The insertion of an acupuncture needle is not a painful experience. Patients are often surprised to learn that the needles are in place without having felt a specific sensation. It would be wrong to suppose that acupuncture is always painless, however first time patients usually say it is more comfortable than they expected.

The Chinese state that if acupuncture is to achieve its maximum effect it is necessary for the acupuncturist to obtain ‘needling sensation’. This involves the needle being moved slightly while it is in the skin, and the sensation experienced by the patient will vary. Needling sensation is not painful but it is a dull, bursting or numb sensation around the site of the inserted needle. The sensation may also travel up or down the channel being treated; the stimulation of an acupuncture point on the right knee may precipitate the experience of a strange burning or numb sensation in the right ankle. This especially applies if the patient is presenting physical pain.

Other disciplines of acupuncture, especially Japanese style, do not require any sensation at the point. They use very fine needles and superficial insertions.

Patient accounts of their sensations during treatment can be broadly categorised as follows:

Having an acupuncture point needled can feel like a weight is being placed on the area. Sometimes this feeling of heaviness expands, spreading throughout the body part where the needle was placed. This heaviness is calming rather than oppressive.

Along with heaviness, an achy sensation can occur at the needling site. It usually dissipates after a few seconds, but occasionally a point will ache or even throb slightly throughout the treatment. This is normal but it can be intense, especially on points that are located on the hands and feet. If it feels too strong, tell your acupuncturist so that he or she can adjust the stimulation.

The needling of certain acupuncture points can feel almost like you’re being shocked or zapped. It’s usually a surprising, traveling jolt that quickly disappears. One of the most common acupuncture points for causing this sensation is Pericardium 6, since the median nerve runs directly beneath it.

A patient once told me that she feels like a Christmas tree when she gets acupuncture. Acupuncture points can cause tingling at the needling site as well as throughout the body. Sometimes this happens immediately upon needle insertion and other times, which is where the Christmas-tree analogy comes from, it happens while you’re resting with needles. Points intermittently tingle like twinkling lights.

A spreading sensation of warmth sometimes engulfs the area around an acupuncture point. This typically occurs a minute or two after the needle is inserted. It is a pleasant feeling, like internal heating pads are being applied to various body parts.

If acupuncture causes you to feel something other than these five sensations — or nothing at all— that’s okay, too. T