Acupuncture is probably the most widely known part of TCM, and the most widely misunderstood.

Most people know it involves needles. Rather fewer have a clear picture of why those points, what happens during and after a session, or how many sessions are involved.

That is what this article covers.

1. The theory: how TCM explains acupuncture

Explaining this properly requires accepting one premise up front: this is TCM's theoretical framework, describing the body in its own language.

In that framework the body is treated as an interconnected whole, containing a system known as the meridians (经络) — along which, in theory, qi and blood move, linking the surface of the body to the organs within. Acupuncture points are specific locations on that system.

Acupuncture means needling at selected points, understood within TCM theory as a way of regulating the overall state.

Two things are worth stating plainly here.

First, the meridian system is a theoretical framework — it is not the same thing as blood vessels or nerves in anatomy. It is how TCM describes and explains the body, with its own internal logic and a long history of use behind it.

Second, we are not going to claim what acupuncture can achieve. An educational article is not the right place — and is not equipped — to reach a conclusion about your situation. This article explains what acupuncture is and what a session involves. Whether it suits you requires assessment by a registered practitioner.

2. What "deqi" means

If you have asked someone who has had acupuncture, you may have heard it described as an achy, distended feeling.

TCM has a concept for this: deqi (得气) — a particular sensation arising when the needle reaches a certain depth and position. It is traditionally described as aching, tingling, distension, heaviness, or a spreading sensation travelling in some direction. In TCM theory it is regarded as one sign that the needling has produced a response.

Worth distinguishing: in the traditional descriptions, deqi and pain are two different things. If what you feel is sharp or burning, that is not deqi — tell the practitioner immediately.

3. What happens in a session

What follows is general clinic practice for an acupuncture session; arrangements vary between clinics and practitioners.

Consultation and assessment. The practitioner takes a history and forms an assessment. A first session usually runs longer, because the questioning is broad.

Point selection. Points are chosen from the assessment. The part that surprises people: where the needles go is not necessarily where the discomfort is. Point selection follows meridian theory, and using points on the hands and feet for concerns higher up is common practice.

Insertion. The skin is disinfected first. Insertion is commonly described as a light tap or a brief prick, and at some points described as barely detectable.

Retention. Needles usually stay in for 15 to 30 minutes, and the retention time is spent lying quietly. The practitioner may adjust them partway through. Some sessions add other techniques — moxa attached to the needle handle (warm needling), or a mild electrical current (electroacupuncture).

Removal. Removal is commonly described as even less noticeable than insertion. The practitioner checks the sites and applies brief pressure where needed.

Afterwards. The practitioner explains what to be aware of that day, and suggests when to return.

4. How many sessions? How long is a course?

The most-asked question, and the hardest to answer in an article — because it genuinely varies between people.

What can be said is how it is arranged:

• The practitioner gives a suggested frequency and number when explaining their recommendation. This is the part to ask about.
• TCM adjustments are usually made in stages. The first plan is a starting point, not a fixed conclusion, and it is revised based on how things stand when you return.
• Being able to describe any change at your follow-up makes the assessment sharper. Nothing detailed is needed — whether sleep, energy and appetite are any different is enough.

Two questions worth asking directly: "Roughly when can we assess whether to continue?" "If nothing has changed, what would you adjust?"

The practitioner sets a point at which to review, rather than an open-ended arrangement.

5. Why we will not list what acupuncture treats

This section needs care.

Clinically, acupuncture is applied to non-urgent health concerns. The range varies between practice settings and between practitioners.

But this is not a list of what acupuncture treats, and we will not provide one. The reason is the same as for herbal prescriptions: whether it suits you depends on an assessment of you. Two people with the same complaint may be assessed differently, and handled differently.

If you want to know whether acupuncture fits your situation, the way to find out is to have a registered practitioner assess it — not to match yourself against an article.

6. When acupuncture is not the route

Difficulty breathing, chest pain, any change in consciousness, injury, or heavy bleeding — call 999 now, or go to the nearest emergency department.

