While the size of acupuncture needles may seem trivial at this point as an acupuncture provider, it is vital we stay up to date on the right size and gauge of our needles for success with treatment of our patients. The truth of it is that the size does matter in regards to treatment, and it will depend on both the type of treatment as well as the part of the body the needles are being placed in as to which size/type is best for the patient.
Many of our first-time patients also have a fear of needles, and it is because of this that many times they miss out on the benefits of acupuncture because of it. The average diameter of an acupuncture needles is 10 times smaller than the average diameter of an injection needle not to mention only 2 times larger than the average diameter of a human hair. That being said, being able to have access to various types of needles will not only improve our treatments, but also the options we can provide to patients who may be hesitant to try acupuncture.
Acupuncture Needle Size
In layman’s terms, yes, the size of acupuncture needles can have an effect on treatment because various areas of the body can handle different sizes. For instance, finer needles should be utilized on sensitive areas like the upper lip or around the eye, and a stronger or mildly thicker needles should be used for the frown muscles of cheeks.
The size of the needle should also be determined by the condition and type of pain that the patient is in. For instance, for a patient with digestive problems, a larger needle may be used if enough body tissue is available, whereas for someone with back pain a shorter needle may be used as there is likely more muscle mass and less body tissue.
Acupuncture Needle Benefits:
- Made of stainless steel or alloy (most common), can also can be made from pure steel, iron, gold, or silver.
- Range from 0.5 to 2.5 inches and gauges from 26 to 40 – known as harmless needles as they are very tiny and blunt.
- The blunt edge tip of an acupuncture needle makes it more difficult to cut the tissue once penetrated unlike a standard needle of the same gauge. Acupuncture needles are specifically designed to go through soft tissue without damage as well as shallow bony tissue.
Most Used Acupuncture Needle Sizes:
- 0.18mm diameter, 13mm length (excluding the handle) – typically used for facial acupuncture as these needles are short and thin allowing for quick and precise insertion that is virtually painless.
- 0.25mm diameter, 25mm length (excluding the handle) – this is one of the most popular sizes of acupuncture needles as it is beneficial for multiple areas of the body especially those that need shallow insertion. The small diameter coupled with a longer length make them more difficult to be meticulous with needling.
- 0.30mm diameter, 40mm length (excluding the handle) – another very popular size for acupuncture needles beneficial for various parts of the body including areas with thicker muscle mass or areas needing a deeper needling. These needles, however, do require some skill and experience as they are smaller in diameter but a bit longer allowing them to bend easily. It is an option to opt for a 0.35mm diameter instead making for better precision, but being a larger diameter means potentially slight pain for the patient during treatment.
- 0.30mm diameter, 50mm length (excluding the handle) – beneficial on parts of the body that need an even deeper insertion such as the buttocks
If you are a newer acupuncturist, and are flooded with an obscene amount of information on which needles are best and which ones you should buy, there are some tests that you can do to determine which needles are right for you and the services you will be offering to patients.
Acupuncture Needles Self-Assessing Tests:
- Sharpness – carefully insert the acupuncture needle on your body in a sensitive area like the fingertip to see how sensitive patients will react to this needle type. Insertion of the needle shouldn’t give off a sharp, fierce pain, and if it does, this shows the needles picked are too thick for the treatments you are trying to offer.
- Resilience – the ability for the needle to keep its shape. Even though acupuncture needles are flexible, they should be able to retain their shape, and if they can’t, then they may potentially bend while in the patient bringing a risk of danger for the patient. Flick the end of the tip aggressively while holding the acupuncture needle, and if it bounces back you have picked a good needle. These will be safe to be used on your patients, if the needle bends and does not bounce back, these are not suitable needles for your practice.
It may seem overkill to spend this much time thinking about the size of our needles, but when it is the backbone of your practice, it is something that needs to be considered to have and maintain a thriving practice with satisfied patients.
Needle Type and Timing
While there is no guide necessarily as to how long to leave needles inserted, and there isn’t cause for concern leaving them in longer, they must be left in for a minimum of 20 minutes. The blood in the body takes 20 minutes to flow completely through the body, therefore this is the bare minimum amount of time needles should be left in as a general rule of thumb. Are there some exceptions? Of course. For instance, the patient preference. If the patient is nervous or wants a more relaxing session, these factors can also determine the duration the needles are in place also depending on the type of practice you’re running.
Regarding the type of needles to buy, while we touched on that, it is also important to understand the types of needles out there to make an informed decision. There are the standard filiform needles made of stainless steel, but there are also needles that are specialized for various types of treatment which should be looked into if you are planning on doing various treatment types in your practice.
Specialized Needle Types:
- Press Needle – used to for long term stimulation as it is pushed in and secured with a patch.
- Plum Blossom Needle – allows for stimulating multiple points at a time, and is made up of 7 filiform needles.
- Copper Loop Handle Needle – the benefits of this needle type is that they are best for moxibustion and e-stim as copper is a good conductor of heat. The issue with this needle type is that they tarnish if they are stored for long periods of time so it may be best to get if you will be using them right away.
- Korean Acupuncture Needle – made of stainless steel, these needles contain a spring handle with or without a loop, and is able to be stored for a long time.
- Three-Edged Needle – used to remove a couple drops of blood from the point site, and they are thick, triangular, and extremely sharp.
- Japanese Acupuncture Needle – ideal for moxa, and have metal tube handles.
- Intradermal Needle – these are utilized specifically for pain relief, and are very short.
- Plastic Handle Needle – these are beneficial to those acupuncturists who are new, and are firm and handled easily.
Even with all of this information, ultimately, the type, size, and gauge needle are entirely up to you as the acupuncture provider. Having the proper information is vital to make the right decision for you and your practice. Your experience as well as the way you choose to run your practice or treatments you offer will make your decision clear in the end.
There is ongoing research on the mechanics and various other aspects of acupuncture needles and how they affect treatment. For instance, in a 2023 study, Mechanical Effects of Needle Texture on Acupoint Tissue, it was determined that “a pattern perpendicular to the movement direction during the acupuncture manipulation creates more stimulation.” These types of research will effect on future needle designs and therefore our treatments, so it is beneficial for us as acupuncture providers to stay in the know on the latest with acupuncture needles.