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Added ''Pearl'' "Needle Phobia" on ''4/18/2009'':
The number one question I am asked is "does it hurt". My answer is always "No, although the normal sensations include achiness, soreness, warmth, tingling, etc. which are actually considered therapeutic although not necessary to achieve beneficial results."

Clinical tips: 1. Needle the least sensitive point first (i.e. LI 11-quchi) instead of a highly sensitive point. 2. Avoid saying the word "needle". 3. Avoid showing the patient the needle unless they ask to see it. (Especially the 3" variety) 4. Have them take a breath upon insertion so that they know it is coming rather than being startled which may stagnate qi. 5. Distract them. If the point is generally painful I may ask them a random question such as "what is your favorite color" and while they are thinking about it continue with the insertion. 6. Insert all of the needles first before going back to specific points to acquire de qi. If de qi is acquired at each individual point in sequence the patient may not be comfortable with adding more points along the way. 7. If a point is particularly sensitive stay calm. Do not be so quick to apologize or withdraw the needle. Inform the patient that this is normal and the sensation usually subsides within 30 sec to a minute. Ask them if it is tolerable. If not then pull the needle up 1-3 fen which may reduce pressure on any underlying structures such as blood vessels or nerves. 8. Use thinner needles and fewer points on initial treatments. As the trust builds between practitioner and patient the patient may be more open to stronger techniques in future visits. 9. Have the patient cough on insertion. Research in Europe supports this technique for reducing the perception of pain when being needled. 10. Listen. The patient will tell you either directly or indirectly what they are comfortable with. The beauty of Chinese medicine is that we have multiple treatments for the same disorder. Find the one that resonates with them. (.i.e. local versus distal) and try to be flexible to their needs rather than what you want to do.