Acupuncture needle sensations associated with De Qi: a classification based on experts' ratings

Many English language words have been used to describe the acupuncture needle sensation known as de qi, words such as dull, aching, and spreading. However, there is little agreement on which actual words are acceptable as descriptors. In experimental trials of acupuncture in which the needle sensation is an important variable, a quantitative measure is needed to monitor and control for variability in de qi.

An established scale in the literature provides a list of 25 sensations associated with acupuncture needling that patients might experience. An international group of acupuncture experts rated these 25 sensations in two categories: those predominantly associated with de qi and those with acute pain at the site of needling. For each category, sensations were classified into hierarchic clusters, one for de qi and one for acute pain, and the results were presented in dendrograms.

Twenty-nine international experts were invited to participate; 22 (76%) responded and 20 completed the questionnaire. On average, they had 21 years' experience in acupuncture practice (range 10-30 years). Seven sensations were found to be in the cluster associated with de qi: aching, dull, heavy, numb, radiating, spreading, and tingling. Nine sensations were found to be in a cluster associated with acute pain at the site of needling: burning, hot, hurting, pinching, pricking, sharp, shocking, stinging, and tender. The experts also raised a number of issues regarding the limitations of the questionnaire used, providing useful data for future research.

Data from experienced acupuncturists have been analyzed to provide two separate clusters of sensations associated with acupuncture needling: a de qi cluster and an acute pain cluster. In the design of experimental trials involving acupuncture needling, researchers will find these two clusters of sensations useful for monitoring and controlling for variation in needle sensation.