"Does Acupuncture Hurt?"

Visit almost any acupuncturist’s website and you will likely find this question in the FAQ section. It is an important question that people genuinely want to know the answer to. Naturally, it does not seem logical that forcing stainless steel into muscle bodies would be a painless experience, let alone a relaxing one! The provided response on these websites is almost equally ubiquitous: “No”. It is usually followed by a brief description of what sensations one might experience during the treatment, but it is a safe bet that the first word will be “No”. The problem with this, as I see it, is that the experience of pain is a very subjective thing, and what one patient calls “pain” another might call “heaviness”. Before we can begin to answer whether acupuncture hurts, we have to define “hurt”. And that becomes a conversation much too complex for a website. I would like to use this article to answer a more accessible question, one that is relatively objective: What does acupuncture feel like?

There are many different styles of acupuncture, utilizing many different kinds of techniques. Japanese acupuncture, for example, is very gentle and generally does not aim to elicit an immediate reaction at the site of the needle. In contrast, modern day Chinese hospitals espouse a type of acupuncture that seeks out a noticeable response from each needle inserted, which is interpreted into feedback about how the body will respond to that acupoint and the treatment overall. This technique is called de qi (得气), or “obtaining qi”, and is integral to many different styles of acupuncture. Multiple factors, including the specific point as well as depth, angle, and stimulation of needling, have an influence on how a person will experience the qi sensation. While the experience can vary from person to person, de qi will typically feel one of four ways:

  • Distended (胀 – zhàng) – This is probably the most common form of qi sensation. Usually obtained at larger muscle bodies, this form of de qi reaction is often described as an achey, swollen feeling. It is both full and deep. You might notice this sensation when your acupuncturist needles Large Intestine 4, the point on the back of your hand between the thumb and index finger.
  • Sore (酸 – suān) – This soreness is the same kind of feeling you get from a deep tissue massage, just without the heavy pressure. It feels similar to the distending sensation mentioned above. Where distention feels full and swollen, however, soreness spreads along the surface. There is a point at the center of your shoulder blade that will exemplify this sensation with mere finger pressure.
  • Heavy (重 – zhòng) – The heaviness of de qi is not quite as obvious as the previous two. It feels more like a pulling at the point, rather than achey or sore. In this case, the acupuncturist can often feel this sensation at the other end, like the muscle is pulling on the needle. Spleen 9 is a point on the inside of the leg just below the knee where a strong heavy sensation is often experienced.
  • Numb/Tingling (麻 – má) – This response, while not very common, is important to note as it can be both startling to the patient and beneficial to treatment outcomes. The tingling sensation is often described as a “zing” or “lightning”. This is actually a reaction from the needle touching the outer coating of a nerve. This technique can be very effective and is used for conditions like neuropathy, paralysis, sciatica, and even back pain. Accessing a point called Pericardium 6 on the inside of the wrist can evoke this kind of response when needled with that intention.

In China, the term for pain, tòng (痛), is used when patients experience a sensation that is not related to de qi. This kind of pain can be a sharp, pinching, intense, and altogether uncomfortable. Unlike pain, the sensations associated with de qi indicate a part of the healing response present in the acupuncture treatment. It is much like the way we speak of a “good hurt” when getting a massage. It should be noted, with the variety of styles of acupuncture practiced, positive treatment results are not necessarily dependent on this sensation of de qi. Treatment outcomes react differently to various approaches based on the condition being treated, the practitioner’s skill set, and the patient themselves. In order to get the best results from your acupuncture treatments, be sure to communicate with your acupuncturist about what you are experiencing during the treatment and try to train your mind to notice these different sensations. The more you take note of it, the more you strengthen the connection between your mind and your body.