Ac needles are not Scary

The Fear of Needles – Why a Fear of Needles Shouldn’t Discourage you from Trying Acupuncture

By Emma Suttie, D.Ac.

It is a terrible thing to admit, but I, an acupuncturist, hate needles.

Whenever I have to go to the doctor to have blood taken, I surprise even myself with the creative ways I manage to not make it down to the nurse to have my blood drawn. My doctor knows this about me, and I am always getting the sass.

The truth is, having blood taken hurts (it hurts me anyways). The needles they use are hollow point, and it usually takes them a few tries before they can get a vein. I am always left with bruises, and this is why I don’t like needles.

Acupuncture needles however, are not like the hollow point needles used to take blood or give injections. They are very fine – 4 times thicker than a human hair in fact (the thickness varies, but they are pretty small), and in most cases, the patient can barely feel them. They are also disposable, and one use only.

I have often had patients over the years who reluctantly came to see me, not committing to a treatment, but wanting to talk about their fear of needles. I always say “no problem, have a seat.” I explain that the needles that acupuncturists use are not the type used by medical doctors, and that they are tiny in comparison. I take out one out, open it and hand it to them so they can feel it, touch it, and this helps with the fear. I then roll up my sleeve and tap the needle gently into my arm to show them how it works, and that I am not screaming in pain. I explain that I am very gentle, and if they would like to try, I can put a needle into the same spot on their arm. I tell them if they feel anything uncomfortable or painful for even an instant, then it comes out.

I have never had anyone after the demonstration, not try one needle. Once they see that acupuncture is not painful, we continue with an intake, and then a treatment. People often have to ask me when I will be putting the needles in when I already have put in several.

Here is a chart that illustrates the difference in size between different objects and an acupuncture needle.

Needle Chart

In my experience, there is a difference in the old school Chinese style of acupuncture which emphasizes strong stimulation of the needles (twirling and twisting the needles to achieve a “qi sensation”), and a gentler style that is better suited to Western patients. When in China, I got to visit a hospital that offered both Western and Chinese medicine and saw some of the acupuncture techniques used. They were a lot more hard core than most patients are used to here in the West. In China, this is what is expected, but if you are catering to Western patients, gentler and kinder is the way to go. It is relatively new here, so it should be introduced gently to those who are trying it out, and especially those who are a bit nervous about needles.

As a kid I went to a Chinese acupuncturist who was incredibly gentle. I never felt any pain from the needles, and I have always fashioned myself after her. There is an intimate trust relationship between an acupuncturist and their patient. They must trust you, and their body must trust you, which you can feel when you are putting in the needles. At first there is often resistance which decreases as time goes on. Eventually, the body accepts the treatment and trusts that you are doing it good and mean it no harm.

So, if you are curious about acupuncture but haven’t gone to have a treatment because of a fear of needles, I would say find an acupuncturist and go and speak to them. Most are aware that fear of needles is common and will do their best to explain and show you so that you can start to reap the wonderful rewards offered by acupuncture. I know I am very glad that I did.


MRI Reveals Acupuncture Modulates Brain Activity

MRI studies reveal the neurological mechanisms of acupuncture on human health. Research published in Autonomic Neuroscience demonstrates that stimulation of specific acupuncture points induces hemodynamic changes in specific brain networks. The researchers add that brain networks accessed by specific acupuncture points relate to specific medical disorders and suggest an “acupoint-brain-organ” pathway. A woman is prepped for an MRI.

Functional magnetic resonance imaging (fMRI) studies reveal specific acupuncture point effects in the brain through blood-oxygen-level dependent (BOLD) measurements. In a meta-analysis of 82 fMRI studies, researchers found a large body of evidence supporting acupuncture point specificity. This applies to both manual acupuncture and electroacupuncture. True acupuncture point stimulation induced specific cortical effects whereas sham acupuncture did not. In addition, the researchers note that acupuncture point stimulation produces significantly “more positive and negative hemodynamic signal response(s) in brain regions compared with sensory stimulation used as a control condition.”

Many important findings were confirmed. Acupuncture exerted a stimulus that “could induce beneficial cortical plasticity in carpal tunnel syndrome patients.” It was also demonstrated that acupuncture relieved pain “by regulating the equilibrium of distributed pain-related central networks.”

