My preferred diagnostic and treatment style is predominantly in the Japanese acupuncture tradition. Based on my patient’s story and physical examination, I will insert the most slender needles possible, with a gentle and mindful technique. In contrast to a Classical Chinese approach, I rarely manipulate the inserted needle to obtain an immediate patient-perceived sensation of what is called the Qi response. Rather, I set the needle into the point, and then allow time for the needle to interact with point (and the nervous system) in a gentle manner. Meditation is sometimes suggested to augment this phenomenon. Some needles are felt during insertion, some not.
In my approach to treatment, I have found that anything beyond a mild sensation associated with needle insertion and/or retention is distracting for patients, and therefore not therapeutic. This is not to state that there will be no sensation, but the overall treatment should be comfortable, indeed relaxing, even though a person may experience a sensation of movement or change during the session. However, people differ in what they perceive at any one point, and during any one treatment. Perceived sensations may range from little or no sensation, to feeling changes both locally and distal to the treatment point. Paradoxically, sometimes the points where the needle almost effortlessly slides in can be the more sensitive for the patient. That sensation should soon pass within less than a minute, but if that is not the case, I remove that needle and find alternatives to achieve our goals.
Importantly, for some people, any needle insertion through the skin is too strong a stimulus, resulting in immediate local pain and a flare in their presenting symptoms. A trial treating a minimal number of points with non-insertion techniques (e.g. using laser light, magnets, Tei-shin needle) can be tried. On rare occasions, even non-insertion techniques are too strong and ultimately not helpful. In these situations, it is best to try non-acupuncture therapies, with referral to other healing arts practitioners.