Needle Manipulation and Deqi
What I Learned
While learning acupuncture techniques, I found that needle insertion is only one part of the needling process. After a needle has been inserted, different manipulation techniques can be used to create and adjust the needling sensation.
Another important concept is Deqi, a traditional acupuncture term describing characteristic sensations that may occur during or after needle insertion and manipulation.
Understanding the basic manipulation techniques first makes it easier to organize the many different names and methods used in acupuncture.
1. What Is Needle Manipulation?
Needle manipulation refers to the techniques used to move or stimulate an acupuncture needle after it has been inserted to an appropriate depth.
In traditional acupuncture terminology, needle manipulation is also associated with Yunzhen (運針), meaning the manipulation or movement of an inserted needle.
The purposes traditionally associated with needle manipulation include:
eliciting or obtaining Deqi;
adjusting the intensity of the needling sensation;
stimulating the acupuncture point; and
applying specific traditional acupuncture techniques.
The type, intensity, direction, and duration of manipulation can vary depending on the technique and the acupuncture system being used.
2. What Is Deqi?
Deqi (得氣) literally means “obtaining Qi” or “arrival of Qi.”
In traditional acupuncture theory, Deqi describes the characteristic sensation that may occur after an acupuncture needle has been inserted and manipulated.
In modern descriptions, Deqi is often discussed in terms of the sensations experienced by the patient and the practitioner rather than as something that can be directly observed or measured as Qi.
Patient Sensations
A patient may experience:
soreness;
numbness;
distension or fullness;
heaviness;
a pulling sensation; or
a sensation that spreads locally or sometimes follows the general pathway of a meridian.
Not every patient experiences all of these sensations, and the intensity can vary considerably.
Practitioner Sensation
The practitioner holding the needle may perceive:
heaviness;
tightness;
resistance; or
a subtle pulling sensation.
Traditional texts sometimes compare this feeling to the sensation of a fish pulling against a fishing line.
These sensations are traditionally associated with Deqi, but their presence or absence should not be treated as a simple measure of whether acupuncture has been effective.
3. When Deqi Is Difficult to Obtain
If a characteristic needling sensation does not occur, several technical factors may be considered.
These include:
inaccurate acupoint location;
an inappropriate insertion angle;
an inappropriate insertion depth;
unsuitable needle manipulation; or
differences in the patient’s sensitivity.
The practitioner may reassess the location, angle, depth, and manipulation technique.
Traditional acupuncture theory also describes situations in which a person’s condition or reduced sensitivity may make Deqi more difficult to perceive. However, the absence of Deqi should not automatically be interpreted as proof of severe Qi deficiency or exhaustion of the Zang-Fu organs.
4. Basic Needle Manipulation Techniques
Two fundamental needle manipulation methods are commonly described:
Lifting-thrusting
Twirling-rotating
These techniques can be used separately or in combination.
Lifting-Thrusting Method
Lifting-thrusting involves repeatedly moving the needle between relatively superficial and deeper positions.
Thrusting moves the needle toward a deeper position.
Lifting moves the needle back toward a more superficial position.
The amplitude, speed, and duration of the movement can vary depending on the technique.
Twirling-Rotating Method
Twirling-rotating involves repeatedly rotating the needle back and forth around its axis.
The amount of rotation and the speed of movement can be adjusted according to the technique being used.
5. Auxiliary Needle Manipulation Techniques
In addition to lifting-thrusting and twirling-rotating, several auxiliary techniques are traditionally described.
Stroking Method (循法, Xun Fa)
Stroking (循法, Xun Fa) involves gently stroking or pressing around the acupuncture point or along the pathway of the associated meridian.
When Deqi is difficult to obtain, this method is traditionally used to stimulate the area and encourage the movement of Qi and Blood.
The practitioner may follow the direction of the meridian pathway, rather than simply rubbing randomly around the acupuncture point. In this context, the direction refers to the traditional pathway of the meridian, not to the numerical order of acupuncture points.
Flicking the Needle Handle
The flicking method involves lightly flicking the needle handle with a finger after the needle has been inserted.
This produces a small vibration in the needle and is traditionally used to enhance the needling sensation.
Scraping the Needle Handle
The scraping handle method involves supporting the needle handle with one finger while repeatedly scraping the handle with a fingernail.
Traditionally, this method is used to stimulate the needle and intensify or spread the needling sensation.
Rocking the Needle Handle
The rocking handle method involves gently rocking the needle handle after insertion.
The needle may be kept relatively upright or positioned at an angle. Traditionally, the direction of the resulting sensation may be influenced by the direction and angle of the needle.
Flying Method (飛法, Fei Fa)
The Flying method (飛法, Fei Fa) primarily uses repeated twisting and releasing movements.
The practitioner rotates the needle and then releases the handle, repeating the movement rhythmically. The technique is traditionally compared with the movement of a bird spreading its wings.
Trembling Method
The trembling method uses small-amplitude and relatively rapid lifting-thrusting and twirling-rotating movements.
The goal is to create a slight trembling movement in the needle and enhance the needling sensation.
6. Organizing the Techniques
The techniques can be organized into two broad groups.
Basic techniques
Lifting-thrusting
Twirling-rotating
Auxiliary techniques
Stroking (循法, Xun Fa)
Flicking the needle handle
Scraping the needle handle
Rocking the needle handle
Flying (飛法, Fei Fa)
Trembling
This classification makes the different techniques easier to remember because the two fundamental movements—moving the needle up and down and rotating the needle—form the foundation for many other manipulation methods.
What I Learned
The main point I took from this topic is that acupuncture needle manipulation is more than simply moving a needle. Each technique has a specific movement, direction, and purpose within the traditional acupuncture framework.
I also found it useful to separate Deqi from the manipulation techniques themselves. Deqi describes a characteristic needling sensation, while needle manipulation refers to the physical techniques used after insertion.
Learning the basic techniques first and then adding the auxiliary techniques makes the large number of acupuncture technique names easier to organize and remember.