"Doctor, is it true that thicker needles work better? My friend said acupuncture must produce a sore, numb, or heavy sensation for it to be effective—is that right?"

This kind of question is very common in Malaysia. Many people encounter acupuncture for the first time through stories from friends or family, and the principles behind it, the choice of needle, and the sensations involved are often reduced to the simple idea that "the more it hurts, the better it works."

This article addresses the five most common misunderstandings about acupuncture: needle thickness, intensity of sensation, safety considerations, frequency of treatment, and the relationship between acupuncture and Western medicine. We will clearly separate the theoretical framework from practical considerations, so you can have a clear picture before considering acupuncture.

I. The Most Basic Layer—What Acupuncture Actually Is

Acupuncture is an external treatment method within the theoretical framework of Traditional Chinese Medicine (TCM). In this framework, the body has a system of "meridians" through which qi and blood circulate. Acupuncture involves inserting very thin needles into specific points on the body (acupoints) to influence the state of qi and blood flow.

It must be emphasised here: meridians and acupoints are a theoretical framework within TCM. They are not equivalent to anatomical structures like nerves or blood vessels. These are two different systems of explanation, each with its own language and logic.

The needles used in acupuncture—general acupuncture needles have a diameter of approximately 0.12–0.25 mm. This gives you a concrete idea: acupuncture needles are far thinner than ordinary injection needles.

Standard clinical practice is single-use sterile needles, discarded after use, to prevent the risk of cross-infection.

II. What Gets Confused With It—"Pain" Does Not Equal "Effective"

"More pain means more effective" is probably the most widespread myth about acupuncture. This claim needs to be examined carefully.

When a needle penetrates the skin, there is a light pricking sensation—that is a physical fact. As for the sensation after insertion, different people describe it differently—it is often described as "sore," "heavy," or "slightly swollen." The intensity of these sensations varies with individual constitution, the area being needled, and the practitioner's technique. It varies from person to person.

In TCM theory, there is a concept called "deqi" (得气), which refers to a specific sensation at the needle site, commonly described as soreness, numbness, heaviness, or distension. But "deqi" is a clinical judgment standard—based on the practitioner's feel of the needle—and it does not mean "the more pain, the better."

"Pain" is a signal that needs to be distinguished. If a sharp, intense, unbearable pain occurs during needling, that is not proof of effectiveness—it is a signal to inform the practitioner immediately. If ongoing discomfort occurs during a session, tell the practitioner immediately so the approach can be adjusted or the needles removed early.

III. At a Glance—Acupuncture vs. "Getting an Injection"

Many people associate "needles" with injections, but the two are entirely different—from theory to practice.

This table deliberately does not state "how often" or "how many sessions until effective." These vary from person to person and should be explained by the practitioner who assesses you.

IV. When Extra Caution Is Needed—Safety and Contraindications

Acupuncture is an external treatment method within TCM, and there are still important precautions. Items generally listed in TCM literature include:

• People with blood clotting disorders: If you bruise easily, bleed readily, or are taking anticoagulant medication, you must inform the practitioner before receiving acupuncture, and never stop prescribed medication on your own.
• Pregnancy: In TCM theory, certain acupoints are considered best avoided during pregnancy. If you are pregnant or planning to conceive, be sure to state this clearly before the session.
• Skin conditions: If the skin at the needling site has an infection, wound, rash, or other condition, those areas are generally avoided.
• People with pacemakers: Certain electro-acupuncture devices may interfere with pacemakers. If you have a pacemaker, please inform your practitioner before the session.
• Extreme fatigue or an empty stomach: Receiving acupuncture while extremely fatigued, on an empty stomach, or shortly after drinking alcohol is generally not advisable. If you feel dizzy, clammy, or nauseated during the session, tell the practitioner immediately.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

⚠️ Safety reminder: If severe pain, difficulty breathing, palpitations, or other abnormal symptoms occur during needling, tell the practitioner on site immediately. If discomfort or unusual reactions persist after leaving the clinic, contact your practitioner. For difficulty breathing, chest tightness or feeling faint, call 999 now — or go to the nearest emergency department.

V. Making It Work in Malaysia—Practical Thoughts Around an Acupuncture Session

In Malaysia, the practical arrangements around an acupuncture session are simpler than you might think, but a few details are worth noting.

Choose your time. How you feel after acupuncture varies from person to person — it is often described as feeling relaxed or wanting to rest, and sometimes as nothing in particular. If you are concerned about needing rest afterwards, consider scheduling the session on a non-working day or in the evening, rather than rushing to the next appointment.

