Medical Acupuncture
A Journal For Physicians By Physicians

Spring / Summer 2000- Volume 12 / Number 2
"Aurum Nostrum Non Est Aurum Vulgi"

LETTERS TO THE EDITOR

To the Editor: Caution for those enthusiastic needle twiddlers who insist on hearing the patient report sensation of the needle grab…I had placed the first needle, a Seirin No. 3 (0.20) X 30 mm, into a tender muscle band on the lateral thigh region of a man. Despite myself having clearly felt the needle grab due to the resistance against my twiddling, the patient reported feeling nothing. After a few more firm twiddles, there was a palpable snap and to my surprise, for the first time in my 3 years of performing acupuncture, I discovered that the handle had snapped off!
    Fortunately, I do not usually insert needles up to the base of the handle, so there remained a significant portion of the needle body still sticking out of the patient. With moderate effort, I was able to remove the broken needle from the contracted muscle without any complication. I chose not inform the patient about our close call, as he was already somewhat apprehensive.
    I continued calmly with larger diameter Seirin needles No. 5 (0.25) x 40 mm. This time with a much more gentle initial twiddling. Using deeper needling, the patient quickly reported sensation of needle grab. The lessons are to not perform the initial twiddling too vigorously after one becomes aware of the muscle grab, especially when using fine diameter needles, and that when doing needling without the patient reporting De Qi, one might wish to select a longer needle, assuming one is over the "target," or perhaps just leave the grabbed needle in that position, without insisting on having the patient provide oral feedback about De Qi.
- Allen L. Fein, MD
Southhampton, NY

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