Does Acupuncture hurt?

Does Acupuncture hurt? dEbunking Myths & Exploring Realities

One of the most common questions acupuncturists are asked is "Does acupuncture hurt?". The short answer is no - as needles are inserted, the sensation is often described as a dull ache, or a slight pressure.

Is Acupuncture Painful?

One of the most common questions acupuncturists are asked is whether or not treatment is painful. The short answer is no – as needles are inserted, the sensation is often described as a dull ache, or a slight pressure. When they reach their intended position patients describe a tingling, which is known as the “qi’ sensation. This sensation is indicative of a therapeutic response, and though it may be uncomfortable it signals treatment is functioning as intended.(2)

Why Don't Acupuncture Needles Hurt?

The feeling is not at all similar to an injection or shot – acupuncture needles are about the width of a human hair, a fraction of the size of a traditional hypodermic needle. Acupuncture needles are also structurally designed to minimize discomfort, and include a guide tube which aids with insertion, ensuring smooth and easy entry. In addition, the needles are regulated by the FDA to minimize side effects. Despite this, the idea of having thin needles inserted into targeted points along one’s body is intimidating to some, and has led to the misconception that there is a significant amount of pain involved.

The truth is much the opposite however, as most patients find the experience calming and therapeutic. In fact, many patients rely on the relaxation they experience during acupuncture as both a mental and physical component of their treatment. Many patients seek acupuncture specifically for managing both acute and chronic pain.

Why Doesn’t Acupuncture Hurt?

The way in which pain and acupuncture interact is multifaceted – impacted by biological, psychological and at times even social factors. Acupuncture simultaneously attacks pain psychologically and biologically – by modulating the body’s response to pain while also altering the body’s perception of pain via gate control.(3, 7)

Acupuncture is able to modulate the way our body registers pain by stimulating the production of natural opioids, which desensitize pain-detecting cells (known as nociceptors) and decrease inflammation-causing cytokines (a substance secreted by immune cells) within the body. Additionally, the production of serotonin and norepinephrine is activated – together, these chemicals further desensitize and decrease the activity of pain receptors.(3) Blood flow also increases during treatment, which expedites the delivery of opioids, serotonin and norepinephrine and the removal of cytokines, further enhancing the effects.

In line with the principles of the Gate Control Theory of Pain, acupuncture can also alter the body’s perception of pain. The Gate Control Theory of Pain suggests there are “gates” in the spinal cord which can either block or allow pain signals to reach the brain. Typically the opening and closing of these gates depends on the balance of pain and non-painful stimuli received by the nervous system – however during acupuncture treatment, needles trigger non-painful sensory nerve fibers which “close” the gates.(7) This effectively inhibits pain signals from traveling through that specific channel to the thalamus and then to the prefrontal cortex, where pain is processed, registered and cognitively evaluated.(8) Acupuncture treatment closes numerous gates, allowing one’s body to adjust how it’s perceiving pain from an injury or ailment, chronic or acute. In addition, acupuncture also promotes the release of endorphins and enkephalins, which can further contribute to the closure of pain gates.(9) This form of treatment is particularly useful for chronic pain patients, as it gives their nervous system a break by closing targeted gates while opening others in order to reduce the perception of pain from particular injury or ailment.

Gate Control Theory of Pain

What does Acupuncture Feel Like?

My first experience with acupuncture, like many, was a nerve-racking one. I wasn’t deathly afraid of needles; however, I was expecting acupuncture to be painful to some degree – I was wrong! I found that the worst needles felt like a mosquito bite, and that sensation would dissipate after a few seconds. I felt nothing at all for most of the needles. For some, I felt a ‘heavy’ sensation which the acupuncturist described as “de-qi.” As mentioned earlier, this is a therapeutic response that acupuncturists work to achieve.

I began acupuncture school in 2013 and was eager to start needling. To my surprise, the class had to wait and study an entire year before even handling a needle. We took a deep dive into human anatomy and the philosophy of acupuncture. Then finally, once we had a solid understanding of the human body and the function of 400+ acupuncture points, we began needling different objects for practice. We needled fruits and inanimate body parts to get a feel for needle depths and different layers.

Finally, my classmates and I began needling each other after the first academic year. I must have been needled thousands of times during school and in all different areas of the body. It didn’t take long for me to start looking forward to needle practice and receiving acupuncture. Today, the very thought of receiving a needle on my legs or back makes me wish I was on an acupuncture table.

It’s important to know that every acupuncturist has their own style of treating people. I have met some who don’t hold back at all when their patients are in pain and some who are too timid when needling a certain body party. My approach meets somewhere in the middle. I make sure that the patient experiences de-qi, or the therapeutic sensation, but not at the expense of their comfort. I stress the importance of communication during treatment and ensure the patient is completely relaxed before I exit the room.

For most of my patients, their acupuncture session is the only hour of their week where they get to rest and meditate without any distractions. Many turn their phones off and take a nap. My favorite line that I hear is, “This is the most relaxing hour of my week, thank you.” I truly enjoy providing pain relief and stress relief for my patients. I encourage you to try acupuncture and find an acupuncturist with whom you can genuinely connect with.

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Sources

  1. Andrew, V. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., & Linde, K. (2017, November 30). https://www.jpain.org/article/S1526-5900(17)30780-0/fulltext. Retrieved April 19, 20323, from https://www.jpain.org/article/S1526-5900(17)30780-0/fulltext  
  2. Cronkleton, E. (2018, July 20). Does acupuncture hurt? pain tolerance for the Eastern Medicine. Healthline. Retrieved April 18, 2023, from https://www.healthline.com/health/does-acupuncture-hurt 
  3. Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014, February). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. Retrieved April 18, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3947586/
  4. E;, L. M. S. E. (2011, February). Acupuncture for pain: An overview of Cochrane Reviews. Chinese journal of integrative medicine. Retrieved April 18, 2023, from https://pubmed.ncbi.nlm.nih.gov/21359919/
  5. Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration. (2018, May). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. The journal of pain. Retrieved April 18, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927830/
  6. MacPherson, H., Vertosick, E. A., Foster, N. E., Lewith, G., Linde, K., Sherman, K. J., Witt, C. M., Vickers, A. J., & Acupuncture Trialists’ Collaboration. (2017, May). The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain. Pain. Retrieved April 18, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393924/
  7. R;, M. (n.d.). Myofascial trigger points: Relation to acupuncture and mechanisms of pain. Archives of physical medicine and rehabilitation. Retrieved April 25, 2023, from https://pubmed.ncbi.nlm.nih.gov/6972204/
  8. Ong, W.-Y., Stohler, C. S., & Herr, D. R. (2019, February). Role of the prefrontal cortex in pain processing. Molecular neurobiology. Retrieved April 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400876/
  9. Sprouse-Blum, A. S., Smith, G., Sugai, D., & Parsa, F. D. (2010, March). Understanding endorphins and their importance in pain management. Hawaii medical journal. Retrieved April 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104618/