Needles are generally made of stainless steel, but are sometimes gold or silver to achieve energizing or sedating effects. Twenty-eight- to 32-gauge solid needles are used. The length of the needle and depth of penetration depends on the thickness of the underlying soft tissue. Many acupuncture points overlie muscle and the depth of needle insertion is usually to the center of the muscle belly. Needles may be inserted perpendicularly, obliquely, or tangentially. The acupuncturist usually tries to elicit a special needling sensation called deqi, which refers to a deep, heavy, warm, spreading or aching sensation that is felt to be crucial to achieve a therapeutic effect.
Stimulation of the acupuncture points is a necessary part of treatment. Needles may be stimulated in a variety of ways: manually by thrusting up and down or twisting back and forth or by tapping or scraping the handle of the needle. Electrical current can be applied to pairs of needles at frequencies of 3-5 Hz or higher frequencies in the 100- or 1000-Hz range. The amplitude of stimulation is adjusted to patient tolerance (Figure 23.2). Needles and
acupuncture points may also be heated in various ways including the use of moxa, a plant that is burned near the acupuncture point or on the needle.
The duration of an acupuncture session is approximately 20-45 minutes. The frequency of sessions is variable depending on the clinical problem, its chronicity, and availability of resources. Typically, treatments are carried out once to three times per week. Sometimes treatments are offered daily or as infrequently as once or twice a month. A course of treatment consists of 10-20 sessions, but for intractable chronic conditions periodic maintenance therapy may be offered. Ultimately, the intervals between treatments and the duration of a course of acupuncture remain empiric.34
Points are chosen for acupuncture either through traditional Chinese diagnostic analysis or by a formula approach, which utilizes a limited number of basic rules for point selection.
• For localized symptoms, needle points in that same region on any meridian. For example, for shoulder pain, needle points on or near the shoulder.
• Tender points are considered acupuncture points and can often be chosen for therapy.
• Points on a meridian will influence symptoms or disorders along the entire meridian.
• Six important distal points on the upper and lower limbs have effects on specific regions of the head, neck, and trunk. For example, the point Hoku (large intestine - 4) in the first dorsal interosseous muscle between the thumb and first finger, affects the head and neck.
• There are subsets of points that have certain general effects such as sedation, tonification (energizing), and immune system regulation, or that influence certain tissues, such as muscle and tendons, bone and cartilage, etc.
• There is a somatotopic organization on the surface of the ear, so that points on the ear can be chosen to influence any other part of the body.
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Have You Always Been Curious About Acupuncture, But Were Never Quite Sure Where To Stick The Needles? If you associate acupuncture with needles, pain and weird alternative medicine then you are horribly misinformed about the benefits of the world's oldest form of medicinal treatment.