I think this is a question that many people thinking of trying acupuncture for the first time have somewhere in amongst all the other questions they might have about acupuncture. Like many other acupuncturists I would like to reassure potential patients and assure them that it doesn’t. To that end we might show potential patients our incredibly thin needles, or at least pictures of them in order to make them seem less frightening. We might reply to the question “Does it hurt?” by saying “Not really” or “You might feel a brief sting” and that is most people’s experience of acupuncture. But these days I’m starting to think this is all a bit disingenuous and I’ll try and explain why.
My initial training was in a system of acupuncture called 5 Element Acupuncture. This is a system that draws a lot from a Japanese system of acupuncture called Meridian Therapy. One of the hallmarks of Japanese acupuncture is its very light needling techniques and a strong emphasis on painless insertion. Needles are often not left in the patients body but are inserted and immediately removed and the idea that the patient should feel ‘deqi’ (needle sensation distinct from the sensation of insertion), something emphasised in much Chinese acupuncture, is absent. The most extreme manifestation of these ideas is perhaps the ‘contact needling’ practiced by the blind acupuncturists of Japan, a technique in which the needle isn’t even inserted but simply rested on the skin over the acupuncture point.
My thinking about acupuncture has been strongly influenced by Meridian Therapy. Not only does it draw on theory that was familiar from my initial training but it provides clear diagnostic criteria and treatment strategies that I found easy to apply in clinic, where reality is often far messier than the theory one has studied. And my interest in Meridian Therapy meant I was keen to improve my needle technique, to work towards the painless insertion extolled by the masters of Japanese acupuncture. I certainly don’t feel I’ve got there yet and of course different people have different responses to needles and different sensitivities to pain. More than that there are some points in which painless insertion seems almost impossible. I’m thinking about some of the points on the feet and especially what are called the Jing Well points, which sit quite close to the ends of our finger and toes. If a patient is going to find any points painful it’s these and I know I have at times avoiding doing certain treatments in order to avoid these points because I don’t want the patient to find acupuncture unpleasant. And this brings me to Sa’am Acupuncture.
Sa’am Acupuncture is a system of acupuncture developed by a Buddhist monk in Korea in the 17th century. Again I became interested in Sa’am because it draws on much of the same theory as 5Element acupuncture and Meridian Therapy, although it creates something very different with it. The theoretical and diagnostic differences between these systems of acupuncture is beyond the scope of this article. What is of relevance is that both Meridian Therapy and Sa’am Acupuncture use the same standard combinations of four acupuncture points. Drawing on the same theories it makes sense that they would but the two systems couldn’t have more different needling techniques. While the Japanese system goes for super fine needles superficially inserted the Korean system goes for much thicker needles inserted much deeper at an oblique angle. Engaging a ‘Jing Well’ point in that way certainly causes some discomfort! (I know because I tried it on myself). So why would anyone choose to use Sa’am rather than some other style of acupuncture?
It might seem odd that Sa’am, a Buddhist monk who had taken a vow to end the suffering of all beings would create a style of acupuncture with such a forceful needling technique. But the acupuncture he pioneered was practiced and passed on among Buddhist monks in Korea, many of whom were mendicant monks, with no fixed abode and who doctored to the people they encountered on their wanderings. In these circumstances many people would get just one or two treatments before the monk moved on and so the acupuncture had to be capable of producing rapid results. In fact while many acupuncturists describe acupuncture in terms of bringing harmony to the body/mind system Sa’am has been described as giving that system a hard shove. Its this that makes Sa’am so powerful. Of course if you’re going to give someone’s system such a strong shove you need to be sure you’re pushing in the right direction. But if you are, the change in a patient’s condition can be almost instant. Its remarkable how powerful four small needles really can be.
And this brings me back to the original question; Does acupuncture hurt? An honest answer might be that ‘Yes sometimes it does hurt a bit and some treatments hurt more than others.’ A better question might be ‘Can acupuncture really make a difference to the problem I have?’ The answer to that is almost certainly yes.
Bruce Bell is a 5 Element acupuncturist working from clinics in Midsomer Norton and Keynsham