In a word, it is unknown. Acupuncture does not have a written record of evolution like herbal medicine in China. Rather the whole system of points is in existence by the time the first book on TCM, the Yellow Emperor’s Classic, appears some 2,500-5,000 years ago in China.  India also has a system of meridians, and there is controversy over whom influenced whom. The meridian system likely evolved with qigong (or qi exercises). The concept of inserting needles may have evolved from ancient Chinese shamanic practice of using swords to cut away evil spirits.

What Acupuncture Does

In Traditional Chinese Medicine (TCM), the fundamental cause of disease is blockage of the flow of Qi (energy) in the body. Qi flows through established Meridians (or Channels) and pools at certain points, used as acupuncture or acupressure points. Inserting a tiny needle into these points stimulates the Qi to course through the Meridian and open up the blockage. In Western terms, this is analogous to popular sports rehabilitation methods that seek to open neuroconnections along the line of injury.


In the modern practice of acupuncture, only sterilized, disposable needles are used. They are disposed of in Sharps containers, just as other disposable medical instruments. The needles most American practitioners use are extremely thin. They look more like filaments than needles. At our clinic, for example, we use 40-36 gauge needles. The tips of acupuncture needles are round, not beveled like hypodermic needles are. This means they do not cut through tissue.

Acupuncture Styles

TCM is a an adaptive medicine. It was adopted and adapted first by nearby countries such as Japan and Korea who developed their own distinct styles, and lately by the West. This has created a variety of styles. Like massage, acupuncture can be performed very gently or aggressively. Westerners, for the most part, prefer painless, gentle acupuncture. Practitioners catering to Western clientele typically use the smallest needles available and do not insert the needles as deeply or as aggressively. If you are still concerned about the treatment being painful you should ask the acupuncturist about his/her style of treatment or seek a Japanese-style practitioner.

The Acupuncture Treatment

The acupuncturist will take your tongue and pulse diagnosis as well as ask questions about your health. You will then lie down. Depending on the style of acupuncture, the practitioner may do some palpation. The acupuncturist will then begin to needle according to his/her diagnosis. You will likely not feel the needles going in at all, but you may feel heaviness, pressure, or an electrical jumping sensation as the stuck Qi is activated. Other modalities may be included like moxibustion, cupping, microcurrent, gua sha, and tui na massage.


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