Acupuncture Needles and Needling Techniques

Different types and lengths of needles are used according to the area to be treated or the technique to be performed.

Filiform needles are used for classical acupuncture with a gauge varying from 0.4 mm to 2 mm and length from 40 mm to 100 mm or longer.

Short needles are used for areas on the head and legs and inserted at an angle. Long needles are used on the trunk, neck and fore and hindquarters.

Good quality needles are flexible but strong, have a smooth surface, sharp tip and are made of finest quality stainless steel. In equine acupuncture it is essential to use quality needles as it is not uncommon to have needle breakage from poor quality or overused needles.

Unfortunately most needles available from human acupuncture suppliers are too short or too thin for use on equine patients. Practitioners might try to make their own needles from stainless-steel wire or obtain them from a specialist equine acupuncture supplier.It is important to use appropriate gauge and length of the needle in order to maximize acupuncture treatment benefits and minimize potential problems. For example, one does not want to use a needle that is too long as it might bounced around causing annoyance to the horse, or too short where it cannot reach the appropriate tissue depth.

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Equine acupuncture needles are available for purchase through the Acupucture4Horses Online Shop.

Types of Filliform Needles

Bleeding needles

Needle Insertion Techniques

Use the needle insertion technique that you are most comfortable with. The aim is to insert the needle smoothly and quickly. The most challenging part is piercing through the skin. Once done, the horse does not experience any significant discomfort. The quality and sharpness of the needle is a critical for effectiveness and equine comfort. A poor quality needle, or a wrong choice of needle, is a common obstacle in developing good needle insertion technique. As acu-points vary in their ease of needling, slightly different techniques and types of needles are needed to accommodate the differences. For example, points on the lower legs are more difficult and require short needles.

Take particular care when needling the Hou-san-li (139 R) point as it is a very sensitive point and horses invariably kick.

When inserting the needle, I generally use both hands. Being right handed, I guide the needle with my thumb and index finger of my left hand and insert the needle by pushing and rotating with the right hand.

For more information consult Practical Acupuncture for Horses application.


Angle of insertion

Needles are inserted at different angels in different parts of the body. There are three recognised angles.

  • Perpendicular – This means at an angle greater than 45 degrees to the body surface at the point location.
  • Acute or Tilted – This means at an angle between 30 and 45 degrees to the body surface at the point location.
  • Parallel – This means at an angle less than 30 degrees to the body surface at the point location.


Depth of insertion

Optimum and average depth

To obtain the full therapeutic effect of acupuncture, the needle must be inserted to the proper depth. Optimum depth of insertion will vary according to the size, condition and reaction of the horse to the needle. When the needle is inserted in the right spot and to the proper depth, the De Qi phenomenon should occur.

The Practical Acupuncture for Horses application provides guidance on the average needle insertion depth for each acupuncture point.


The De Qi phenomenon

In humans, this phenomenon is a distinctive sensation, which can be described as tingling, electricity surge or numbness. It is not easy to describe the sensation, which may vary between points. The best way to familiarise yourself with it is to undergo acupuncture treatment by a good human acupuncturist. It is a unique sensation.In a horse the phenomenon of De Qi can be evidenced by the animal’s reactions such as:

  • avoidance
  • lacrimation
  • muscular twitching
  • tail switching
  • vocalisation
  • salivation
  • ears flicking
  • wind passing
  • defecation
  • altered respiration
  • eye movement (similar to nystagmus).


The intensity of the signs varies. They can be very subtle and might vary between sites.  For example, when the needle is inserted in the back, the back will make an obvious movement when the correct depth is reached.  Similarly, in the hindquarters, the tail will be tucked in towards the body when the needle has reached the appropriate depth.  A needle inserted in the forelimb may cause the horse to raise its leg.

The sensation of De Qi or “arriving or capture of Qi” can also be felt by the practitioner.

The practitioner, while inserting and driving the needle into the musculature, can feel grasping of the needle (capture of Qi) by muscular tissue when the appropriate depth is reached.  It is a similar sensation to having a bite on a fishing line.  When one tries to pull the needle out it feels as if it’s secured with “latex glue”.

Sometimes the needle can be inserted to the correct depth without producing the “De Qi” sign.  If the “De Qi” sign cannot be produced at or about the recommended depth, there are some manipulations which can be performed to produce the signs.  In these cases the needle can be partly withdrawn and reinserted at a slightly different angle, either up, down or left, right.  Other manipulations include twisting, flicking, flexing, rubbing or scratching the needle to produce the sign.

Avoiding and Recognising Needle Insertion Problems

Most problems can be avoided by applying common sense, by having a thorough knowledge of anatomy, and by following basic aseptic procedure.The most common problems and causes:

  • Needle breakage:


Most commonly occurs when the horse gets frightened and moves suddenly and/or when a weak and/or overused or poor quality needle used.

  • Needle bending and twisting


Due to muscular twitching and spasm or when the animal moves while being treated. It is quite common especially when a small gauge needle is used.

  • Needle appears to be “grabbed” by the tissue


This occurs when the needle has been twisted excessively and mainly in one direction. Work the needle out slowly by gentle pulling, following the curvature and direction of the needle.

  • Haematoma/bleeding
    Occasionally blood vessels are encountered while inserting the needle.  It is usually not a big problem. The bleeding is easily controlled by applying local pressure to the area.

Methods of Needle Stimulations

The actual needle stimulation method will depend on many factors. The experience of the practitioner plays a major role. Other factors are – the type of disease and its duration; and the sensitivity and condition of the horse.

My advice is that one should not be concerned too much with the different methods of needle stimulation at the beginning of learning acupuncture; leaving the needle in situ will give very satisfactory results in most cases.

For more information consult Practical Acupuncture for Horses application.

NOTE: It is not always possible or safe to manipulate the needle especially on sensitive patients or on horses’ legs.  For a sensitive animal it is safer to leave the needle in situ.


Leaving the needle in situ

Generally, for most conditions it is sufficient to insert the needles and leave them in situ for 15- 20 minutes.

The purpose of leaving the needle in is to either wait for the “Qi” or to regulate the “Qi”. Leaving the needle in will help to regulate and support the “Qi”.

In the case of a weak “De Qi” sign, the needle can be manipulated in order to invoke the “Qi” to come to the point.