This has to be the question that I get asked the most by new patients or folks considering acupuncture. As with so many things in life, the answer is…it depends! I know, sounds like a cop out but really it is not. Firstly, I have found that patients are typically surprised by how little the insertion of the needles hurts. Often patients will actually say “That’s it? You put a needle in?” The majority of patients get in to a such a deep state of relaxation, the will fall asleep. The only discomfort is when the needle is initially inserted. Most will experience a pinch and then a sensation of heaviness or drawing in around the needle as it is inserted deeper. I tell everyone who comes in that if there is continued discomfort to let me know because there simply should not be. If there is, the needles can be adjusted or relocated so that you are not in ongoing discomfort.
Acupuncture uses filiform, stainless steel, single use, sterile needles that are mostly no thicker than a human hair. They are much different than the hypodermic needles that we are used to here in the west. Those needs are much thicker and as many as 40 acupuncture needles can fit in the tip of a hypodermic needle! Hypodermic needles are also hollow to allow for blood to be drawn or medication to be administered and therefore cause much more trauma.
The amount of discomfort will also depend on what area of the body is to be needled. Some areas of the body (the fingers and toes, the lips among others) simply have many more nerve endings than others. If you think about it, areas like the fingers have to be more sensitive in order to do their job. Fine work like painting and differentiation of textures takes more feedback. You can confirm this for yourself. Take two toothpicks and hold them slightly apart. Press them in to a finger. You should be able to tell that there are two distinct sensations. Now keep the toothpicks the same distance apart and press them in to your shoulder. It will feel like one sensation because there are fewer nerve endings in this area of the body.
The other dependent factor? You! Everyone is different. Some will say “I have a high tolerance for pain” and they will therefore be less sensitive to the needles. While these people may be less sensitive to the needles, pain tolerance has nothing to do with it. Some people simply have more nerve endings and pain receptors than others. So what might feel mild to some, will feel more intense to others due to the amount of information the brain is receiving! So toughness really has nothing to do with how you experience pain. In fact, I would posit that those who are more sensitive and continue to get treatment because the are getting good results are tougher than those with less sensitivity. It is harder for them but they push through it anyway!
So there you have it, it depends! In the end, change is hard and much of what we are doing with acupuncture is instigating a change in the body so that it can heal itself. In order to instigate that change we are “communicating” with the body through the needles. Once the body has gotten in to a pattern of pain or dysfunction, that communication often has to be loud in order to really change things!