Will this Hurt?


On Thursday the 2nd, I got the opportunity to participate in a MOPS Spa Day. MOPS (Moms of Preschoolers) is an organization that provides community and support for women with young children, you can learn more about the organization here. There were a couple of massage therapists also in attendance, as well as several tables of ladies offering manicures and similar services. I was doing free relaxation treatments.

MOPS International

I really enjoy events like this because for many of the people trying the relaxation treatments it’s their first time experiencing acupuncture. For a lot of people there’s a lot of trepidation surrounding that first needle. After all, most people’s experience with medical puncturing of any kind has been from getting blood draws or injections. Many times the clinician performing the procedure will assure you that, “This won’t hurt at all.” And as you all know very well, it’s a filthy lie.

So when I tell people that acupuncture generally doesn’t hurt, they usually think I’m feeding them the same old line they’ve heard too many times before. The surprise on their faces when the first needle goes in and they genuinely don’t feel a thing is always entertaining.

Why does acupuncture feel so very different from injections and blood draws? It’s all about needle gauge. The needles used for subcutaneous injections are generally 27 gauge, while those used for intramuscular injections are 21-23 gauge. Higher numbers translate to smaller needle diameters, so SC injection needles are 0.41 mm across, while IM injections needles are a hefty 0.82 – 0.64 mm across. Because acupuncture needles are not used to inject anything, they can be much, much smaller. The general purpose needles I use in my clinic are 38 gauge, that’s 0.18 mm across, that’s less than half the diameter of an SC needle and anywhere from a third to a quarter the diameter of an IM needle. For ear points and other sensitive spots I have 40 gauge needles which are only 0.16 mm.

Because the needles are so fine, 80-90% of the time when a needle goes through the superficial skin layers the patient doesn’t feel anything at all. There may be rare cases where the needle hits some micro-structure in the skin that has a nerve associated with it such as a hair follicle or venule. This can cause a sharp or burning sensation but it is usually possible to adjust the needle or redo the point so that it is no longer uncomfortable. Once the needle has been inserted to the proper depth it may produce a variety of sensations such as a feeling of heaviness, hot or cold sensations or a dull ache similar to the muscular ache from exercise. In Chinese medicine they are call De Qi sensations and are taken as an indication that the point is active and the needle is doing its job.

Most people find acupuncture to be a relaxing experience, and I hope that was the case for the ladies who got treatments at the MOPS Spa Day, even the ones trying to hold squirming one-year-olds while the needles were in.

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