Food and drink. A general suggestion is not to come on an extremely empty stomach. If your appointment is before lunch, having a light snack—like a piece of toast or a cup of kopi—is a reasonable idea. But arriving overly full is also not ideal.

Communication matters. Before needling begins, the practitioner will ask about your health. Please be as complete as possible: medications you are currently taking (both Western and Chinese medicine), past medical history, any current health concerns, and your sensitivity to pain. This information helps the practitioner decide on the approach.

Life after acupuncture is normal. After the session, you can go for teh tarik at a mamak, drive home, or return to work—there is generally no special restriction. The needled areas simply need reasonable care—keep them clean and dry. If discomfort persists or unusual reactions occur, contact your practitioner.

About "treatment courses." Some people expect a single session to resolve everything; others worry that once they start, they will need it for life. In reality, the frequency and number of sessions "vary from person to person"—depending on your situation, constitution, and the assessment. These questions should be asked directly of your practitioner during the consultation, rather than based on a friend's experience.

Misunderstanding 5: "Can acupuncture replace Western medical treatment?" No. TCM and Western medicine complement each other — this is not a choice between the two. If you are under a doctor's care or taking prescribed medication, tell your practitioner, let your doctor know you are having acupuncture, and never stop prescribed medication on your own.

Conclusion

✅ Remember these points:

1. Acupuncture needles are very fine—approximately 0.12–0.25 mm in diameter—and completely different from injection needles.
2. "Deqi" is a description of needling sensation in TCM theory; it is not the same as "the more pain, the better."
3. Sharp, intense pain should be reported to the practitioner immediately—not endured.
4. Before acupuncture, be sure to tell your practitioner your full health picture, including medications, pregnancy, skin conditions, and more.
5. The frequency and number of sessions vary from person to person and should be explained by the practitioner who assesses you.

❌ What not to do:

1. Do not endure severe pain without telling the practitioner just because "you heard the more pain, the more effective."
2. Do not go for acupuncture on an extremely empty stomach, after alcohol, or in a state of extreme fatigue.
3. Do not self-diagnose "I must have a certain constitution so I should..."—pattern differentiation is the practitioner's job, not a self-labelling exercise for readers.

👉 If you are unsure — "in my situation, is acupuncture actually suitable for me?" — feel free to reach out to HansMed for an online consultation, where you will be assessed by a practitioner registered under the T&CM Act 2016.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，是不是针越粗越有效？我朋友说针灸一定要有酸麻胀痛的感觉才算有做到位，是真的吗？」

这类疑问在马来西亚相当普遍。许多人第一次接触针灸，都是听亲友转述经验，但针灸的原理、针具的选择和过程中的感受，往往被简化成「越痛越好」的说法。

这篇文章要回答的，正是关于针灸最常见的 5 个误会：针具粗细、感觉强弱、安全考量、治疗频率，以及针灸与西医的关系。我们会把每一个迷思背后的理论框架和实际操作分开说明，让您在考虑接受针灸之前，先有清楚的概念。

一、最基础的那一层——针灸到底是什么

针灸是中医理论框架中的一种外治方法。在中医理论中，人体有「经络」系统，气血在其中运行。针灸透过将细针刺入体表特定位置（即「穴位」），来调整气血的流动状态。

这里必须强调：经络与穴位是中医的理论框架，不等同于解剖学上的神经或血管结构。这是两套不同的解释系统，各有各的语言与逻辑。

针灸所用的针具，一般针灸用针直径约 0.12–0.25 毫米。这个数字可以给您一个具体概念：针灸针比普通注射针头细得多。

正规临床使用的针具是一次性无菌针，用完即销毁，目的是避免交叉感染的风险。

二、常被混淆的另一样东西——「痛」不等于「有效」

「越痛越有效」大概是针灸迷思中流传最广的一个。这个说法需要拆开来理解。

针具刺入皮肤时，会有轻微的刺入感，这是物理事实。至于刺入之后的感觉，不同的人描述不同——常被描述为「酸酸的」、「胀胀的」或「有点沉」。这些感受的强度与个人体质、针刺部位、操作手法都有关系，因人而异。

中医理论中有一个概念叫「得气」，指的是针下出现某种特定的感觉，通常被描述为酸、麻、胀、重。但「得气」是一种操作上的判断标准，由医师根据针下的手感来判断，不等于「越痛越好」。

