Is It Better for Acupuncture to Be Painful or Painless?

Many patients visiting the acupuncture department often ask whether acupuncture is painful. Due to concerns about pain, some patients who are particularly suited for acupuncture treatment may forgo it, thereby missing the optimal treatment window. For some patients with sequelae of stroke, their families believe that the more painful the acupuncture, the better, as it indicates the patient's nerves are still sensitive. An increasing sensation of pain during acupuncture is also seen as a sign of efficacy. So, is it better for acupuncture to be painful or painless?

Usually, after the needle is inserted into the acupuncture point, sensations of soreness, numbness, distension, and heaviness are produced. Sometimes, these are difficult to describe; some patients find them comfortable, akin to a pleasant pain, but some patients may mistakenly perceive this numb and distended discomfort as pain. This discomforting pain exists within the 'acupoint' and 'meridians', not on the skin surface, and is typically deeper. From a professional perspective, these sensations indicate 'De Qi', a reaction that the acupuncture point has been correctly needled and the technique is effective. If these sensations are too weak, acupuncturists may adjust the feeling of 'De Qi' through techniques like 'twisting', 'lifting', and 'thrusting', based on different conditions and constitutions, to enhance the therapeutic effect of needling.

Upon the needle's instant insertion into the skin, there may be a brief 'mosquito bite' like pain. Skilled practitioners cause minimal or even imperceptible pain, which also relates to the patient's mood; the more relaxed they are, the less obvious the sensation. However, if there is a stinging pain on the skin surface, it may be due to the needle hitting a pore or capillary. This sensation persists from needle insertion until removal, and in such cases, practitioners may choose to reinsert the needle.

Therefore, during acupuncture treatment, there is generally no pain, or at most, a slight mosquito bite-like transient pain. The local or meridian-related sensations of soreness, numbness, distension, and heaviness are usually felt and are a valid response to acupuncture. As for the efficacy of acupuncture treatment, it cannot be simply evaluated by pain or the absence of it.

(Xu Ying)