Point selection is most important in determining the number of points to be treated. And that depends upon the diagnostic impression, physical examination and patient response. The number of points selected for treatment will therefore vary. Typical in my practice would be treating from one to 16 points over the course of a several-step, 45-50 minute treatment that often includes an opportunity for quiet rest or meditation, and as a final step, perhaps a form of massage (Tui-na). My preference is to use the fewest possible points (10 or less), but sometimes there are special indications that require more.
It is not necessary to insert needles through the skin in order to effect a therapeutic change. Other techniques to work with an acupuncture point and channel include massaging the point or body area, placing a specialized Tei-shin needle on the skin but not through it, warming the point or area with moxibustion, applying magnets, electricity, and/or using a medical grade laser light to painlessly but effectively stimulate a point. All these modalities are available in my practice.