There is a range of different styles that have been developed throughout the history of acupuncture that incorporate a variety of different needling techniques. While some, like seen in Japanese acupuncture, use a very superficial insertion of needles just under the skin with an extremely gentle stimulation of the point locations, it has become a commonly accepted practice in Traditional Chinese Medicine to elicit a strong needle sensation experienced by the patient at each point location by inserting a needle to the desired depth (based on anatomical location) and manipulating the needle manually by lifting and reinserting it or by twirling the needle.
This can be felt by patients in a various ways and described as a soreness, numbness, distension, heaviness, or pain. Yes, pain. Acupuncture has long been touted as not being painful but this is not always the case. This may be due to this technique being central to the clinical practice of acupuncture for over 2000 years that this strong needle sensation was recognized to have unique therapeutic value and experienced separate from pain. For many Americans, though, who are new to acupuncture, acupuncture can be described as being painful.
The needling sensation can also be observed by the practitioner as a gripping quality around the needle when tugged, an involuntary twitching of the muscles, and sometime redness of the skin around the needle site.
If you’ve read any research trials that utilize acupuncture treatment, you may have seen this technique described in the Methods section as “needling sensation, “acupuncture with stimulation,†or sometimes by the pinyin term “deqi†which is commonly translated as “obtaining the vital energyâ€. Interestingly, researchers have also studied this needling sensation with neuroimaging using fMRIs and have found stronger activation of different regions of the brain than when using only tactile superficial stimulation of acupuncture points.
In the scientific community, this local sensation felt by patients has long been associated with stimulation of afferent nerve fibers but more recent research suggests that involvement of the deformation of connective tissue through acupuncture may play a strong part with the mechanism of acupuncture. Local vasodilation also results from needle stimulation along with the local release of substances like histamine, nitric oxide, prostaglandins, and many others which are currently being studied for their relationship in explaining how acupuncture works.