Although acupuncture needles are obviously the main tool for acupuncture, they are rarely discussed. I insert approximately 70,000 needles each year, and so spend a great deal of time with needles either in my hands or between my fingers. I am fascinated by these needles. When I first got my hands on some acupuncture needles while I was in college, I carried them with me everywhere. I practiced needling fruit, bus seats, the soles of my sneakers, paper, and anything else I could think of. Learning to handle the tool of the trade was a fun part of the process for me. This article discusses some of what I have learned about acupuncture needles.
History of Acupuncture Needles
The modern acupuncture needle is just that – modern. The oldest acupuncture needles found so far are stone tools known as bian, which date from the third millennium B.C. There is good evidence to suggest that acupuncture consisted mostly of bloodletting at his time, as the tools were likely not smaller than small finishing nails. With time, acupuncture needles were formed out of bone, wood (such as bamboo), ceramic, and eventually metal.
Metal acupuncture needles date to middle of the second millennium B.C., during the Bronze Age. It was not until a thousand years later, during the Iron Age, that fine, steel needles were fashioned. Stainless steel is the metal of choice today, but since over two thousand years ago, needles made of gold, silver, copper, and other alloy metals have been used.
The common acupuncture needle with which most people are familiar is the filiform needle. The narrow body and conical, non-beveled tip easily push tissue aside rather than tearing it (as a hypodermic needle does). This leads to easy insertion, and minimal if any pain and bleeding. However, there have been many varieties of needles developed, and nine of these are discussed in The Yellow Emperor’s Internal Classic, compiled approximately 2000 years ago. These needles were used for minor surgical procedures, lancing, bleeding, and application of pressure. These needles are rarely used in the Western practice of acupuncture, with the exception of two which have evolved from these older needles. Disposable lancets are used for pricking the skin to let small droplets of blood, and plum blossom needles are used for superficial pricking and stimulation of the skin.
Styles of Acupuncture Needles
Typical Chinese style needles are longer and thicker than those which most people in the West are used to. Chinese needles typically range from 26 gauge (0.40 mm diameter) to 32 gauge (0.25 mm). Japanese style needles can be as small as 44 gauge (0.12 mm diameter). The most common sizes used in America are around 36 gauge (0.20 mm diameter), which is about the thickness of 5 pieces of average human hair. A very small hypodermic needle is 26 gauge, the same size as the largest possible acupuncture needle.
Japanese style acupuncture is practiced differently than Chinese style, and thus the needles were made finer. The technology and the desire for these needles have affected most styles of acupuncture in the West. There is no longer any real difference between a Chinese style needle and a Japanese style needle, except that the latter is used to imply finer gauge needles. Some styles of Japanese acupuncture still use needles made of other metals, such as copper and zinc. Besides China and Japan, needles are also commonly made in Korea.
Production of Acupuncture Needles
Interestingly enough, there are no acupuncture needles made in the West at all. In fact, acupuncture needles were classified as “investigational” in the United States by the FDA until 1996. The running joke in the acupuncture profession was that this made acupuncture the longest running experiment in history.
There are many brands of acupuncture needles. I use only Carbo brand needles in my practice. American stainless steel is exported to China as wire, where it is transformed by hand into acupuncture needles and then shipped back to North America through Canada. All acupuncture needles are still hand made. Several pieces of wire are cut and then polished at once by hand on a sanding wheel into filiform needles. The handle is formed by wrapping a steel and nickel alloy around the body of the needle, creating the needle shape most people are used to seeing. Needle production, packaging and sterilization are performed in a highly controlled, filtered environment, by well trained and fairly paid employees of Carbo. I personally know and communicate regularly with the owners of the Carbo factory in China. Each packet of needles is coded not only with manufacturing and expiration date, but with a lot number which allows Carbo to identify the specific individual who manufactured each needle. This ensures high quality production.
Unfortunately, such high standards are not the norm with acupuncture needles. The desire for cheap needles often leads to poor working conditions and an unsanitary production area. As is true in all other sectors of the economy, you get what you pay for. Some of the higher quality needles are coated with silicon for ease of insertion. There is still a great deal of controversy regarding the safety of silicon, and I personally do not feel it is either wise or necessary to use it.
Regulation of Acupuncture Needles
Acupuncture needles are considered to be medical devices. Their sale, usage and disposal is highly regulated. Used acupuncture needles are considered to be medical waste, and must be disposed of according to state laws. The New Jersey Department of Environmental Protection regulates medical waste disposal in New Jersey. Most needles are picked up and incinerated out of state, and there is no other option for this.