Guest guest Posted February 25, 2008 Report Share Posted February 25, 2008 Hi, I'm having a strange experience with two of my patients in the sense that I feel their skin is actually resistant to the insertion of the needles. I'm wondering if anyone can give me some suggestions on how to make acupuncture less painful for them. By way of background, I should say that their patterns, signs and symptoms, as well as their body types and ages, are totally different from each other. I have an extremely gentle touch and am usually successful in working with people who have found acupuncture with others to be too painful for them. The gauge needle I use is either a 38 or a 40. And I'm pretty skilled at helping people relax and feel safe on the table. I've tried massaging the skin before insertion, distracting them, using a harder touch with insertion, teaching them breath work techniques, etc. etc. I keep thinking there's something obvious I'm missing, but the answer continues to escape me. Any explanation and/or suggestions would be much appreciated!! Thanks, Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2008 Report Share Posted February 25, 2008 Liz I found that often, a thinner needle is more difficult to insert. Try a 34 or 36 gauge (Seiren preferably) The needle will hold its' integrity and insert with ease. Good Luck Joni Tirro,A.P561-371-4863Jupiter/Wellington ACU-SAGE for EquestriansUnity with horse and riderI'll see you at the Olympics in Beijing!! : lizzzrd: Mon, 25 Feb 2008 01:21:20 +0000skin resistance Hi, I'm having a strange experience with two of my patients in the sense that I feel their skin is actually resistant to the insertion of the needles. I'm wondering if anyone can give me some suggestions on how to make acupuncture less painful for them.By way of background, I should say that their patterns, signs and symptoms, as well as their body types and ages, are totally different from each other. I have an extremely gentle touch and am usually successful in working with people who have found acupuncture with others to be too painful for them. The gauge needle I use is either a 38 or a 40. And I'm pretty skilled at helping people relax and feel safe on the table. I've tried massaging the skin before insertion, distracting them, using a harder touch with insertion, teaching them breath work techniques, etc. etc. I keep thinking there's something obvious I'm missing, but the answer continues to escape me. Any explanation and/or suggestions would be much appreciated!!Thanks, Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 Liz, Ditto to Joni's response. I usually use 36 gauge needles, actually on the smaller side relative to lots of practitioners I've encountered. Once someone asked Dr Richard Tan what gauge needle he uses. More than one person was quite surprised when he stated that he uses 36 gauge needles. I tried 38's for a while. Harder to insert, it also took longer to get deqi then it arrived more abruptly. That experiment did not last long. I do use 38's for auricular. Ear points are so small, and I find them easier to insert than 36's and larger. Btw, drug tx centers use 36's. I don't like Seirins, no to plastic handles for moi. Of course, they used to make needles with coiled handles, though they were harder to find, do not know if they still have those. I had an acupuncturist who used those. I used Carbo's for years, have switched to Helio's AcuGlides and AcuMaster. They insert so easily. No, I don't own stock Lynn --- Joan Tirro <acudoctir wrote: > Liz > I found that often, a thinner needle is more difficult to insert. Try a 34 or 36 gauge (Seiren preferably) The needle will hold its' integrity and insert with ease. > Good Luck > > Joni Tirro,A.P561-371-4863Jupiter/Wellington > > To: > Chinese Medicine: > lizzzrd: Mon, 25 Feb 2008 01:21:20 > +0000skin resistance > > Hi, I'm having a strange experience with two of my > patients in the sense that I feel their skin is actually resistant to the insertion of the needles. I'm wondering if anyone can give me some suggestions on how to make acupuncture less painful for them... I have an extremely gentle touch and am usually successful in working with people who have found acupuncture with others to be too painful for them. The gauge needle I use is either a 38 or a 40. And I'm pretty skilled at helping people relax and feel safe on the table... Thanks, Liz ~ Doing Better Than I Deserve ~ Pain is Normal - Be Weird! Lynn Detamore, MS, L.Ac., Dipl.Ac. Licensed and Board Certified Acupuncturist PO Box 14, Sheridan, OR 97378 503.474.8876 lynndetamore ______________________________\ ____ Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 I have noticed that some patients seem to have thicker skin than others, and this can make needle insertion a little more challenging. I notice this often with patients who have high levels of anxiety, as if the skin itself is tightened, to ward off some expected assault. Joan Tirro <acudoctir wrote: Liz I found that often, a thinner needle is more difficult to insert. Try a 34 or 36 gauge (Seiren preferably) The needle will hold its' integrity and insert with ease. Good Luck Joni Tirro,A.P561-371-4863Jupiter/Wellington ACU-SAGE for EquestriansUnity with horse and riderI'll see you at the Olympics in Beijing!! : lizzzrd: Mon, 25 Feb 2008 01:21:20 +0000skin resistance Hi, I'm having a strange experience with two of my patients in the sense that I feel their skin is actually resistant to the insertion of the needles. I'm wondering if anyone can give me some suggestions on