「痛」是一种需要区分的信号。如果针刺过程中出现尖锐的、剧烈的、难以忍受的疼痛，这不是「有效」的证明，而是需要立即告知医师的信号。若过程中出现持续的不适，请立即告知医师，让医师调整操作或提早起针。

三、一张表看懂——针灸与「打针」的差别

很多人听到「针」就联想到打针注射，其实两者从理论到操作都完全不同。

这张表刻意不写「多久做一次」或「做几次会有效」。这些因人而异，应由为您评估的医师说明。

四、这些情况要特别小心——安全与禁忌

针灸属于中医的外治方法，进行前后仍有需要注意的事项。中医文献一般列出的注意事项包括：

• 凝血功能异常者：如果您有容易出血、不易止血的情况，或正在服用抗凝血药物，接受针灸前必须告知医师，切勿自行停药。
• 孕产妇：怀孕期间，某些穴位在中医理论中被认为需要避免刺激。若您正在怀孕或计划怀孕，务必在针灸前明确告知医师。
• 皮肤状况：针刺部位的皮肤若有感染、伤口、皮疹等情况，一般会避开这些区域。
• 心脏起搏器使用者：某些电针设备可能对心脏起搏器产生干扰，若您装有心脏起搏器，请务必在针灸前告知医师。
• 极度疲劳或空腹状态：极度疲劳、空腹或刚喝完酒的状态，一般不建议马上接受针灸。若您在针灸过程中出现头晕、冒冷汗、恶心等不适，请立即告知医师。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

⚠️ 安全提醒：如果在针刺过程中出现剧烈疼痛、呼吸困难、心悸等异常情况，请立即告知在场的医师。若离开诊所后出现持续不退的不适或异常反应，请联络您的医师。若出现呼吸困难、胸闷或快要昏倒，请立刻拨打 999，或前往最近的急诊部。

五、大马生活里怎么安排——针灸前后的实际考量

在马来西亚，接受针灸前的实际安排，比您想像中简单，但有几个细节值得留意。

选对时间。针灸后的感觉因人而异，常被描述为放松或想休息，也可能没有特别感觉。如果您担心针灸后需要休息，建议选择在非上班日或下班后的时段进行，避免赶着去下一个行程。

饮食方面。一般建议不要在极度空腹的状态下去针灸。如果您约了午餐前的时间，可以先吃一点轻食，比如一片面包或一杯 kopi。但也不建议吃得太饱。

沟通很重要。在开始针灸之前，医师会询问您的健康状况。这时候请尽量完整地说明：正在服用的药物（包括西药和中药）、过往的病史、目前的身体状况，以及您对「痛」的敏感程度。这些资讯帮助医师决定用针的方式和部位。

针灸后可以正常活动。针灸后，您可以去 mamak 喝茶、开车回家、继续上班——一般没有特别的限制。针刺部位在当天需要妥善护理，保持清洁干燥即可。如果出现持续不退的不适或异常反应，请联络您的医师。

关于「疗程」。有些人以为针灸一次就能解决所有问题，有些人则担心一旦开始就要终身依赖。实际上，针灸的频率与次数「因人而异」，取决于您的情况、体质和评估结果。这些问题应该在看诊时直接问您的医师，而不是听朋友的经验。

误会五：「针灸可以取代西医治疗吗？」 不可以。中医与西医是互相补位的关系，不是二选一。如果您正在接受西医的治疗或服用处方药物，请让医师知道，也请让您的医生知道您在接受针灸，切勿自行停药。

结语

✅ 记住这几点：

1. 针灸针非常细，一般直径约 0.12–0.25 毫米，与打针完全是两回事。
2. 「得气」是中医理论中针感的描述，与「越痛越有效」不是同一回事。
3. 尖锐的、剧烈的疼痛需要立即告知医师，而不是忍痛。
4. 针灸前务必告知医师您的完整健康状况，包括用药、怀孕、皮肤状况等。
5. 针灸的频率与次数因人而异，应该由为您评估的医师来说明。

❌ 不要这样做：

1. 不要因为「听说越痛越有效」而忍住剧烈疼痛不告诉医师。
2. 不要在极度空腹、酒后或极度疲劳的状态下直接去针灸。
3. 不要自行判断「我是什么体质所以应该怎样」——中医的辨证是医师的工作，不是读者自我标签的工具。

👉 如果您不确定「以我的情况，到底适不适合针灸」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。

无论身在何处，与持证中医师对坐。

汉方现代中医