Hypersenitive to skin puncture

What is the overall diagnosis for the patient? From the brief description it sounds like yin deficiency perhaps. Either way, I'm not sure I see where LV 3 and/or LI 4 fit into either the diagnosis or the treatment. For knee problems we most often use LV 8 and of course the extra points for the knee.

Sensitivity to needling is nearly always related to technique. There are, I imagine, a few people with heightened sensitivity and in those cases using GV 19 (sensory cortex of the brain) can be helpful. Technique wise, however, we use insertion tubes, possibly with seirin's and with even insertion (no manipulation, no "obtaining deqi", etc.) - just get the needle in and leave it alone.... Personally I've never had a patient that couldn't handle needling, some we just have to be a bit more adaptable (outside of just the types of needles being used). PC 7, if necessary, is a far better choice than HT 7 or PC 6 in this case.

A heightened sensitivity to needles can be a sign of a couple of things. One is heat, especially Empty Heat. Heat combined with dampness on the skin (in the form a slight sweat at the site you are needling) can make the sensitivity even worse. Another very common factor is an over stimulated nervous system, e.g. a "fight-or-flight" condition which will tend to lead to hyper-reactivity and also to hyper "wei qi responses" such as hives, rashes or swellings with needling. The key is to signal to the brain that the stimulation is not invasive or does not require a strong Wei Qi response. Do this by keeping all touch very calm and slow and by minimizing the prodding or number of needles.

I have treated many clients with needle sensitivity and can recommend the following.

<ul>
<li>Make sure you and your hands are truely relaxed.</li>
<li>Ask the patient to take a big breath and then insert with exhale. Breath in deeply with the patient and exhale as you insert and always use a soft tapping with the tube.</li>
<li>Use the thinnest needle possible; this patient will benefit even from a tiny needle.</li>
<li>Try stroking the point slowly before needling.</li>
<li>Needle the points you think might be the least sensitive first (this might mean you do your back treatment first --beginning with upper back or ST line on leg is especially good).</li>
<li>If the point is wet or sweaty: make sure it is dry. If the patient is not too hot try a cone moxa on the spot first. </li>
<li>The smell of moxa can be extremely relaxing so you might burn a cone or two some where (stay below the waist if the patient has XS or def Heat signs.</li>
<li>Try pressballs in or the ear or even on Yintang first. Try: Master Cerebral, Shenmen, Point Zero; or just gently and slowly tug on the ear for a few seconds.</li>
<li>Use other tools on the points if the patient cannot tolerate the needles. Some choices include: magnets (10,000 gauss), presstacks, non-insertive needles such as teishins, even essential oil on points or taping ear seeds. </li>
</ul>

Remember to keep pt rx simple and to minimize needling in very sensitive areas such as the inner wrist (just do one side or see above).

Good luck!

Suzahne

I never used it, but would laser treatment also be an option in this case?