how to make acupuncture less painful for them.By way of background, I should say that their patterns, signs and symptoms, as well as their body types and ages, are totally different from each other. I have an extremely gentle touch and am usually successful in working with people who have found acupuncture with others to be too painful for them. The gauge needle I use is either a 38 or a 40. And I'm pretty skilled at helping people relax and feel safe on the table. I've tried massaging the skin before insertion, distracting them, using a harder touch with insertion, teaching them breath work techniques, etc. etc. I keep thinking there's something obvious I'm missing, but the answer continues to escape me. Any explanation and/or suggestions would be much appreciated!!Thanks, Liz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 > Couple of comments, I too like Helio's needles. To my knowledge, they are the only needle that doesn't use silicone coating. Silicone coated needles can produce skin granulomas. Acuglide and Acumaster needles are pricey however. They undergo a process that creates an easier insertion that doesn't involve coating with silicone. Also, I have found some patients, especially rugged, outdoor labor inclined men, where the needle of any gauge is more difficult to penetrate the skin. This type of patient does not experience pain from a more forceful insertion. However, I notice after 2 - 3 treatments, insertion becomes much easier. Is it because I am more comfortable or their bodies are more receptive? Who knows - probably a combination of both. I also agree with the comment that those patients more sensitive to the needling are apt to respond to treatment quickly. Janis ______________________________\ ____ Looking for last minute shopping deals? Find them fast with Search. http://tools.search./newsearch/category.php?category=shopping Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 Helio's acuglide and acumaster needles are coated with a carbon polymer. I noticed that the needles have a blue-black sheen and called to get information about why this is so, and after being transferred to numerous people at Helio, learned about the polymer. I don't believe any research has been done on the safety of this substance, as has been done with silicone, but the folks at Helio told me that since it is carbon-based (as are we), it is " biocompatible " . I have tried Helio's needles, and find they feel " sticky " upon insertion and removal, as if the coating creates some resistance or drag that is palpable. To me, this coating is experimental, and I will not use these needles. Janis Egan <janis3934 wrote: > Couple of comments, I too like Helio's needles. To my knowledge, they are the only needle that doesn't use silicone coating. Silicone coated needles can produce skin granulomas. Acuglide and Acumaster needles are pricey however. They undergo a process that creates an easier insertion that doesn't involve coating with silicone. Also, I have found some patients, especially rugged, outdoor labor inclined men, where the needle of any gauge is more difficult to penetrate the skin. This type of patient does not experience pain from a more forceful insertion. However, I notice after 2 - 3 treatments, insertion becomes much easier. Is it because I am more comfortable or their bodies are more receptive? Who knows - probably a combination of both. I also agree with the comment that those patients more sensitive to the needling are apt to respond to treatment quickly. Janis ______________________________\ ____ Looking for last minute shopping deals? Find them fast with Search. http://tools.search./newsearch/category.php?category=shopping Subscribe to the free online journal for TCM at Times http://www.chinesemedicinetimes.com Help build the world's largest online encyclopedia for Chinese medicine and acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia and adjust accordingly. Please consider the environment and only print this message if absolutely necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 Drat. Thanks for uncovering this info, Andrea Beth. What kind of needles do you use, and what sorts have worked poorly in your experience? Lynn --- < wrote: > Helio's acuglide and acumaster needles are coated > with a carbon polymer. I noticed that the needles > have a blue-black sheen and called to get > information about why this is so, and after being > transferred to numerous people at Helio, learned > about the polymer. I don't believe any research has > been done on the safety of this substance, as has > been done with silicone, but the folks at Helio told > me that since it is carbon-based (as are we), it is > " biocompatible " . I have tried Helio's needles, and > find they feel " sticky " upon insertion and removal, > as if the coating creates some resistance or drag > that is palpable. To me, this coating is > experimental, and I will not use these needles. > > ~ Doing Better Than I Deserve ~ Pain is Normal - Be Weird! Lynn Detamore, MS, L.Ac., Dipl.Ac. Licensed and Board Certified Acupuncturist PO Box 14, Sheridan, OR 97378 503.474.8876 lynndetamore ______________________________\ ____ Never miss a thing. Make your home page. http://www./r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 Janis, There are other needles that are not silicone coated, but I have found Helio's to be easiest for insertion and manipulation. Yes, the Acu- needles are pricey. I do not recall that they are pricier than Sierin's, though. I decided to ignore that factor with