Guided by diagnosis grounded in Chinese medical science, acupuncture treatment has been used for millenia to alleviate acute and chronic disorders of all kinds. It is the most well known modality in Chinese medicine, and has been developed into culturally unique versions in Korea, Japan, the UK and many other places.
Does it hurt?
Usually one of the first questions people have about acupuncture is whether or not it hurts. Most of us are familiar with hypodermic needles used to give injections and draw blood – and have had some pain from those procedures. Thus, the question! The simplest answer is – no, it doesn't hurt, particularly in comparison with those needle experiences.
The more complex, and honest, answer is that it depends. The style of the acupuncturist, your current health situation, even the heat and humidity of the treatment area can all contribute to the amount of sensation you feel during acupuncture. That said, the vast majority of patients do not feel significant pain during treatment, and those that do usually find that after the initial needle insertion, the sensation decreases to almost nothing for the duration of treatment.
There are many reasons that acupuncture is less painful than other needle experiences. However, probably one of the most important is that the needle bore is MUCH smaller than hypodermics. I use 32 gauge needles – which average about a quarter of a millimeter in size. The average blood draw is done using 18-21 gauge needles, which are around .8 of a millimeter in size. Now, those sizes are small and it may seem that there's not too much difference between those sizes. See the picture to the right for some visual comparisons that may help.
Acupuncture safety & training
US based acupuncturists undergo rigorous training, similar to other licensed medical professionals. Entry level programs are 3-4 years, with the final year being mostly clinical, and there are minimum standards for number of supervised clinical hours. During our schooling, we receive training about blood borne pathogens and how to make sure that the single-use, sterilized needles we use stay sterile until they are used. We also go through a national certification process using standardized board exams, just like most medical providers. Finally, we must go through a state controlled licensure process where our background, mental and physical fitness and education are discussed & verified.
Not the fly by night quackery that some people would have you believe! We must also do continuing education to be eligible for renewal of our licensing and certifications – most acupuncturists seek out extensive post-graduate training, including residency, to improve our skills. In fact, one of the first things I learned in school, from one of my most cherished mentors, is the importance of continuing to deepen our knowledge and skill in the medicine for the rest of our lives.
Different styles of acupuncture
If you go to ten different acupuncturists in the US, you might notice ten unique interpretations of the modality. While those of us born in the US are guided by a unified curricular format determined by the requirements of licensure and ethical practice, the medicine lends itself to the development of lineage and personal styles.
In 5 element acupuncture, for example, points are fewer, used with slightly different intention than in other forms of practice, and the stimulation tends to be gentle. Gentle stimulation is also a hallmark of Japanese acupuncture, and yet it differs from 5 element acupuncture in its interpretation of the channel system and the treatment protocols. The stimulation tends to be more intense in mainland Chinese styles, and those who practice more classical Chinese styles of acupuncture tend also to needle deeper, use bigger gauge needles and stimulate those needles more intensely. That said, even strong stimulation with needles is often much less painful than people nervous about acupuncture would expect.
Even those who consider themselves to practice more or less “by the book” (meaning the standard China-based TCM methods) often display a unique style in terms of how they dictate the flow of treatment, the way they hold the treatment space, and their actual technique with the needles.
I am one of those rare acupuncturists that started out with a real fear of needles! Because of this, and due to the mentors I was exposed to, I use a generally gentle and minimal approach that contains aspects of 5 element acupuncture and Japanese acupuncture.
If needed, I will use more intense techniques – but those instances are rare. Further, for me, all things being equal the most important thing to me is that you are able to relax and enjoy your treatment. While most of us understand that some discomfort may be necessary to get and stay healthy, I don't see any reason to make that discomfort more profound than it absolutely needs to be! We will always talk about what I plan to do, and make sure it doesn't cross any difficult boundaries for you.
I believe that treatment is more effective when all the senses and aspects of a person are being impacted. For example, I tend to use music specially selected to enhance your treatment, and also love to use essential oils which add a relaxing element to the session. The surface you rest on is warm and comfortable, and I use various methods to make sure you don't get chilly as you lie there during treatment. This combination of overt treatment (the needles), sound (music), scent (essential oils) and care paid to your warmth and softness seem to have a more powerful effect than any of those aspects alone.
Finally, know that I can – and often do – use non-insertive techniques in treatment. Cupping, moxibustion, various types of bodywork and qigong can all be used to stimulate the body in ways similar to acupuncture. If you want to learn more about the non-insertive techniques, please click here. While there are times that needling a point is absolutely necessary – we can always discuss other options – never hesitate to start a conversation about this.
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