The de qi sensation

The “Qi” sensation is a widely discussed phenomenon in acupuncture. All needles produce a needle sensation when inserted, and there are a number of factors that are at play each time a needle is inserted. They are as follows:

  1. In general the quality of the needle will determine the nature of the insertion sensation felt by the patient. Lower-end, or poor quality needles will create more discomfort as the needle tips are not consistent, may be dull, blunt or broken. Higher-end needles have better needle tip geometry and will generate less or no sensation when inserted.

  2. It must be noted that all needles - regardless of the quality - can cause an intense pain when inserted. This will occur with 5% of needle insertions and results when a nerve ending or blood vessel is nicked during insertion. When this occurs the sensation can be described as a “biting or burning” sensation and is significantly different than the sensations produced by other needle insertions. If you warn your patient about this infrequent phenomenon, they will be able to help you determine if the needle needs to be reinserted to relieve the discomfort. If you do not warn your patient about this occasional intense sensation, they may try to just bear it and consider acupuncture to be a painful experience.

  3. The “False Qi” sensation and working with thinner gauged or lubricated needles.

  4. Points To Consider

    Thicker gauge needles or non-lubricated needles are prone to giving the practitioner the impression that they have “de qi”. The “de qi” sensation is characterized by a grabbing or pulling sensation felt by both the patient and practitioner. Often, with thicker or poor quality needles, the grabbing of tissue is felt by the patient who responds by informing the practitioner who then assumes the “de qi” is obtained and stops the stimulation.

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    For more exacting practitioners, this is where working with good quality needles or lubricated needles becomes very important. With thinner, or higher-end needles you are able to insert and penetrate to the depth of tissue desired without causing discomfort. Then stimulation to reinforce or disperse can begin. Now the “Qi Sensation” takes on a different quality that is a deeper pulling, heaviness or tingling, as opposed to the discomfort associated with the “False Qi Sensations”.

    With finer or lubricated needles, one has to be exacting on point location as, if one is slightly off, there will be no “Qi Sensation” when reinforcing or dispersing the point. It will feel like nothing to the patient and the practitioner will feel like she/he is twirling the needle in air. At that point it is advised to withdraw the needle slightly and probe on angles to get the qi; or simply remove the needle, discard, recheck the location and insert a new needle into the point and stimulate.

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