, rather than the fingers pushing the needle.

When the needle stops, I’ve learned to trust that it is now located where the patient needs it to be.  To check, I find that, if the needle is correctly positioned, a gentle tug will produce a new resistance, as if something on the inside of the body has taken hold of the needle’s point and is holding on to it from the inside.  Usually, if asked, the patient will confirm they are getting some interesting sensations at this point.  This is the point, and not before, at which I feel comfortable applying a specific needling technique, of which there are many, depending upon the specific treatment aim for that session.  It is only at this point that I feel the patient’s body has invited, and accepted, the presence of the needle, and is open to the proper commencement of its therapeutic work.

So, in acupuncture, needling a person is always going to be a subtle, two-way conversation, a thing that cannot happen with an inert orange.  This is what makes it an endlessly fascinating study and practice.

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February 21, 2013 · 10:21 pm

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