Investigating the effects of three needling parameters (manipulation, retention time, and insertion site) on needling sensation and pain profiles: a study of eight deep needling interventions

Abstract

Introduction. In traditional Chinese acupuncture, needle sensation (deqi) is purported to contribute to a therapeutic outcome. While researchers have attempted to define deqi qualitatively, few have examined the effects of needling parameters on its intensity. Methods. 24 healthy subjects completed eight interventions scheduled at least one week apart, which involved manual acupuncture to LI4 or a designated nonacupoint (NAP) on the hand, with real or simulated manipulation each three minutes and needle retentions of one or 21 minutes. Intensities of needling sensation and pain were reported every three minutes and sensation qualities were reported post-intervention. Results. Immediately after needle insertion, similar levels of mean needle sensation and of pain were reported independent of intervention. At subsequent measurement times, only two interventions (one at LI4 and one at NAP) maintained statistically significantly elevated needle sensation and pain scores and reported higher numbers of needle sensation descriptors. For both, the needle was retained for 21 minutes and manipulated every three minutes. Neither intervention differed significantly in terms of levels of pain, and needle sensation or numbers and qualities of needle sensation described. Conclusion. In this group of healthy subjects, the initial needling for all eight interventions elicited similar levels of needle sensation and pain. These levels were only maintained if there was ongoing of needle manipulation and retention of the needle. By contrast, the strength of needle sensation or pain experienced was independent of insertion site.

Figure 1

Location of LI4 and NAP in relation to the two extra acupoints luozhen and yao tong xue.

Figure 2

The mean pain intensity scores (left hand graph) and the mean sensation intensity scores (right hand graph) for the eight interventions at three-minute intervals during the 21-minute intervention period. The error bars depict ±1 standard error of the mean. The same colour key applies to both graphs.

Figure 3

Comparison of the eight interventions with respect to the number of subjects at each three-minute recording interval who had: neither pain nor needle sensation (a); both pain and needle sensation (b); only pain (c); or only needle sensation (d). In all cases, total number of subjects = 24.

Figure 4

Comparison within each of the eight interventions of the number of subjects at each three-minute recording interval who had neither pain nor needle sensation; both pain and needle sensation; only pain; or only needle sensation. Total number of subjects = 24.

Figure 5

Profiles for each intervention for the frequency (N) and intensity (I) of sensory descriptors reported from each descriptor category list. (1) flickering, pulsing, quivering, throbbing, beating, pounding; (3) pricking, boring, drilling, stabbing; (4) sharp, cutting, lacerating; (5) pinching, pressing, gnawing, cramping, crushing; (6) tugging, pulling, wrenching; (7) hot, burning, scalding, searing; (8) tingling, itchy, smarting, stinging; (9) dull, sore, hurting, aching, heavy; (17) spreading, radiating, penetrating, piercing; (18) tight, numb, squeezing, drawing, tearing; (19) cool, cold, freezing; (21) electricity; (22) warm; (23) indescribable.