Should Acupuncture Be Painful?

 

"The art of healing comes from nature, not from the physician. Therefore the physician must start from nature, with an open mind."
- Paracelsus

Does acupuncture hurt? This is a common question that I get asked on a regular basis. And for good reason—everyone has either experienced a shot by a medical doctor or simply getting stuck with a pin or needle. It hurts!

The first thing for you to understand is that acupuncture is a principle, not a technique. This means it is not about sticking needles in someone's body, but about various ways to stimulate specific points on the body that affect the nervous system to elicit a measured physiological response. This includes the use of needles, laser and pressure.

Over my almost twenty years of clinical acupuncture experience, I began to wonder why most of my patients found their acupuncture treatment not only relatively painless, but extremely relaxing while telling me how painful their previous experience had been. 

After some research, I believe I found the answer. Each style of acupuncture has different physiological goals, utilize different sized needles, and vary significantly in technique. The two most common forms of acupuncture are traditional Chinese acupuncture and Japanese acupuncture. Although they use the same points, the application and patient responses are quite different. 

To begin, Chinese acupuncture needles are larger diameter than those used in Japanese acupuncture. Logically, the larger the needle, the more pain noted during insertion. A painful sensation is actually desired in Chinese acupuncture. One of the main goals during Chinese acupuncture is to manipulate the needle to elicit what is known as "de qi" (pronounced Dah-Chee), which can be quite painful. Needles are also inserted deeper into the tissues and twisted to create a physiological response in the connective tissues. This combination of thicker needles, deeper penetration, and manipulation create the common painful experience many patients will experience with Chinese acupuncture.

Do not get me wrong. This does not mean it is not effective. On the contrary, traditional Chinese acupuncture has been a highly effective treatment for literally hundreds of millions of patients over thousands of years.

Japanese acupuncture, on the other hand, uses very thin needles that are also sharper, allowing them to enter the skin virtually painlessly. Needles are also inserted much shallower and are not manipulated. Where Chinese acupuncture involves deep penetration into the connective tissues (muscles, ligaments, tendons...), Japanese acupuncture focuses upon stimulating the  sensory nerve fibers just below the skin. That may sound painful, however, the vast majority of these nerve fibers do not function as pain receptors. Instead, they monitor sensory stimulation such as stretch, pressure, vibration, and temperature. Due to the connections of these fibers into the brain, Japanese acupuncture works by modifying the brain's response to any stimulation, including pain. 

As you may have guessed, I practice Japanese style acupuncture. Having personally experienced both with equal success, I have chosen the path of comfort for both myself and my patients. Please read some of our patient testimonials (here), including 10 year old Kimberly who called acupuncture her "favorite!" If you or someone you know has had a painful experience with acupuncture, they may want to give our office a try.

I have also been asked about dry needling, a technique many physical therapists now utilize. This treatment should not be confused with acupuncture. While Chinese and Japanese acupuncture styles may vary, both function through the stimulation of specific points that have been mapped over thousands of years and tested for their clinical effectiveness for a wide variety of conditions (see the official research publication by the World Health Organization). Dry needling, on the other hand, does not use traditional acupuncture points but instead targets tender areas in muscles.   

Dry needling specifically addresses pain related to myofascial trigger points.  Needles are deeply inserted directly into these trigger points with the primary purpose of stimulating a "twitch response," which is usually elicits pain as well. Many times an electrical impulse is connected to the needles to enhance this response. Once again, it can be very effective for pain, but many people find it very uncomfortable and would much rather receive the same results using acupuncture without the pain. While dry needling is specific for pain, acupuncture's benefits are much broader as perviously noted. Over the years, many patients have returned to our office after undergoing dry needling due to the comfort and effectiveness of our treatment.

Feel free to contact our office if you have any questions on how acupuncture may be of benefit to you. For those who may believe acupuncture is merely placebo, please read what my dog had to say about that in my article, "Dogs Never Lie: What My Dog Taught Me About Acupuncture."