needles. Interesting, your experience with patients with tougher skin. I bet part of it is truly that the nervous system comes to know and be more receptive to the needles. Lynn --- Janis Egan <janis3934 wrote: > > Couple of comments, > > I too like Helio's needles. To my knowledge, they > are the only needle that doesn't use silicone coating. Silicone coated needles can produce skin granulomas. > > Acuglide and Acumaster needles are pricey however. > They undergo a process that creates an easier insertion that doesn't involve coating with silicone. > > Also, I have found some patients, especially rugged, > outdoor labor inclined men, where the needle of any > gauge is more difficult to penetrate the skin. This > type of patient does not experience pain from a more > forceful insertion. However, I notice after 2 - 3 > treatments, insertion becomes much easier. Is it > because I am more comfortable or their bodies are > more receptive? Who knows - probably a combination of both. > > I also agree with the comment that those patients > more sensitive to the needling are apt to respond to > treatment quickly. > > Janis ~ Doing Better Than I Deserve ~ Pain is Normal - Be Weird! Lynn Detamore, MS, L.Ac., Dipl.Ac. Licensed and Board Certified Acupuncturist PO Box 14, Sheridan, OR 97378 503.474.8876 lynndetamore ______________________________\ ____ Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 I have definitely noticed this also with highly anxious individuals. More than once I have abandoned my treatment plan for one day and treated the 4 Gates. One early patient came back and said, " Was that supposed to make me more relaxed? " Ah, yes. Lynn --- < wrote: > I have noticed that some patients seem to have > thicker skin than others, and this can make needle > insertion a little more challenging. I notice > this often with patients who have high levels of > anxiety, as if the skin itself is tightened, to ward > off some expected assault. > > ~ Doing Better Than I Deserve ~ Pain is Normal - Be Weird! Lynn Detamore, MS, L.Ac., Dipl.Ac. Licensed and Board Certified Acupuncturist PO Box 14, Sheridan, OR 97378 503.474.8876 lynndetamore ______________________________\ ____ Never miss a thing. Make your home page. http://www./r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 Lynn, I agree that needle price would not necessarily change my preferred needle choice. I think the Acu needles are competitively priced when compared to Seirin, and for me, the parylene coating process of Acu needles makes for a consistent performance. A few years ago I was involved with troubleshooting increased pain in my company's blood collection needles (stainless steel coated with silicon). I was surprised to learn how variables in grade of steel and eveness of coating could make a huge difference in the patient experience. Regards, Janis ______________________________\ ____ Looking for last minute shopping deals? Find them fast with Search. http://tools.search./newsearch/category.php?category=shopping Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2008 Report Share Posted February 26, 2008 The best needles I ever had were from Ito Nippon Sha, which was bought out and discontinued by Seirin several years back. They used to make samurai swords, and their needles were superb. I then went to Seirin lasers, which I still use, but found a new needle, Unico, distributed by Kenshin Inc. out of Los Angeles. They are of equal quality to the Ido needles, and don't have silicon coating. My patients notice the difference immediately. On Feb 26, 2008, at 7:32 AM, wrote: > Helio's acuglide and acumaster needles are coated with a carbon > polymer. I noticed that the needles have a blue-black sheen and > called to get information about why this is so, and after being > transferred to numerous people at Helio, learned about the polymer. > I don't believe any research has been done on the safety of this > substance, as has been done with silicone, but the folks at Helio > told me that since it is carbon-based (as are we), it is > " biocompatible " . I have tried Helio's needles, and find they feel > " sticky " upon insertion and removal, as if the coating creates some > resistance or drag that is palpable. To me, this coating is > experimental, and I will not use these needles. > > > > Janis Egan <janis3934 wrote: > Couple of comments, > > I too like Helio's needles. To my knowledge, they are > the only needle that doesn't use silicone coating. > Silicone coated needles can produce skin granulomas. > Acuglide and Acumaster needles are pricey however. > They undergo a process that creates an easier > insertion that doesn't involve coating with silicone. > > Also, I have found some patients, especially rugged, > outdoor labor inclined men, where the needle of any > gauge is more difficult to penetrate the skin. This > type of patient does not experience pain from a more > forceful insertion. However, I notice after 2 - 3 > treatments, insertion becomes much easier. Is it > because I am more comfortable or their bodies are more > receptive? Who knows - probably a combination of > both. > > I also agree with the comment that those patients more > sensitive to the needling are apt to respond to > treatment quickly. > > Janis > > ________ > Looking for last minute shopping deals? > Find them fast with Search. http://tools.search./newsearch/category.php?category=shopping > > Subscribe to the free online journal for TCM at > Timeshttp://www.chinesemedicinetimes.com > > Help build the world's largest online encyclopedia for Chinese > medicine and acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia > > > and adjust accordingly. > > Messages are the property of the author. Any duplication outside the > group requires prior permission from the author. > > Please consider the environment and only print this message if > absolutely necessary. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2008 Report Share Posted February 28, 2008 Hey Liz: I have a couple of thoughts on skin resistance I have experienced. Maybe something will apply to your cases. Gentleness - Sometimes there is fear of inflicting pain which slows the reflex of incertion. I like to practice on myself now and again on tough spots like the face and hands. Improves my technique greatly. Acupoint Location - Sometimes they are not exactly where tradition says they are. At any point, 1mm laterally and we can find " tough " or low conductive tissue. This is seen with electrodiagnosis all the time. A point locater might be of some help to you and the patients if they are wondering " why all the pain? " . Heat vs Cold. When there is much heat, pain and resistance will be encountered with incertion. This is normal to some degree. Remove the heat. Tough skin is seen in cold conditions as well. I use SI 3 (Houxi) to excite things and add warmth (Houxi relaxes muscles, opens DU and clears Shen)prior to additional needle incertion. Sometimes there is resistance in acute, heated or cold tissues, but more often I find that I just missed the point. And if I move over a smidge, voila there it is! Palpation - All acupoints are palpable with a gentle touch. I feel them as a cone with apex in towards the body (feels as if to follow or accept the pads of my fingers). Leique (LU 7) is great in that regard. It's also a great point to clear and disperse wind and regulate the REN channel which is helfpul for folks who " resist " ! I assume of course, that traditional locating methods have first been applied. Palpation " fine tunes " the location. Practice - professionals need it. While self-treatment is not always a good idea, we can perform a little " emergency " therapy on ourselves, both for health and practice! Follow the course of any meridian you choose and palpate for tender spots (about the size of a grain of sand felt beneath the skin, small areas of " congestion " , and/or " depressions " which follow the pads of the fingers. Feel for the " cone " . Incert the needle. It should go in " like butter " ! I like to use The Yangming and Taiyin channels of the upper extremity for practice as they are readily available, they help my pathologies, and I feel like they connect me with the ancients! That's LI and LU, but use any you like or need. Re-think your point selection. " Right " points gracefully accept the needle. Don't over think this one though. Sometines stubborn is just stubborn. For these I use the barrel. Or maybe use some other modality first, such as guasha, Teshin, electrostim, laser or massage. Since folks feel they are paying for the needle, I incert as many as tolerated in areas of least resistance and use modalities on the rest for the first few visits. Opposite hand techniques - I like to use " spread the wheat " , namely to use the non-needling hand to stretch the skin over the point. Others which work well: I also use " follow the nail " and incert after pre-pricking the point with my palpating finger nail. On the face, hands and feet, as well as any thin skinned area, I pinch the skin at the point (sometimes marking it first with the nail bit above). When first starting out I used a dry erase pen to " dot the spot " which was great with obese or loose skinned individuals. Something I found out using Moxa is that a paper thin piece of garlic over the spot is analgesic! Try needling through some. Purists may choke on this, but there are many analgesic creams which might be applied first to resistant areas. Get people well first and worry about the fineries of technique later, I say. The Chinese love to " raise Qi " with deft needle incertion, to the point of raising the patient off the table! My teachers used to laugh and say in broken English: " That good, he, he, he! " . I never thought it was. " First do no harm " is more my speed. I find the raising of Qi happens with gentle, precise incertions and the effects are just as fantastic. People seem to come back too! Anyway, keep on helping people. All this is just my opinion. Use it if you wish, Bill Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 29, 2008 Report Share Posted February 29, 2008 Difficulty inserting needles is not due to skin resistance, muscle tension or needle type. It is due to Qi resistance just like practitioners of hard Qigong can resist sharp spears thrust into various parts of their bodies. The hardest point to penetrate in some patients is Yintang. It marks the upper Dantian, storing a lot of energy, and also there is some fear of the needle going to the eyes and more mind awareness of this point. A premise of Qigong is the mind leads the Qi. It is harder to penetrate points on the hands and arms then the back. The mind is more aware of regions of the arms than back. What seems to help is to stop trying to needle a resistant point, needle other points and come back to the resistant point later. **************Ideas to please picky eaters. Watch video on AOL Living. (http://living.aol.com/video/how-to-please-your-picky-eater/rachel-campos-duffy/ 2050827?NCID=aolcmp00300000002598) Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.