Month: June 2025

This article offers a brief yet important note for those who use acupuncture needles while treating patients. For comprehensive needling guidelines, please consult an authoritative source such as Deadman’s Manual of Acupuncture

• Needling Depth & Angle Matter: Always consider anatomical structures—e.g., lungs, major blood vessels, or organs.
• Avoidance Zones: Avoid needling over arteries, large veins, eyes, nipples, umbilicus, and areas with skin infections or ulcers.
• Pregnancy Warning Points: Certain points (e.g., LI4, SP6, BL60, BL67) may stimulate uterine contractions and should be used cautiously or avoided in pregnancy.

Lung Channel (LU)

• LU1 (Zhongfu): No deep perpendicular needling – risk of pneumothorax.
• LU2: Risk of pneumothorax – avoid deep needling.

Large Intestine Channel (LI)

• LI1 – LI20
• LI4 (Hegu): Contraindicated in pregnancy – may induce labor.

Stomach Channel (ST)

• ST1 – ST45
• ST1, ST2: Near the eye – use caution, shallow needling only.
• ST9 (Renying): Over carotid artery – avoid vigorous needling.
• ST17: Do NOT needle – located on the nipple.
• ST25: Over intestines – use caution with depth in thin patients.
• ST42: Dorsal foot artery passes nearby.

Spleen Channel (SP)

• SP1 – SP21
• SP6 (Sanyinjiao): Contraindicated in pregnancy – strongly affects uterus.
• SP11 – SP12: Near femoral artery and nerve – caution with depth.

Heart Channel (HT)

• HT1 – HT9
• HT1: Deep needling may puncture axillary artery or lung.

Small Intestine Channel (SI)

• SI1 – SI19
• SI8: Near ulnar nerve – caution needed.

Bladder Channel (BL)

• BL1 – BL67
• BL1: Very close to eye – specialized needling required.
• BL11–BL21: Risk of pneumothorax – all located near thoracic spine.
• BL22–BL34: Over kidneys or sacral foramina – angle needle properly.
• BL40: Tibial nerve and popliteal artery run deep – avoid deep perpendicular needling.
• BL60: Contraindicated in pregnancy.
• BL67: May be used to induce labor – caution in pregnancy.

Kidney Channel (KI)

• KI1 – KI27
• KI11 – KI13: Close to bladder – avoid deep needling.
• KI21: Risk of peritoneal cavity puncture.
• KI22 – KI27: Risk of pneumothorax – on chest wall.

Pericardium Channel (PC)

• PC1 – PC9
• PC1: Close to lung – risk of pneumothorax.

San Jiao Channel (SJ/TE)

• SJ1 – SJ23
• SJ17–SJ23: Near facial nerves and vessels – use caution.

Gall Bladder Channel (GB)

• GB1 – GB44
• GB21 (Jianjing): Major caution – risk of pneumothorax, especially in thin patients or if deeply needled.
• GB20: Close to brainstem – needle obliquely and avoid deep insertion.
• GB30: Deep point near sciatic nerve – insert carefully.

Liver Channel (LV)

• LV1 – LV14
• LV5: Close to great saphenous vein.
• LV13 – LV14: Over liver and spleen area – caution with depth.

Ren (Conception Vessel)

• Ren1 – Ren24
• Ren5–Ren7: Avoid during pregnancy unless specifically indicated.
• Ren8: Do not needle – moxa or massage only.
• Ren14–Ren15: Risk of injury to heart or liver in thin patients – shallow insertion.

Du (Governing Vessel)

• DU1 – DU28
• DU15 – DU16: Near medulla – avoid deep needling.
• DU21 – DU22: Do not needle in infants – fontanel not fully closed.

Acupuncture depth and angle are critical components of effective and safe treatment.

Safety: Avoiding Injury

• Vital organs, blood vessels, and nerves lie beneath the skin. Incorrect depth or angle can cause serious complications like:
• Pneumothorax (collapsed lung) from needling too deeply into the chest area.
• Nerve damage if a needle penetrates or irritates a nerve directly.
• Bleeding or bruising from hitting blood vessels.

Therapeutic Effectiveness

Acupuncture works by stimulating specific tissues, such as muscles, fascia, or nerve pathways.

Correct depth ensures the needle reaches the intended tissue layer, which may vary depending on:

• The point location
• The desired physiological effect
• The patient’s body type (e.g., muscular vs. thin)

Proper Qi Sensation (“De Qi”)

• Traditional Chinese medicine emphasizes the sensation of “De Qi”—a dull ache, pressure, or spreading sensation.
• Achieving De Qi often depends on reaching the correct tissue plane, which requires precise depth and angle.
• Shallow needling might miss this, while too deep might cause discomfort or pain.

Anatomical Variability

• Depth and angle are adjusted based on:
• Region of the body (e.g., scalp vs. thigh vs. abdomen)
• Individual anatomy (fat, muscle mass, age)
• Position of the patient (lying down vs. seated)

For example, acupuncture at LI4 (Hegu) is angled obliquely away from the bone to avoid discomfort and target the correct tissue.

Needle Technique and Treatment Goal

• Sometimes shallow needling is used for surface-level conditions like skin issues.
• Deeper insertion might be needed for muscular or joint pain.
• The angle also helps direct stimulation, such as following the meridian line or dispersing stagnation.
• Proper depth and angle are essential in acupuncture for:

Ensuring safety

• Targeting the right tissues
• Maximizing therapeutic effects
• Avoiding complications
• Respecting anatomical and individual differences

A trained acupuncturist will assess all of these factors to tailor treatment precisely to the patient’s needs.

This is a video of Special Needling Techniques: