needling depth

[Guest guest]

Hi everyone,

I think one of Cat's recent messages can be used as a good starting point to

talk about needling depth. This message is not in direct response to hers, but

is prompted by it.

 

Many of my teachers have said that the needling techniques in China are very

different from what is commonly taught here in the US. People in China, in

general, grow up with more knowledge about acupuncture than people in the US.

The first question most Americans new to acupuncture ask is " Will it hurt? " Many

of us have developed a fear of needles from being subjected at young ages to the

huge needles used in vaccination. Many of us also go to great lengths to avoid

pain or sensations we interpret as negative, even if that might help us in the

end.

I just asked my teacher about this the other day. He is well known in my school

for his very deep and very intense needling technique. I asked if in China

people coming to get acupuncture also ask " Will it hurt? " He said, in his

experience, they don't ask, and they expect to feel strong sensation.

Several teachers have mentioned that in China, people expect or want to feel the

sensation of the nerve being touched. This often requires deeper needling than

what current American acupuncture textbooks recommend. Some needling techniques

for certain disorders require hitting the nerve for optimal effect.

The first thing my classmates asked was, " won't this damage the nerve? " But the

answer is no. You just touch the nerve, you don't try to go through it, and you

don't apply heavy stimulation to it. Acupuncture has been practiced this way

safely in China for much longer than acupuncture has been practiced here.

In China, if someone is not feeling a strong " deqi " (arrival of qi) sensation,

then they think their doctor is not doing a good job of needling! Here we are

also trained to aim for the " arrival of qi. "

For those Americans who are afraid of needles or are very sensitive to needles

or who feel qi very quickly, and thus do not need or want deep needling, it may

be to their benefit to find an acupuncturist who was raised and schooled here in

the US. There is a better chance that your acupuncturist will understand and

respect your concerns about deep needling. And there is a smaller chance of

having what you say be misunderstood or misinterpreted. I personally like going

to acupuncturists trained in China, but several people on this list have

reported communication difficulties and misunderstandings getting in the way of

their treatment.

For me, personally, I have experienced many different styles and techniques of

acupuncture over the past several years, and the person that I keep coming back

to, the person that has helped me the most, is the Chinese teacher I mentioned

who has a reputation for being the deepest needler and most intense needle

manipulator at my school.

I have lived with Fibromyalgia for the past 9 years and the pain is at a very

deep level. I cannot even massage deep enough to reach it. So for me, to have

a needle that goes to this deep level is not just beneficial, it is essential.

Now that I have experienced the needling by this teacher, which I have gotten

the most benefit from, I tell every other practitioner I see (I see " my guy " 2

times a week, but usually need an additional appointment in between) that I want

a strong, deep treatment, and that I am not afraid of a lot of needles. (I

think my guy used 48 on me yesterday when I had a severe flare-up of the FMS) I

tend to be shy, and it is hard for me to tell someone " This is what I want, "

especially if they have different ideas about how to needle. But I have gotten

several treatments recently by other people that were just not effective. So I

have finally gotten up the courage to politely request more needles or more

stimulation or greater depth, becasue this is my

health and my money that are on the line here.

The same should go for people who want less stimulation or less needles. If you

are uncomfortable, you have the right to clearly express this to your

practitioner. He or she then should do one of the following: either listen to

your wishes or explain to you why s/he is not going to listen (for example, that

s/he needs a deeper technique or more needles for your specific condition).

S/he should not just ignore you.

For example, yesterday, when I was hooked up the the electric stimulation on the

needles, it was on a pretty high level, but not as high as usual, becasue my

cramping was so severe, that I just didn't want more cramping. When my teacher

came in to check on me, he said it would be better to have a higher level

stimulation, but when he turned it up, my leg cramp got tighter. I said that is

was hurting me, so he paused and asked about it. " Is it the same pain or

different pain. " I said it was a little different and asked if it was ok to

have my leg tighten and cramp more. He explained that it was okay and that there

is one famous doctor who developed a theory " Use pain to treat pain " and that

for me right then, that would be a good method to use. So, since that made

sense to me and since I trust him, I let him do a much higher stimulation, and

it helped me.

This is an example of a doctor who explained why he wanted to do a treatment

that felt uncomfortable to me. It is not a doctor's job to make you

comfortable, it is their job to try to heal you. But a doctor/practitioner will

not be able to heal you if they scare you away from treatment. A doctor will

not be able to heal you as well if s/he does not earn your trust and answer your

questions.

It sounds like Cat's practitioner was not doing a good job to earn her trust

and to take her feelings into account. One idea for the first session (or the

first phone call) with the next practitioner might be to say/ask even more

explicitly, " I do *not want* deep needling. Can you treat me effectively

without needling deeply? " If the person says they can do it, then you can tell

them that you plan to hold them to it. If they say that they think the most

effective treatment involves deep needling, then you will save some time.

BTW, people should know that some bruising is normal and acceptable in

acupuncture. I had one practitioner before who stated that explicitly in her

patient information packet that she gives out during the first session, so that

all her patients would be aware of it. It is normal to occasionally leave a

treatment with a bruise from needling or marks from hot cupping or gua sha if

those treatments are applied. If the amount of bruising is a concern, talk to

your practitioner who might have some recommendations, or who might be able to

apply another technique to reduce the chance of bruising.

Well, that was a long message, but hopefully interesting to some of you. I have

been thinking a lot lately about needling depth, because a few different

teachers here have some very different techniques, and because I am finally

starting to get some good results from one technique that I know a lot of people

do not like. In the end, I am starting to think that the best practitioner is

one who is skilled in several techniques and knows which one to use on which

patient, and how to introduce the technique to the patient so that they can feel

comfortable with it.

 

To good health,

ZY

 

 

 

 

 

" Cat ^. .^ ~ " <iceisit wrote:Worse news yet . . . the new

acupuncturist not only insists on putting the needles in to the point of me not

being able to move on the table and worrying about putting them in too deep, he

left a huge bruise on my neck and my back is messed up in places from the

acupressure which it never hurt before. Just to aggressvie, and I told him the

first day that I left the last Chinese person because she was way too rough.

What is it with these people any way that when someone explains that

" My body is very receptive to acupuncture, you don't need to cause pain to get

great results with me. " They do NOT listen. Infurating.

 

So here I am yet again in search of another acupuncturist.

 

Thanks for your note - Cheers, Cat

 

 

 

 

 

 

 

[Guest guest]

<zhongyi4all-list wrote:

>Hi everyone,

>I think one of Cat's recent messages can be used as a good starting point to

talk about needling depth. This message is not in direct response to hers, but

is prompted by it.

 

I cannot help but have a defensive reaction to your post, even though you said

nothing inappropriate. I am almost 55 years old and have acupuncture on and

off since 1971!

 

I have had Chinese people trained in China and I have had American trained in

America. In my opinion the practitioners that I have had who were trained here

were almost totally ineffective. Two gave me bad infections from dirty needles.

I have also had Japanese technique which didn't do much for me.

 

Some people's bodies are very receptive to acupuncture and I don't need to feel

pain to get an effective healing session.

 

I have had some Chinese people tell me the less needles the better and they

thought less needles meant a more skilled the technician. My experience does

NOT agree with that. Another place I go to someone else (Chinese woman who

came from a family of doctors in China) and she comes in and put about 80

needles in me within 10 minutes and after an hour I feel fantastic. The

people who have hurt me the worst were of the theory that fewer is better.

Another practitioner who used few needles and never hurt me but wanted $150 a

session so I couldn't continue that for long term. No problem there except the

price.

 

I had had a huge variety of acuPRESSURE techniques. The huge bruise which can

be seen from across the room and will show up quit nicely on the photographs a

friend took was from PRESSURE, not needles. No one should leave huge bruises

from acupressure. Everyone who has seen it has gasped and said " I hope you are

not going back to this person. " I said " Of course not. "

 

I have had the little pools of blood from needs that come from acidentally

hitting a blood vessel or vein, This is NOT what I was referring to. I

coudln't even notice those until I saw them in a mirror. I was talking about

pressing his fingers in way too hard and too long. I have to put ice on my

back and neck for three days as I was in constant pain. Surely this is not to

which you are referring. I have bulged disks in my neck and have had back

surgery and that was WAY TOO ROUGH. It was not proper technique. And

unnecessary.

 

How do I know? I have had many GREAT acupuncture and acupressure sessions which

were very effective and not intensely painful. These practitioners are in

other states and too far to drive. I have NEVER in my life been afraid of

needles and I am still not. What I am afraid of is insensitive practitioners

who DO NOT LISTEN when I say that something hurts. Each and every time I went

in the last 4 times we had to go through how deep to put htem and he kept saying

" Oh this is just a learning process for me until I find out what you want. " He

knew what I wanted the first time and kept doing what he wanted to do each

following session.

 

A slight sensation is very different from making muscles jump and bounce with

pain. I have had that with the last two. I never in my life experienced

anything so lacking in skill and clumsiness.

 

Anyone who has FM or CFS should not be experience more STRESS due to rough

treatment. That is just my opinion. The previous practitioner left HUGE

BURNS on my back by putting heat lamps too close for too long after putting cups

on my back. She had *nothing* to treat the burns with. That was a poor

judgment call and I did not stop seeing her then, but perhaps should have.

 

I always ask for a practitioner who is Chinese trained in China. I have had

many who have been Chinese trained in China who have been excellent and I have

gone for months with extremely good results. Not all Chinese practitioners

trained in China makes their clients writhe in pain. I am not talking about

minor discomfort here, I am talking searing pain.

 

I am a professional athlete and have been able to tolerate way more pain than I

should. One time I went to a massage therapist who handled my neck too rough

and I ended up not being able to turn my neck for a week. The no pain no gain

theory just does not apply to acupuncture/acupressure for me because I have had

very skillful practitioners do a wonderful job without all the extreme pain.

 

So, for any students or practitioners reading this, be sure to listen to your

clients. They know their own body better than anyone. If someone wants the

needles twirled, more power to them, but that doesn't make it better treatment

if the next person who comes in goes home worse than when that person came in.

Listen to the client.

 

 

^. .^ ~

 

 

 

 

 

" Enjoy the edge you're on . . . don't think about the one to come! "

http://www.webspawner.com/users/fayskelley/index.html

[Guest guest]

Even in " TCM " , there is variation on this point. You can take the classical

principles and apply them differently, or emphasize certain points and less

others. For example, Master Tong style acupuncture, where you use very few

needles, but standard TCM size and depth. It utilizes all of the information

about point qualities, names, 5 element category, channel, etc. But you do

no local needling whatsoever, usually.

 

And the leading Master Tong expert, Dr. Young, is quite popular in Shanghai.

 

Benjamin Hawes, MAOM, Lic. Ac.,

 

CORTEZ FAMILY ACUPUNCTURE

1430 E. Main Street, Suite #4

Cortez, CO 81321

(970) 565-0230

 

 

 

>

> Message: 8

> Sun, 31 Oct 2004 10:18:21 -0000

> " skip8080 " <skip8080

> Needling Depth -Technique

>

>

>

> I'd like to get to the bottom of this issue.Lets have a survey. How

> deep do you needle,what size needles and WHY?

> I was trained straight Shanghai TCM, and I believed that the " proper

> depth " (CAM, Deadman, etc..) was the way. Sure enough in Chinese

> hospitals thats what they do, I assume because it Works. My fellow

> student in school for the most part used thin seirins because you

> want to keep your clients coming back and graduate.no pain.i always

> thought this was a poor idea since we were taught very well by

> chinese docs.I learned to use the 30 gauge 2 inch needle and do it

> painlessly.

> i basically scoffed at the 5 element school nearby where the needles

> would fall over... there was a study showing that manipulating the

> needle, entangling the myofascia, (de qi) was more effective.

> so i have assumed that shallow needling would be okay for the wei qi

> level but innapropriate for anything else.Of course i saw japanese

> technique , and even toyo hari, but with so much " I want to believe "

> going on in the new age, and so much " making stuff up " going on, i

> remain skeptical of this. Some practitioners including myself ,

> gradually needle less and less, because of economics. Its less

> painful, but is it equally effective? Once you start prescribing

> herbs, well theres a sure fire therapeutic effect, so why torture

> the client with chinese acupuncture?

> Sometimes i feel that intention alone is sufficient to heal, but

> that confuses this issue even more.

> for example my girlfreind had hiccups, and i said " they may stop

> without any insertion " I dropped the needle onto neiguan, and they

> stopped! I started thinking about all this...so,

> So, whats the deal? Why the classical chinese depth, and what is the

> clinical reality of shallow needling alone???

>

>

[Guest guest]

Chinese Medicine , " Benjamin Hawes "

<ben_laura@n...> wrote:

>

> Even in " TCM " , there is variation on this point. You can take the classical

> principles and apply them differently, or emphasize certain points and less

> others. For example, Master Tong style acupuncture, where you use very few

> needles, but standard TCM size and depth.

<snip>

> > Sun, 31 Oct 2004 10:18:21 -0000

> > " skip8080 " <skip8080>

> > Needling Depth -Technique

> >

<snip>

> > So, whats the deal? Why the classical chinese depth, and what is the

> > clinical reality of shallow needling alone???

 

one more quick point:

 

" Classical " depth and " TCM " depth are two different things. See for example the

passage

in Ling Shu on channel depth in which the deepest needling is done on Yangming @

6 FEN

(0.6 cun), and all the yin channels are about half that depth. For a good

though brief

discussion of this see Birch & Felt, " Understanding Acupuncture " .

 

I could say much more but i'll restrain myself.

 

rh