With a history stretching back more than 2,500 years, acupuncture is a well-proven, low-risk way to treat a myriad of conditions, most notably pain and stress. Understandably, for many the idea of having acupuncture needles inserted into your body feels a little unnerving. To help alleviate your concerns, we’ve created this comprehensive guide that explores everything you need to know about acupuncture needles, including:
- What is an acupuncture needle?
- What do acupuncture needles do?
- How do acupuncture needles work?
- Where do acupuncture needles go?
- How many needles are used in acupuncture?
- How deep do acupuncture needles go?
- How long should acupuncture needles stay in?
- Is acupuncture painful? – Not if you see a properly qualified practitioner.
What Is An Acupuncture Needle?
An acupuncture needle is a sterilised, thin needle, used by an acupuncturist to stimulate acupuncture points in your body. Made of solid, flexible stainless steel, these needles are typically as fine as a strand of hair (approximately 0.2 mm wide).
In accordance with Australian law, acupuncture needles must use pre-sterilised and single-use. They are designed to be inserted into the skin, fascia and muscle tissue without penetrating arteries or veins.
Where Do Acupuncture Needles Go?
Acupuncture needles stimulate strategic points in the body, some are channel or meridian points and some are not. All points are anatomically defined areas on the skin that correspond to certain landmarks on the body.
How Do Acupuncture Needles Work?
What do acupuncture needles do? Acupuncture needles create a tiny wound when they pierce the skin, to kickstart the body's natural wound healing response.
A number of studies suggest that acupuncture needles stimulate specific neurohormonal pathways and biochemical processes to activate the sympathetic and parasympathetic nervous systems. Ultimately, they cause the body to release endorphins, serotonin, enkephalins, and γ-amino-butyric acid (GABA, a major inhibitory neurotransmitter of the brain), norepinephrine, and dopamine. Endorphins and Beta-Endorphins bind to opioid receptors in your brain to block your perception of pain, much like an opioid pain medication like oxycodone or morphine.
Other recent studies suggest that stimulating certain points of the body with acupuncture needles helps reduce pro-inflammatory markers — including TNF and IL-1β — in the body.
How Many Needles Are Used in Acupuncture?
The short answer: A typical acupuncture treatment uses between 5 and 20 needles.
The long answer: The number of acupuncture needles your acupuncturist uses will depend on your condition and the type of acupuncture practiced.
Many acupuncturists prefer to use the minimum number of needles. Why? First, some acupuncturists specialise in techniques that use very few needles.
Second, using lots of needles in a session can make it more difficult to pinpoint which acupuncture points are having a beneficial effect and which are not. Generally, it is much more efficient to use just a few needles in the first few treatments and add more later.
How Far Do Acupuncture Needles Go In?
How deep do acupuncture needles go?
Acupuncture needles are inserted to various depths at strategic acupuncture points on the surface of the skin. Needles can be inserted anywhere from 2mm up to 3 or 4 centimetres in depth. The depth of insertion will depend on:
- Where on the body the needle is being inserted - Places that have a lot of muscle or fat lend themselves to a deeper insertion. However, needles going into hands, feet, ears, wrists and less fleshy parts of the body are inserted more shallowly — a couple of millimetres deep.
- The nature of the condition - Different conditions require different needle depths. For example, hands and feet will generally be treated with fine gauge needles, inserted shallowly near joints and tendons, but deeper in fleshier areas. Needling around the face also tends to employ ultra fine and smaller needles. In contrast, needling around the glut, into thigh muscles or around the knee will require deeper insertion.
- The patient’s size, age and constitution - A patient with a stronger constitution or a more robust body shape can have deeper needling than a smaller framed patient or someone with a weaker constitution. Constitution is decided by a number of factors such as chronic illness, age, the health condition someone is presenting with, or the types of medication someone has been taking.
- The angle of insertion – is determined due to a number of factors, including the constitution, where the needles are being inserted and the style of acupuncture being applied. Obliquely angled needles are typically not inserted as deeply as needles inserted straight in.
- The style of acupuncture being practiced – Japanese style meridian therapy uses ultra fine needles with guide tubes for very shallow insertion. Taiwanese styles tend to use more free needling techniques with a range of depths and insertion techniques that depends very much on who and what is being treated. Auricular (ear) acupuncture involves tiny, short ear needles. Japanese-style and Korean hand acupuncture typically have a shallower insertion depth than Chinese-style acupuncture.
- Safety - Safety plays a significant role in needle depth. Needling around the head, neck, spine, and near internal organs demands care on the part of the practitioner. Licensed acupuncturists devote years to studying correct needle depth and placement.
How Long Should Acupuncture Needles Stay In?
Acupuncture needles will usually stay in place for 25 to 40 minutes. Sensitive people can expect shorter time frames, while people with chronic conditions can expect longer. Children typically receive non-retained needling or meridian therapy techniques which are non-insertive.
- Lin, J.G, Chou, P.C. & Chu, H-Y. (2013). An Exploration of the Needling Depth in Acupuncture: The Safe Needling Depth and the Needling Depth of Clinical Efficacy. Evidence-based Complementary Alternative Medicine, 740508.
- Zhang, X., Park, H-J & Lee, H. (2015). Do acupuncture needle size and needling depth matter? A laser Doppler imaging study. Integrative Medicine Research, 4(1):66-67.