It has recently come to my attention that some of my patients avoid, or at least delay, coming to see me for help with pain conditions because they don’t like the discomfort of local acupuncture or dry needling.
People have always joked about this and I could easily understand and commiserate. But I always thought it was more of an acupuncture joke. (There are many of them, mostly bad, such as “get to the point.”) I believed that they would of course come if they needed help.
The more I thought about it, the more I realized I wouldn’t actually know if people were staying away from treatment not because it didn’t help, but because they didn’t want to experience the associated discomfort or pain.
My basic belief until now has been, who wouldn’t love acupuncture? I’ve been involved with acupuncture for 41 years of my life. It’s second nature to me. I can barely imagine life without it. Nevertheless, I believe I am aware of and sensitive to people’s response to treatment. I don’t push or insist. I tune in and listen and pay attention to the grimaces and grunts. Still though, hard as it is for me personally to imagine, some people might not love acupuncture.
Here is my response to the question, “Does acupuncture have to hurt?”
No. Acupuncture doesn’t have to hurt. I can always choose less sensitive points, use thinner needles, apply gentler needling techniques.
Yes. Sometimes acupuncture does and should hurt. The purpose of acupuncture, regardless of style or technique or theory, is to move the Qi. Sometimes that requires more stimulation, and we may experience this as pain. There’s no idea in acupuncture that we shouldn’t feel the needles. This–when it exists–is a modern, Western notion. In part this is due to lack of understanding; in part it is simply lack of familiarity and thus comfort.
We routinely endure uncomfortable or painful medical treatments because they are familiar and because we understand and accept the benefits. Simple examples related to pain conditions include: MRIs, EMGs, epidural injections, medications with side-effects, and surgeries. As we are less certain about acupuncture, and have no frame of reference for either its sensations or effects, we may be less willing or able to endure the discomfort. In addition, acupuncture is typically administered routinely over potentially long periods of time; it’s not so bad to experience needle discomfort once or twice, but ten times is another story.
Maybe. We can choose together how strong or aggressive or uncomfortable we will make the treatment. The nature of treatment is always and ideally negotiable. The more we both pay close attention to the constantly shifting needs and conditions of the treatment and the patient, the better the result. More communication, more flexibility and more negotiation equate to better outcomes.
When you come to see me (or any other acupuncturist or health care professional, for that matter), please speak up.
I have learned that people will endure discomfort at the risk of sounding too needy or demanding. As a patient, as a human being, it is your right to express your feelings and your needs. It is the responsibility of the practitioner to respond appropriately to this. It is also the responsibility of the practitioner to understand what sort of therapy is required, and to communicate this to the patient. Sometimes treatments with strong physical sensations are a good choice. But they are never the only choice. Maybe it makes sense to treat more gently over a longer period of time, rather than create too much discomfort for the sake of quicker relief. And sometimes the opposite is true. It doesn’t need to be the same each time, or for each point.
Generally, it is the local treatment that elicits more discomfort during treatment. By local, I am referring to the direct needling of the area that is causing a patient pain. This aspect of treatment can include techniques such as sparrow pecking and dry needling. Typically, when the condition being treated involves pain, it is the only local treatment that produces some discomfort. Most of the acupuncture treatment is gentle and feels relaxing to the patient.
The correct treatment is always the one that is appropriate to the patient at that time.
Acupuncture and dry needling allow for varied techniques and levels of stimulation, so it is always possible to adjust the treatment to the needs of the patient. There is no technique that needs to be imposed. Regardless of the method, acupuncture should ultimately make you feel better. There will be times during and after treatment that you may experience pain or soreness or even worsening or changing of symptoms (this is true mostly when the condition being treated is pain, such as sciatica or shoulder pain). This can be normal and part of the healing process (we are sore after we exercise for the first time, and we understand that is an expected response). But the overall experience of acupuncture itself is positive for most people. The vast majority of patients find acupuncture to be a pleasant experience. It should ideally be something that you look forward to, knowing that you will experience less pain, reduced symptoms, greater energy and more relaxation as a result.