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Size of acupuncture needles. How to choose?

In acupuncture (from the Latin acus - needle and puncture - placement), there are correct needle measurements for each procedure. To choose the correct needle for the procedure we must know what the values ​​that characterize the acupuncture needle mean.



Acupuncture appeared in China in the middle of the Stone Age approximately 4500 years ago and is constantly evolving. Technological advances (new instruments and techniques such as ultrasound, infrared radiation, laser beam and other equipment) and their use in different areas of medicine have enriched the treatment resources.


According to Traditional Chinese Medicine (TCM), treatment through acupuncture aims to normalize diseased organs through functional support that has a therapeutic effect.


The acupuncture needle consists of the handle and the blade. The needle body corresponds to the blade while the handle is the hard and polished metallic filament with the tapered tip to allow application. 


For acupuncture beginners, choosing the right needle for the treatment may not be an easy task because there are several needles, different brands , various materials, etc.  


Needle measurements are usually expressed in millimeters (mm): diameter (or caliber) and length. It is usual to indicate the gauge first and then the length. For example , a 0.25 x 30mm needle means it is 0.25mm in diameter / gauge (thick) and 30mm long (not counting the needle handle).


These two parameters influence the perspective of the patient receiving the treatment, or the perspective of the professional who handles the needle. Thus, for the patient , the smaller the diameter (thickness) of the needle, the less the sensation of discomfort and / or pain caused by the insertion of the needle that is, the better their experience in the treatment. 


In the therapist's perspective , the larger the needle diameter, the easier the insertion act will be, since it reduces the risk and the inconvenience of the needle bending during treatment.


It is precisely in the balance between these two factors that the choice of the right needle for each type of treatment must be made. 


Below, you can find some of the most used measures in therapeutic practice:


  • 0.16 x 10mm
  • 0.16 x 15mm;
  • 0.25 x 25mm
  • 0.20 x 25mm
  • 0.22 x 25mm
  • 0.30 x 25mm;
  • 0.30 x 40mm
  • 0.30 x 5 mm
  • 0.30 x 75mm. 


Compare each of these measures and their most common applications:


It is one of the thinnest and shortest needles you can find. The combination of these two characteristics, at the same time, makes it especially suitable for patients who are very sensitive to pain and, at the same time, suitable for use in the most sensitive areas of the body. Its extremely reduced thickness makes the pain sensation in the patient almost non-existent. On the other hand, because it is very short, it can be handled and inserted with greater precision and speed than needles of longer lengths. 


Together with 0.16 x 15mm, or even 0.13 x 7mm , they are one of the measures of choice in the practice of facial acupuncture and auriculotherapy.





It is the most used measure in acupuncture due to its versatility. It can be used on various parts of the body. It is recommended for shallow and / or shallow insertions. More experienced therapists opt for the 0.30 x 25mm needle which is slightly thicker but has the advantage of being easier to insert.


It is also a measure widely used for versatility, however, it is more used in the parts of the body where muscle groups of greater density are located or in acupuncture points that require greater depth of insertion.


It is a longer needle than the previous ones and, in order not to run the risk of bending, it is advisable to choose diameters of not less than 0.30 (mm). The experience, expertise and refined technique also minimize this risk. But not only. The risk can also be reduced by choosing better quality needles, with better polished tips that facilitate the smoother slide of the needle upon insertion.


Alternatively, many professionals opt for 0.35 x 40mm needles, slightly less thin than 0.30 x 40mm, but can reduce the risk of the needle becoming deformed.


Of course, there will be a disadvantage in this choice of possibly increasing the patient's feeling of discomfort or pain because it is a needle with a greater thickness. It is a balance and trade off exercise that is not always easy to do.

In the 0.30 (mm) diameter needle family, there are still other options of greater length, namely 0.30 x 50mm and 0.30 x 75mm , especially suitable for inserts with depth beyond 3.5cm , the latter being normally used for inserts in the body areas around the buttocks.


Finally, it should be noted that the gauge of the needle has some influence on the discomfort or pain in the sting but the relationship is not absolute as the thick needles are easier to handle and allow quick insertion (which can minimize discomfort).


In addition to the needles discussed earlier, there are other needle measures.

We can divide the needles into fine, medium and thick:

  • thin to 0.20 mm;
  • averages around 0.25 mm
  • thick 0.30 mm or more

Needles can be short , medium, long and extra-long, depending on the length of the blade (indicated in millimeters or cun)

  • short - the blade measures up to 15 or 20 mm (1/2 cun);
  • medium - about 25 mm to 30 mm (1 cun);
  • long - 40 mm to 50 mm (1.5 cun to 2 cun);
  • extra-long - 60 to 70 mm (3 cun) or larger.

In the measure of wires there is another standard, the wire gauge (gauge of wires) or simply gauge. The wire number inversely accompanies the gauge in millimeters because originally this standard indicated the number of holes through which the wire passed in its making, the more holes the thinner the wire (thus WG 32 indicates a thin wire (0.20mm) and the WG 30 a medium wire (0.25mm)).

There are acupuncture machines that work with only one needle model, but it is best to have a varied set that allows you to choose the most appropriate needle on a case-by-case basis. For the face, for example, it is better to use thin needles (short or medium length); for deep insertion into muscles, medium or large gauge needles are chosen, with long length (or extra-long for bulky muscles), etc.

Choosing the right needle, when the therapist has a lot of experience, becomes a matter of personal preference for the therapist. Regarding the number of needles, in general, 10 to 15 are used; however, the good doctor who specializes in acupuncture uses as few needles as possible because he has an accurate diagnosis and an accurate choice of points.

It is not recommended to reuse the needle (individual kit) especially when the patient takes it with him, and it may not be stored properly, asepsis itself is impaired, putting both the patient and the professional at risk.


Based on: https://www.panda.pt/pt/sobre-mtc/como-escolh-agulhas-de-acupunctura-parte-i/ 



Catarina Vilela - Nurse