It depends.
For pediatrics, we use extremely thin needles that we call "cat whiskers", which produce no pain to very minimal discomfort. We also use Shonishin, which is gentle non-insertive needles. They do not penetrated the skin and are very well tolerated by the little ones. The rest of the blog applies to adults.
The acupuncture sensation can range from no pain to strong therapeutic discomfort, depending on what we are working on. In general, needle sensation is stronger when we work on neuromuscular pain and injury. Sensation is weaker and more gentle when we treat anxiety and other internal medicine complaints. In the blog, we will break down what different sensations mean.
The bottom line is that we as acupuncturists always work within the patient's comfort level and maintain good communication. Acupuncture can be very gentle for patients who are nervous about needles. Acupuncture can also be stronger for patients who are result-driven. During acupuncture treatments, most patients take a nap and feel very relaxed afterwards.
Dull, achy, and heavy sensations: These are the most common sensations with acupuncture. Initially, there is a teeny-tiny pinch with the needle insertion. After that, one often feels Qi sensation. It is an indication that the needle is in the right place and the correct mechanism is taking place. In Chinese, the words describing this sensation are Suan 酸 and Zhang 胀. There is no direct translation of these words. Most people describe it as dull, achy, and heavy sensations. It usually goes away after a couple of minutes as one dozing off to sleep.
Traveling sensation: Sometimes the needle sensation is local. Other times one can feel a traveling sensation down the arm or leg, or along a particular acupuncture channel, or spreading outwards like rippling effect. Sometime you can even feel a few needles connecting and "talking" to each other like a gentle whisper.
Twitch response: A twitch response happens when we needle into a nodule or trigger point in the muscle, which contracts and then relaxes. The bigger the trigger point, the more twitching sensation we feel. Sometimes the sensation is local to the muscle. Other times we can feel traveling sensation down the arm or leg. Twitch response is a normal therapeutic release of chronic muscle tension. Though uncomfortable at first, the twitch response through trigger point needling is particularly useful and helpful when treating neuromuscular pain.
Trigger points are formed when the muscle overloads past its capacity and runs out of ATP (or Qi), which is required for muscles to relax as well as to contract. When a muscle is overloaded through either an acute overload or chronic repetitive misuse or overuse, it can be depleted in Qi or ATP. A deficit in Qi or ATP will cause the bands of muscle to stay in a chronically shortened and contracted length. Nodules and trigger points will form because the muscle is not able to relax adequately. Nodules and trigger points can obstruct blood flow and cause connective tissue deposition to accumulate around them, making the muscle tough, grainy, fibrous, and stiff. Small blood vessels and nerve endings can start to grow into them, so they become areas of tenderness. These tender nodules can refer pain when they are pressed on or when a needle is inserted into them. Acupuncture can reduce trigger points, which are associated with joint pain and chronic inflammation.