Acupuncture is not the route for an emergency. TCM and Western medicine complement each other — this is not a choice between the two.

Separately, the following do not mean you cannot have acupuncture — they mean the practitioner needs to know beforehand in order to adapt:

• Taking anticoagulant medication, or any bleeding or clotting condition — tell the practitioner, and never stop prescribed medication on your own
• Pregnancy, or possible pregnancy — certain points carry specific considerations
• A pacemaker or other implanted electronic device — directly relevant to whether electroacupuncture is used
• Skin infection or an open wound at the intended site
• Previous fainting during needling

7. Common questions

Does it hurt? That deserves its own article. The short answer: an acupuncture needle and a hypodermic are different objects, but sensation differs between people and we won't presume yours.

→ In detail: Does Acupuncture Hurt? 5 Things to Know Before Your First Session

How many needles? It varies — anywhere from a few to a dozen or more.

How deep? It varies considerably by site and by assessment. The practitioner decides from experience.

Can acupuncture and tuina be done in the same session? Yes — combining them is common, arranged by the practitioner.

Can acupuncture be done online? No. It requires the practitioner to be physically present. No hands-on treatment can be delivered in an online consultation.

What should I wear? Loose clothing that rolls or lifts easily. If a specific area needs to be exposed, the practitioner will say beforehand.

In closing

Acupuncture is not "needle wherever it hurts", and it is not a one-off.

It is a staged approach, with points chosen under an overall assessment. What you can do is describe your situation clearly, say what worries you, and be able to report whether anything has changed when you return.

👉 If you are unsure what acupuncture actually involves and whether it suits you, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you.

Written and reviewed by Mr. Lim Gao Hong, a TCM practitioner registered with Malaysia's Traditional and Complementary Medicine Council under the T&CM Act 2016. Areas of practice: Acupuncture, Pain Management and General TCM.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

针灸大概是中医里最广为人知，也最容易被误解的一项。

多数人知道它「拿针扎」，但对于为什么扎、扎完之后发生什么、以及要扎几次，通常没有清楚的概念。

这篇文章处理的就是这三件事。

一、原理：中医理论怎么解释针灸

要说清楚这一点，得先接受一个前提： 这是中医的理论框架，用它自己的语言在描述身体。

在中医理论中，身体被视为一个互相关联的整体，其中有一套被称为经络的系统——理论上，气血沿着经络运行，连结体表与内在的脏腑。穴位则是这套系统上的特定位置。

针灸的操作，就是在选定的穴位上施针，在中医理论里，这被理解为对整体状态的一种调节。

这里有两件事值得说清楚：

第一，经络是一套理论框架，不等同于解剖学上的血管或神经。 它是中医用来描述与解释身体的方式，有自己的内在逻辑，也有长久的使用历史。

第二，我们不会宣称针灸能做到什么。 一篇科普文章不适合、也不应该替您的情况下判断。这篇文章说明的是针灸是什么、过程怎样，至于它适不适合您，需要注册中医师评估。

二、「得气」是怎么回事

如果您问过做过针灸的人，可能听过「酸酸胀胀的」这种描述。

中医里有一个概念叫得气——指的是针达到一定深度与位置时出现的一种特定感觉。传统上被描述为酸、麻、胀、重，或是一种沿着某个方向扩散的感觉。在中医理论中，这被视为针刺产生反应的一个指标。

