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Guide tubes vs free needling for accuracy?


#1

Hi all. Im curious to hear your needling method?

In college we have to use guide tubes with the clean needle technique, but have done some free needling with certain lecturers.

What is your preference? Is it just me, or does anyone else share the thought that plastic guide tubes that the needles come with are very innacurate at times? I have noticed on most occasions that after tapping the needle, rather than breaking the skin in the center of the tube hole, it enters the skin at the side of the tube, possibly missing the point?

Theres something seen in the skill of being able to insert a needle painlessly. what are your methods?

How big are actual acupuncture points width wise? are they the same as a standard guide tube hole?

Alot of questions :-) Eager to learn what works best for you :-)

Regards,

CC


#2


Yes, free nedleing is more acurate, but guide tube are better at preveting pain on isertion. The hardest part about free needleing is getting past the outer dermal layers without hitting a nerve ending.



Acupuncture points vary in size. LU9 and HT7, for example, are both very shallow and in small spaces. The indentation for SP6 is much bigger, allowing for more flexability.


#3

I believe it is more personal preference than anything. I&#39ve seen highly skilled practitioners use either method and have never been able to see a difference clinically amongst good practitioners. There are some tricks, however. Needle pain generally comes not passing through the outer layers of the skin (the only place there is sensation) quick enough which the tube circumvents by passing it as quickly as possible through this area. Beginners tend to needle slowly which will only bring about pain to their patients. Tube or no tube you need to needle quickly - past the first couple mm or so at least. For free needling it helps to choke up on the needle (some, even though CNT might not like it, hold up even to the point where they want the needle to go - that is on the body of the needle itself) - then just put it in like a dart (or as one of my teachers says like the "strike of a lion").


As far as accuracy to say free needling is more accurate would discount entire systems of acupuncture, particularly Japanese (where tube needling is commonplace) and I&#39m not about to do that. The key to accuracy with the tube is to hold the needle somewhat firmly against the tube so that the needle is held out the other end, then place the needle exactly where you want it to go (i.e. rest it on the skin), then release the pressure on your other hand and tap it in - it will be very accurate each time. Certainly just putting it in the tube and setting the tube on the skin and tapping the needle through will not be extremely accurate.


As an aside, It&#39s interesting that your school uses tube needling and that you mention it with regards to CNT. Free needling or tube needling is irrelevant to the clean needling technique discussion and your school should be teaching you effective ways to do both. The school I attended, for example, didn&#39t allow tube needling at all - except in the Japanese program.


#4


Thanks for the quick response everyone.



Yes Chad, my school insists on guide tubes whilst in school clinic. Although that is just through one lecturer(the power that be) All our other lecturers dont use tubes themselves and encourage free hand needling.



I have found the japanese metal guide tubes to be much thinner than plastic tubes which come with needles, therefore be very accurate.


#5

A teacher once told me it is not the brush that paints a beautiful painting but the hand that wields it.


Small town doctors use jelly jars for cupping technique plays the biggest role.


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