Does Acupuncture Hurt?


When people discover that I’m an acupuncturist, the first question I’m always asked is, “Does it hurt?” Unfortunately, fear of needles is one of the biggest deterrents for people who are suffering and could benefit from acupuncture treatment. Thus, I believe that the complex topic of needling sensation deserves my heartfelt and in-depth interpretation.


Patient Comfort


My patients’ comfort is my priority. Pain is a very individual experience, so I never judge a patient’s response to acupuncture, and the vulnerability he or she entrusts to me is held near to heart. The first acupuncture treatment is a learning experience for both of us: patients learn what to expect when receiving acupuncture and I learn how best to treat them. There are a lot of sensations that are completely normal, but if my patient feels uncomfortable at any time, I remove the source of the discomfort immediately. I cultivate the principle of non-violence; never expecting a patient to “tough it out” in order to feel better, continuously monitoring reactions, and adjusting my treatments according to the individual.


Insertion Versus Retention


There are two distinct aspects of an acupuncture treatment: needle insertion and needle retention. After needles have been inserted, they are retained for an average of 20 minutes. The patient lies comfortably on a massage table in a darkened room with relaxing music in the background. During this time, although the patient may have an awareness of needle location, there is no pain. I check on patients every 10 minutes and am commonly greeted by a sleeping patient when I re-enter a room. Before I walk away from a patient I ensure that they are not experiencing any discomfort; if my patient feels nervous or uneasy, I remain in the room or check on him or her more frequently.


The needling sensations I am about to discuss are short lived, occurring only during needle insertion, which takes approximately 5-10 minutes.


Pain Versus Sensation


For someone who has never had acupuncture, the only real frame of reference regarding needling sensation is hypodermic needles. Acupuncture needles are extremely fine, flexible even; once I was told that 18 acupuncture needles will fit into the inner diameter of a hypodermic needle. Acupuncture certainly does not feel like getting a shot or having blood drawn.


I like to differentiate between pain and needling sensation. When a patient has been told that acupuncture doesn’t hurt, they often mistakenly believe that they will not feel anything during their treatment. This can lead to worry or distress when they discover that acupuncture is not sensation-free.


Let me be realistic: acupuncture involves the insertion of needles into the body, so it is extremely rare for a patient not to feel anything. Having had acupuncture from dozens of practitioners; I can honestly say that I’ve never had a treatment that was completely free of sensation. Neither have I ever experienced an acupuncture treatment that was painful. I think acupuncture feels…well, weird… believe it or not, I like it!


My average patient does not believe that acupuncture is painful. Some of the needles are felt when inserted, but not all; occasionally a needle will sting a bit; and infrequently a needle will bother him or her enough that we mutually decide to remove it.


Normal Needling Sensation


Needling sensation is not only normal, in a traditional sense it is considered to be a desirable, some would say an essential, aspect of acupuncture’s therapeutic effect. The most common sensation that people experience is very mild and sharp, a little bit like pricking a finger on a needle or a pin. Sometimes there will be a very mild itching or burning sensation at the location of the needle, akin to a mosquito bite. Some people experience a mild aching or throbbing sensation that I liken to the pressure that is applied during a massage or during acupressure. Less often, people describe a mild electric or zinging sensation that feels somewhat similar to being zapped by staticky laundry. Since sensations usually last only 30 seconds to 1 minute, I ask my patients to take a few breaths to see if the feeling subsides. If the sensation persists after a minute, my patient and I decide together whether or not the needle should remain.


Needle Sensitivity


As I mentioned earlier, acupuncture can elicit a multitude of completely normal sensations that are not experienced universally by every patient or at every needling site. Most importantly, on the rare occasion that an inserted needle is distracting or uncomfortable to my patient, I remove it immediately.


Reactions to acupuncture are diverse, and occasionally I encounter a patient who is very sensitive to needling sensations. These patients can only tolerate a very small dose of acupuncture: by this I mean a minimum number of the tiniest needles available. Even extremely needle sensitive patients continue with acupuncture because their symptomatic relief far outweighs the brief discomfort experienced during treatment.


That Point Hurt…Is Something Wrong?


The answer is a resounding no! I would like to be very clear regarding the safety of acupuncture needles. There are nationally and internationally recognized standards regarding the acceptable depth and direction of needling at every acupuncture point and at every location on the body. Beyond a rigorous Master’s level education, Certified Acupuncturists, like Kristin and I, undergo 1,000 hours of supervised clinical practice, pass several national board exams and are state and nationally certified before beginning to practice.


Picture a burly parole officer pounding his fist on a podium, striking fear into the hearts of the audience, and you’ll have an image in mind of my needling instructor, Craig Westerlund. Ay me! How we students cried and moaned about being forced to use the largest available needles to practice needling one another to the maximum allowable depth. “This doesn’t hurt me a bit!”, Craig would say with a devilish grin. Looking back I feel blessed to have learned my limits in such a vivid and unforgettable way.


I have since adopted a gentler needling style, but because of Craig, I can say with absolute confidence that I always practice acupuncture safely. Inserting an acupuncture needle into human tissue creates a microscopic injury. It doesn’t happen often, but occasionally that tiny injury stings. When I remove a needle, however, it is simply to enhance my patient’s experience, not because something is wrong.


Acupuncture Works – Give it a Chance!


I recently went 10 weeks without an acupuncture treatment because Kristin, my business partner and preferred acupuncturist, was on maternity leave. The suffering! I do not know how people live without acupuncture. Acupuncture has had a profound effect on me personally, and I’m humbled on a daily basis by the positive life changes that this medicine has on my patients.


If you are considering acupuncture, I implore you – please don’t let a fear of needles prevent you from getting treatment. The vast majority of my patients genuinely enjoy acupuncture, with the added bonus of an improved quality of life. Simply stated, you will never know unless you give it a chance. I hope to see you soon!


Elissa Langer
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