Needling the acupoint – Options and permutations

“Nature spontaneously keeps us well. Do not resist her!” — Henry David Thoreau

By John Russo Jr./

VICUS.COM (16 Aug. 2000) — Raise and thrust, twirl and rotate, pluck, scrape and tremble.

Once the acupuncture needles are in place, manipulation to achieve the desired effect can take many forms. Needling is typically accomplished through physical manipulation of the needles.

Alternatively, a range of techniques (see table) are used to stimulate acupoints that may appear exotic and, perhaps, even puzzling. They include,in order of most frequently used to least frequently used, auriculotherapy, electro-acupuncture, acupressure, reflexology,
cupping and  moxibustion.


Auriculotherapy, or ear acupuncture, is a form of acupuncture developed in France following World War II.

It is based on the observation that the ear has many acupuncture points that correspond to parts of the body. During treatment, these points on the outer ear, or auricle, are stimulated using a small electronic pulse or by applying pressure with the forefinger and thumb. The ear being treated may turn red or blush.


Electro-acupuncture is the term given to the use of very small electrical impulses through the acupuncture needles. The power used is only a few microamperes, but the frequency varies from 5 to 2,000 Hz, depending on the condition being treated.


Acupressure is essentially acupuncture without needles. The acupressurist works with the same acupoints, but stimulates these healing sites using finger pressure, rather than inserting fine needles. Stimulation of the acupuncture points is performed with the fingers, knuckle or an instrument with a hard, ball-shaped head (like a pencil eraser).


Reflexology (also called Zone Therapy) is a variation of acupressure where the soles of the feet, certain regions of the ankle joints and sometimes the hands are stimulated.

In 1913, Dr. William Fitzgerald, an American ear, nose and throat surgeon, noted that pressure on specific parts of the body could have an anesthetizing effect on a related area. He divided the body into 10 equal and vertical zones, ending in the fingers and toes. He concluded that pressure on one part of a zone could affect everything else within that zone.

Thus, reflex areas on the feet and hands are linked to other areas and organs of the body within the same zone.

In the 1930s, Eunice Ingham further developed and refined zone therapy into what is now known as foot reflexology. She observed that congestion or tension in any part of the foot mirrors congestion or tension in a corresponding part of the body.

For example, when you treat the big toes there is a related effect in the head, and treating the whole foot can have a relaxing and healing effect on the entire body.


Cupping is a method of stimulating acupuncture points by applying suction through a metal, wood or glass jar, in which a partial vacuum has been created. This technique produces blood congestion at the site, which is thought to stimulate it.

Two types of cups are used: traditional and vacuum. Traditional cups use a flame to create a vacuum, while the vacuum cups use a pump.

Vacuum pumps are safer and more commonly used today.

The endpoint of treatment is a deep dark purple color of the skin. The procedure takes about 20 minutes. The purple color usually goes away in about 24 hours.


Moxibustion is a form of thermotherapy that stimulates the body by burning a small amount of moxa, the dried and processed leaves of the mugwort (also known as wild chrysanthemum).

At one time, this was done by burning the moxa on the skin. In recent years, the moxa has not been placed directly on the skin.

Rather, the heat from burning moxa is transmitted to the skin indirectly through needles or other devices. Acupuncture and moxibustion are complementary forms of treatment, and are commonly used together.

Table. Alternatives to traditional acupuncture,
in order of most frequently used to least frequently used

Technique Description
Auriculotherapy Auriculotherapy is the process of stimulating the acupuncture points on the outer ear, or auricle.
Electro-Acupuncture The use of minute electrical impulses through the acupuncture needles.
Accupressure An acupressurist works with the same points used in acupuncture, but stimulates these sites using finger or knuckle pressure, or the pressure of an instrument with a hard, ball-shaped head (like a pencil eraser).
Reflexololgy A variation of acupressure where the soles of the feet, the posteroinferior regions of the ankle joints, and sometimes the hands are stimulated.
Cupping A method of stimulating acupuncture points by applying suction.
Moxibustion The process of applying heat from burning moxa to acupuncture points.


John Russo Jr., PharmD, is senior vice president of medical communications at He is a pharmacist and medical writer with more than 20 years of experience in medical education.

This article was updated on 16 Aug. 2000.


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