How to manipulate acupuncture needles according to traditional theory? The most known is the lifting and thrusting with the needle, but many more are described and developed throughout time. These are the main characteristics of insertion and manipulation±
Angle of insertion| Angle | Method | Points |
|---|---|---|
| Perpendicular | The needle is inserted perpendicularly, forming a 90 degree angle with the skin surface. | Most points |
| Oblique | Used for points close to important viscerae or where muscles are thinner. A angle of 45 degrees with the skin surface is formed while puncturing. | Points as Lieque (L7) Jiuwei ( Ren 15) Qimen (Liv 14) points on the back |
| Horizontal | There where muscle is thin. | Points such as Baihui (Du20) Touwei (S8) Zanzhu (B2) Yangbai ( B14) Tanzhong ( Ren 17) |
| Insertion general | Inserting the needle aided by the pressure of the finger of the pressing hand. | Inserting the needle with the help of the puncturing and pressing hands | Inserting the needle with the fingers stretching the skin. | Inserting the needle by pinching the skin. |
|---|---|---|---|---|
| The needle should be inserted coordinately with the help of both hands. The posture for insertion should be correct so that the manipulation can be smoothly done. Generally the needle should be held with the right hand known as the puncturing hand. The left hand known as the pressing hand pushes firmly against the area close to the point. | Press beside the acupuncture point with the nail of the thumb or the index finger of the left hand, hold the needle with the right hand and keep the needle tip closely against the nail, and then insert the needle into the point. . | Hold the needle tip with the thumb and the index finger of the left hand, leaving 0.2-0.3 cm. of its tip exposed and hold the needle handle with the thumb and index finger of the right hand. As the needle tip is directly over the selected point, insert the needle swiftly into the skin with the left hand, meanwhile the right hand presses the needle downward to the required depth. | Stretch the skin where the point is located with the thumb and index finger of the left hand, hold the needle with the right hand and insert it into the point rapidly to a required depth. | pinch the skin up around the point with the thumb and index finger of the left hand, insert the needle rapidly into the point with the right hand. |
| Points | This method is suitable for puncturing with short needles such as for needling Neiguan (P6), Zhaohai (K6). etc | This method is suitable for puncturing with long neeldes, such as those used in needling Huantiao (G30), Zhibian (B54) etc. | This method is suitable for the points on the sbodomen where the skin is loose, such as Tianshu (S25), Guanyuan,(Ren4) etc. | This method is suitable for puncturing the points on the head and face, where muscle and skin are thin, such as Zanzhu (B2), Dicang(S4), Yintang (extra), |
| Depth | Structures | |
|---|---|---|
| Superficial | Cutaneous, subcutaneous, superficial muscles | |
| Deep | deep muscles, bones |
| Manipulation techniques | Reinforcing/tonification | Reducing/sedation |
|---|---|---|
| Lifting and thrusting | Quick and heavy thrusting; gently and slowly lifting | thrusting gently and slowly; lifting forcefully and quick |
| Rotating and twirling | rotating gently and slowly with small amplitude. | rotating quick with large amplitude. |
| Insertion | Slow | Quick |
| Withdrawal | Quick | Slow |
| Action after withdrawal | Press the point to close the hole | Shake it to enlarge the hole |
| Direction of needle tip | Follow the running course of meridian | Against the flow of meridian |
| Respiration | Insert needle when patient breathes in. | Insert needle when patient breathes out. |
| Retention of needle | 20-25 min. arrival of Qi once | 20-25 min. Arrival of Qi three times. |