Despite the fact that acupuncture has existed as part of a comprehensive tradition of medicine for millennia, newcomers to this form of treatment often have doubts and questions before trying it for themselves. One of the most common questions that I am often asked is: "Does acupuncture hurt?". Other times, people have simple curiosities and apprehensions about trying something new. All of this is so reasonable.

I hope that the following helps to explain some of the common sensations and experiences you’ll encounter in an acupuncture session, and perhaps dispels common misconceptions.

Understanding Acupuncture Needles

Often when people envision needles, they imagine the hypodermic needles used for injections or blood draws. However, acupuncture needles are 10x smaller than these types of needles, closer to a strand of hair in their thinness. The needles we use in the treatment space are almost imperceptibly lightweight and flexible. Their slender structure allows for gentle penetration, often accompanied without any sensation upon insertion.

The Sensations of Acupuncture

The experience of acupuncture is subjective and can vary from person to person. It can also vary depending upon the places on the body a needle contacts. Most people say they feel no pain during treatment. In fact, some describe the sensations as soothing, relaxing, or even energizing. The most common sensations experienced during acupuncture include:

• Tingling or Warmth: When acupuncture points are stimulated, you may feel a tingling or warm sensation either locally or in a distant but connected place in the body, often radiating along the acupuncture channel (energy pathways of the body). This is a sign that the acupuncture points are stimulating an overall shift or a rebalancing effect is taking place.

• “Like Little Faucets Being Opened”: Sometimes people experience a state of flow or a gentle softening when connecting with the acupuncture point finally allows some qi (energy) to move in the channel. This can feel gentle, relaxing, and like the body has a chance to reconnect to previously stagnant or stuck areas.

• Gravity or Heaviness: Some people might feel a mild, dull ache or heaviness at the site of needle insertion. This sensation is generally not painful and usually means that the body is responding to the treatment.

• Pressure or Movement: When stimulating an area of the body that is more dense, tight, or has a lot of accumulated energy, the insertion of an acupuncture needle can feel like pushing up against the existing pressure that’s there. Usually pressure sensations are temporary and can feel extremely gratifying and relieving. Usually the pressure subsides as the energy behind it dissipates. Often people feel a sense of lightness having these areas of dullness or density rebalanced in a matter of minutes . . . something that might take hours of work using other therapies.

• Emotional Release: Acupuncture is known to have a profound effect on the emotions. It's not uncommon for individuals to experience an emotional release during or after the treatment. This can manifest as simply being able to connect with or contact your own body or emotional state or may be accompanied by the release of a few tears, laughs, or the sensation of feeling much lighter after getting up off the treatment table. The channels carry physical, emotional, and spiritual qualities within them and so acupuncture can often bring interconnected processes to the surface to help heal them together.

One of the fundamental characteristics of successful acupuncture is related to achieving these various subtle sensations after the needles are inserted. These sensations are referred to as de qi (得气) where de means to obtain and qi means vital energy.

Aspects that May Influence the Sensations you feel in an Acupuncture Treatment

Several variables can influence the kinds of sensations you may experience during an acupuncture treatment include:

• The Skill of the Practitioner: A skilled and experienced acupuncturist will use the appropriate techniques to minimize your discomfort. If you’ve had acupuncture before and it wasn’t comfortable, you might be interested in working with a different practitioner.

• Your Sensitivity: Each person's pain threshold and sensitivity to needles may vary. Adept practitioners of any experience level will check in with you before and during your treatment to see how you are doing and titrate the intensity and sensation level to your comfort. If you are highly sensitive, have experienced longstanding pain, trauma, or know that you have difficulty perceiving some kinds of sensations, it is recommended that you share these things about yourself at the start of your visit. You can always let your practitioner know if any sensations aren’t comfortable for you and request adjustments.

• The Style of Treatment: Certain styles of treatment may involve more superficial and gentle approaches while others may involve deeper and stronger sensations. I work with various styles of acupuncture and needle gauges (thicknesses) in my practice to calibrate treatments to have the desired effect.

• The State that You Are In: You may notice that you may feel more open and relaxed on some days, and other days more tense. The physical, mental, and emotional state you are in can influence how you perceive the treatment. This in another thing to be taken into consideration during treatment and tailored. Again, a skilled practitioner will adjust treatments to how you are feeling on any given day by checking in with you, noticing qualities in the pulse and the channels, and responding by adjusting their approach so that it’s comfortable for where you are at that day.

Can I request a needle-free acupuncture treatment?

If you want to try acupuncture but you’re not sure whether or not you’ll have a good response, don’t worry, there are lots of options. You can book an appointment and receive bodywork only (hands on therapies similar to massage) without any needles. These therapies can still access the philosophy and understanding of the acupuncture meridians and help balance and treat your symptoms, but do not rely on needles.

There are also some forms of acupuncture—like Japanese-style acupuncture—that do not involve needle insertions. Instead, a special metal instrument called an enshin or a teishin is placed on top of the skin at an acupuncture point until the desired effect is achieved. This type of work is often helpful for sensitive individuals and for kids.

Anxiety about Resting With the Acupuncture Needles In

One thing that doesn’t get addressed often enough is that some people feel anxious about resting with the acupuncture needles by themselves. This makes sense.

• For some people, they feel comforted knowing they can ring a bell to let their practitioner know they need help or would like the points adjusted or needles removed.

• For those who don’t feel comfortable resting with needles by themselves, I often offer to stay in the room with them. We can work on other areas of the body such as head, neck, and shoulder relief or treat the feet while needles are busy doing their work in another area. Double the benefit; much less anxiety. We also have the opportunity to adjust or remove the needles as needed. (Note that fast-paced insurance-based acupuncture practices often treat multiple patient rooms at one time, so practitioners in these practice structures may not be accustomed to or able to take the opportunity to stay in the treatment room with each patient.)

• For those who do feel comfortable resting with needles in for a short while, this is very safe. It is also an opportunity to check in with yourself and to tap into the underlying self-healing force of the body. These handful of minutes alone , resting on a warmed treatment table with soothing sounds and the sensation of the meridians balancing can be a deeply restorative and sacred time.

Try Acupuncture for Yourself

The vast majority of people find acupuncture to be a relatively painless and a therapeutic experience. The benefits acupuncture offers in terms of relaxation, stress reduction, and improved well-being most likely outweigh any temporary sensations of mild discomfort felt during treatments. Ultimately, the best way to find out is to try it for yourself. and consult with a qualified acupuncturist who can address your concerns and offer individualized care.

REFERENCES

❍ Yang Y et al. Factors contributing to de qi in acupuncture randomized clinical trials. Evid Based Complement Alternat Med. 2013; 2013:329392. doi: 10.1155/2013/329392. Epub 2013 May 30. PMID: 23818924.

❍ Unschuld, Paul U. 2016. Huang Di Nei Jing Ling Shu: The Ancient Classic on Needle Therapy. Berkeley: University of California Press.