The researchers note that a fundamental principle of Traditional Chinese Medicine (TCM) is that “specific acupoints have therapeutic effects on target organ systems remote from the needling site….” Recent fMRI investigations support this principle. The researchers note that “fMRI investigations regarding several acupoints have demonstrated that acupuncture stimulation at disorder-implicated acupoints modulates the activity of the disorder-related brain regions.”

In TCM, acupuncture point Neiguan (PC6) is indicated for the treatment of nausea and vomiting. The fMRI research supports this ancient principle. The researchers note, “Acupuncturing at Neiguan (PC6) could selectively evoke hemodynamic response of insula and cerebellar-hypothalamus in order to exert modulatory effects on vestibular functions, indicating the specific treatment effect on nausea and vomiting.”

Acupuncture point GB37 (Guangming), located on the lower leg, is indicated for the treatment of vision related disorders within the TCM system. The name of the point, Guangming, is translated as bright light and indicates the acupoint’s use in the treatment of visual disorders. It is categorized as a Luo-connecting point and has the TCM functions of regulating the liver and clearing vision. The point is indicated for the treatment of hyperopia (farsightedness), myopia (nearsightedness), night blindness, and eye pain. The research demonstrates that GB37 increases neural responses in the occipital cortex. The researchers add that it was “discovered that modulations in vision-related cortex (BA18/19) were responsive to the specificity of GB37….” This connection between fMRI findings and TCM indications confirms the specificity of GB37 for the treatment of visual disorders.

A broad body of research suggests “that acupuncture at different acupoints may modulate relatively specific cerebral areas,” according to the researchers. Acupoints demonstrating this phenomenon in fMRI include:

  • Hegu (LI4)
  • Zusanli (ST36)
  • Taichong (LV3)
  • Taixi (KI3)
  • Qiuxu (GB40)
  • Guangming (GB37)
  • Jiaoxin (KI8)
  • Auricular Brain Stem
  • Sanyinjiao (SP6)

Many examples of acupoint cortical specificity were included in the research. The following are some highlights. The researchers note, “Acupuncture at the three classical acupoints of Hegu (LI4), ST36 and Taichong (LV3) produced extensive deactivation of the limbic-paralimbic-neocortical brain network as well as activation of its anti-correlated activation network.” Differentiation between the points was noted as the following, “LI4 was predominant in the pregenual cingulated and hippocampal formation, ST36 response was predominant in the subgenual cingulate, and LV3 in the posterior hippocampus and posterior cingulated….” Taixi (KI3) mediated the executive network, Qiuxu (GB40) activated the auditory network, and “Jiaoxin (KI8) was associated with (the) insula and hippocampus in pain modulation.” Acupuncture to a back shu point is applied.

The mechanisms of cerebral action of true acupuncture were found distinct from sham acupuncture. The researchers note, “Acupuncture at Taichong (LR3) could specifically activate or deactivate brain areas related to vision, movement, sensation, emotion, and analgesia compared with sham acupuncture.” They add, “Several studies have found that there were different brain responses between traditional acupoints and sham points….” It was found that “ST36 could induce greater activation in ventrolateral periaqueductal gray (PAG) and produced linearly time-variant fMRI activities in limbic regions, such as amygdale and hippocampus….” Needling acupuncture point Erjian (LI2) activated the insula and operculi but this did not occur with sham acupuncture. Other research examples were cited. The researchers concluded, “These results provided evidence to support that acupoints may have its own functional specificity to sham point.”

A multiplicity of fMRI studies investigated the effects of deqi. The elicitation of deqi by acupuncture needling techniques is often described by patients as electrical, dull, or heavy. Deqi is often described by licensed acupuncturists applying manual acupuncture as a pulling or tugging sensation on the needle. The fMRI research shows “ that acupuncture with deqi induced extensive deactivation in limbic-paralimbic-neocortical network (LPNN) and activation in somatosensory regions of (the) brain.” Other research suggests that the bilateral postcentral gyrus, insula, ipsilateral inferior frontal gyrus, inferior parietal lobule, claustrum, and contralateral ACC are related to deqi elicitation. In addition, the researchers note that deqi sensations are directly “correlated with activation in sensorimotor and cognitive (dorsomedial prefrontal cortex) processing, and deactivation in DMN (default-mode network regions).”

