Not literally you understand, now that would be painful on the ear and lead to a major exodus of my clients! But I do ‘twiddle’ the needles once they are in place during a treatment, which is my way of saying I manipulate and stimulate them or get them to ‘sing’ and connect with my clients. In Chinese Medicine terms we call this getting ‘deqi’. I would like to explain more about what I’m doing with these needles and what clients feel as a consequence. There is quite an art to this and years of different traditions and beliefs. Getting deqi is seen as critical to treatment efficacy by some practitioners. I do realize this might all seem a bit esoteric but as with a lot of Chinese Medicine it offers a different perspective on health and wellbeing. I’ve kept things practical though to give you an insight into a small part of your acupuncture treatment.
Inserting a needle
Clients sometimes ask me ‘will it hurt?’ The art to needle insertion is skill, along with knowledge and anatomy of each acupuncture point. It is also about directing one’s consciousness towards the tip of the needle and being sensitive to the sensations received as the needle penetrates different kinds of body tissue, and partly on directing one’s own Qi in front of the needle to ‘part the way’. (Qi we roughly translate as energy – though this is a gross simplification). So mostly this is painless, though sometimes a transient sharpness will be felt.
The question of depth
‘How deep do you needle?’ I’m asked too. The question of depth relates to anatomy, purpose of needling and obtaining deqi, which the client feels as acupuncture sensations. Acupuncture textbooks indicate average proper depths for each point, which is modified depending on the build and physical type of the client. Sometimes it is desirable to direct deqi in a particular direction and this may only be obtained at a certain depth. For example Dr. Xiao in Nanjing, would needle a point at the back of neck, near the skull called Fengchi GB-20 until deqi was felt either over the top of the head, or through the head to the forehead. This will often mirror the course of a client’s headache. Dr. Xiao’s simple but profound advice on needling is what we must follow, “one must combine confidence with caution”. To be confident and not cautious, would be highly dangerous.
I tell clients what sensations to expect when the needles are in the body. This is when I will manipulate the needles to obtain deqi. Ling Shu says,
“Only when the Qi arrives is the therapeutic effect produced. This is the key point in acupuncture”.
This can be a dull ache, numbness, soreness, heaviness, tingling, electric shock sensation or warmth. It is not pain though and nothing should be uncomfortable, there is ‘no pain, no gain’ required. There is a clear distinction between pain and deqi which reflects a cultural difference between China and the West. In China the word pain describes a specific sensation and is readily differentiated by most Chinese patients from soreness, heaviness, distension etc produced by acupuncture, which may be just as strong. However by describing to the client the kind of sensation they should experience with the arrival of Qi. Most people can then differentiate between pain on the one hand, and soreness, numbness etc. on the other. It can be diagnostic too.
“The needling sensation occurring quickly means the therapeutic effect will be produced rapidly; needling sensation appearing slowly means the therapeutic effect will be produced slowly.” (Biao You Fu)
Very occasionally I get clients who are unable to be objective about needle sensation and feel everything as uncomfortable. My experience is that these people tend to be highly stressed and anxious people, although those in chronic pain can very occasionally be like this also. The key to this response, is the person’s Shen or psycho-emotional wellbeing being disturbed and resulting in there being no healthy distance between bodily sensation and one’s ‘inner self’, so that all strong needling sensation is experienced as equally uncomfortable. Any form of deqi is experienced as further, undesirable pain. For such clients I have to slowly and gently introduce them to deqi, though this may lead to their treatment being prolonged.
A good sensation of deqi can be a good prognostic sign, as I’ve described in my shingles blog, often the elderly for example do not feel deqi – it is hard to obtain. This is because such clients have a weak constitution or have been suffering chronic disease for some time. A couple of points to make here, is that although deqi may be weak during the first few treatments, as the client’s condition improves so will the deqi. Secondly, there is an exception to every rule and in some cases there will be good results from treatment despite absence of deqi.
Sensations while the acupuncture needles are in place
Some kinds of needle sensation will disappear quickly after obtaining deqi. Others will tend to continue whilst the needle is retained and even after it has been removed. So to end this short delve into acupuncture needling I will leave you with some comments made by clients as to what acupuncture feels like:
“I feel like I’m levitating’
“It’s like having a massage but from the inside”
“There is always one point when inserted where I feel my whole body go heavy and sleepy”
“I feel like I’m sinking down into the couch”
“I felt waves of sensations in different parts of my body”
“I could feel different points at different times, and one would set off another point; tingling, aching and numbness”
“oh god that’s such a relief” (as pain is replaced by the acupuncture ‘dull ache’)
And possibly one of my favourite descriptions from my client Chris a few years ago is “I’ve got the champagne effect”.
Journal of Chinese Medicine (1984) Needle Technique (part one). Peter Deadman