要区分的是：在传统的描述里，得气的感觉与「疼痛」是不同的两回事。 如果出现的是尖锐的刺痛或灼热感，那不是得气，请立刻告诉医师。

三、一次针灸会发生什么

以下说明的是中医诊所进行针灸的一般做法，各诊所与医师的安排会有差异。

看诊与判断。 医师会先问诊，形成辨证判断。第一次通常花比较长的时间，因为要了解的范围很广。

选穴。 依判断选定穴位。这里常让人意外的是： 扎针的位置不一定是感到不适的地方。 中医的取穴依循经络理论，处理上半身的困扰时取用手脚的穴位，是很常见的做法。

进针。 医师会先做皮肤消毒。进针的那一下， 常被描述为像被轻轻碰一下，或是一点短暂的刺感；在某些部位则被描述为几乎察觉不到。

留针。 一般留针 15 至 30 分钟。留针期间就是安静躺着的，医师可能会中途来调整。有些情况会加上其他做法，例如在针尾加艾（温针）或接上微电流（电针）。

取针。 取针的感觉，常被描述为比进针更轻微。医师会检查针孔，需要时按压一下。

之后。 医师会说明当天的注意事项，以及建议的回诊时间。

四、要做几次？一次疗程多久？

这是最常被问、也最难在文章里回答的问题——因为答案确实因人而异。

能说的是这件事怎么被安排：

• 医师会在说明时给出建议的频率与次数。 这是您应该问清楚的部分。
• 中医的调整通常是分阶段进行的。 第一次的安排是起点，不是定案；医师会依您回诊时的状况修正方向。
• 回诊时说得出变化，会让判断更准确。 不需要详细记录，睡眠、精神、胃口这几项有没有不同，说得出来就够了。

值得直接问医师的问题：「大概多久可以评估要不要继续？」「如果没有变化，接下来会怎么调整？」

医师会与您约定一个检视的时间点，而不是无限期地继续。

五、为什么我们不提供「针灸可以治什么」的清单

这一段需要谨慎地说。

针灸在临床上的应用集中在非紧急的健康困扰，实际范围因执业环境与医师而异。不同的执业环境、不同的医师，实际应用的范围也会有差异。

但这不是一份「针灸可以治什么」的清单，我们也不会提供那样的清单。 理由和中药处方一样：是否适合，取决于对您个人的评估。 同样的困扰，两个人的辨证结果可能不同，处理方式也就不同。

如果您想知道针灸适不适合自己的情况，正确的做法是让注册中医师评估，而不是对照文章自我判断。

六、哪些情况不该用针灸处理

呼吸困难、胸痛、意识改变、外伤，或剧烈出血—— 请立刻拨打 999，或前往最近的急诊部。

针灸不是急症的处理途径。中医与西医是互相补位的关系，不是二选一。

另外，以下情况不代表不能针灸，但医师需要事先知道，才能调整做法：

• 正在服用抗凝血药物，或有凝血方面的健康状况——请告诉医师，切勿自行停药
• 怀孕或可能怀孕——部分穴位在孕期有特定考量
• 装有心脏起搏器或其他植入式电子装置——这与是否使用电针直接相关
• 施针部位有皮肤感染或开放性伤口
• 曾经晕针

七、几个常被问到的问题

针灸会痛吗？ 这个题目值得单独一篇。简短的答案是：针灸针和注射针是两种东西，但每个人的感觉不一样，我们不会替您预设。

→ 详细说明：《针灸会痛吗？第一次针灸前需要知道的 5 件事》

要扎几针？ 依情况而定，从几针到十几针都有可能。

扎多深？ 依部位与判断而定，差异很大。医师会依据经验决定。

针灸和推拿可以同一次做吗？ 可以，临床上合并使用很常见。由医师安排。

线上可以针灸吗？ 不行。针灸需要医师在现场操作，线上问诊无法进行任何动手的治疗。

穿什么去比较好？ 宽松、方便拉起或卷起的衣物。若需要露出特定部位，医师会事先说明。

写在最后

针灸不是「哪里痛扎哪里」，也不是一次就结束的事。

它是在一个整体判断之下，选定位置、分阶段进行的处理方式。您能做的，是把情况说清楚、把顾虑说出来，并且在回诊时说得出这段时间有没有变化。

👉 如果您不确定「针灸到底是怎么一回事、适不适合我」，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。

本文由 林高鸿 医师 撰稿审阅。林高鸿 医师依 2016 年 T&CM 法令于马来西亚传统与辅助医药理事会注册执业，专长为针灸、疼痛管理与中医全科。

无论身在何处，与持证中医师对坐。

汉方现代中医