The depth of needling affects cerebral responses to acupuncture. It was found that deep needling of KI3 elicits “more extensive connectivity related to therapeutic effect(s) of acupuncture in mild cognitive impairment patients” when compared with superficial needling. Other important clinical findings were documented. Acupuncture successfully regulated DMN and motor-related networks in stroke patients. The application of acupuncture to acupoints LR3 and LI4 activated cognitive related regions in Alzheimer’s disease and mild cognitive impairment (MCI) patients. The study notes that abnormal functional connectivity in the temporal regions of the hippocampus, thalamus, and fusiform gyrus for mild cognitive impairment patients “significantly improved.”

The mechanisms by which laser acupuncture exerts antidepressant effects was revealed in fMRI. The DMN (default mode network) is at its peak activity level when the brain is a rest and deactivates when the brain is task or goal oriented. Laser acupuncture to Ququan (LR8), Qimen (LR14), and Juque (DU14) stimulated both the anterior and posterior DMN in depressed and non-depressed individuals. However, posterior DMN modulation was wider in depressed individuals receiving laser acupuncture at the parieto-temporal-limbic cortices.

Acupuncture has also been shown to regulate DMN activity in Alzheimer’s disease patients. In addition, brain activation induced by acupuncture in healthy patients is different than brain activation induced in Parkinson’s disease patients. One study was found showing that “acupuncture may regulate the cardiovascular system through a complicated brain network from the cortical level, the hypothalamus, and the brainstem to improve body pain and vitality in primary hypertension patients.”

The researchers note that fMRI assists in understanding the neural effects of acupuncture. The researchers conclude, “Acupuncture could induce hemodynamic changes in a wide cortico-subcortical network, large portions of which are overlapped with the disorder-related areas, indicating that there maybe exist a specific pathway connecting “acupoint-brain-organ” underlying acupuncture induced therapeutic effects.”
He, Tian, Wen Zhu, Si-Qi Du, Jing-Wen Yang, Fang Li, Bo-Feng Yang, Guang-Xia Shi, and Cun-Zhi Liu. “Neural mechanisms of acupuncture as revealed by fMRI studies.” Autonomic Neuroscience (2015).

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Why Acupuncture Works – Western Perspective

Acupuncture promotes blood flow. This is significant because everything the body needs to heal is in the blood, including oxygen, nutrients we absorb from food, immune substances, hormones, analgesics (painkillers) and anti-inflammatories. Restoring proper blood flow is vital to promoting and maintaining health. For example if blood flow is diminished by as little as 3% in the breast area cancer may develop. Blood flow decreases as we age and can be impacted by trauma, injuries and certain diseases. Acupuncture has been shown to increase blood flow and vasodilation in several regions of the body.

Acupuncture stimulates the body’s built-in healing mechanisms. Acupuncture creates “micro traumas” that stimulate the body’s ability to spontaneously heal injuries to the tissue through nervous, immune and endocrine system activation. As the body heals the micro traumas induced by acupuncture, it also heals any surrounding tissue damage left over from old injuries.

Acupuncture releases natural painkillers. Inserting a needle sends a signal through the nervous system to the brain, where chemicals such as endorphins, norepinephrine and enkephalin are released. Some of these substances are 10-200 times more potent than morphine!

Acupuncture reduces both the intensity and perception of chronic pain. It does this through a process called “descending control normalization”, which involves the serotonergic nervous system.

Acupuncture relaxes shortened muscles. This in turn releases pressure on joint structures and nerves, and promotes blood flow.

Acupuncture reduces stress. This is perhaps the most important systemic effect of acupuncture. Recent research suggests that acupuncture stimulates the release of oxytocin, a hormone and signaling substance that regulates the parasympathetic nervous system. You’ve probably heard of the “fight-or-flight” response that is governed by the sympathetic nervous system. The parasympathetic nervous system has been called the “rest-and-digest” or “calm-and-connect” system, and in many ways is the opposite of the sympathetic system. Recent research has implicated impaired parasympathetic function in a wide range of autoimmune diseases, including arthritis, lupus, rheumatoid arthritis and inflammatory bowel disease.