Thoughts on Needle Gauges

dcantor: April 15, 2019, 11:56pm
Thought I’d share my experience so far with needle gauges and would be curious to hear others’ take on this. I
have been using .25 down to .18 needles and have had a lot of clinical success with this method over the last 9
months – both immediate and prolonged results. I’m precise with needle placement and careful to get a good
connection between the needle and the fascia – “binding the fascia” as others have mentioned – and I’ve found the
stimulation/connection to be more important than needle thickness. I think it is easier to get that connection for
some patients with bigger needles, but interestingly, for at least one patient in particular, I’ve found that the sense
of connection at the acupoints and the overall impact of the treatment is better with thinner needles.
There are times that I haven’t gotten the result I wanted or hoped for and have wondered if the patient’s response
might have been better with thicker needles…but then I think about all the times the treatments have been
successful without them, and usually conclude that my diagnosis was incorrect or there was something else
limiting the patient’s response. That said, I of course appreciate and respect the information passed down to Toby
from his teacher, who recommended thick needles. And I’ve observed Toby providing treatments with .4 needles
and it’s not like patients are screaming in agony or jumping off the table, which was good for me to see! Patients
were peaceful and calm, and the more sensitive ones found ways of dealing with the momentary discomfort.
What have you all found in trying out different needles with this system?

KristinWisgirda: April 17, 2019, 1:55pm
Hi @dcantor,
This is such an interesting area for discussion. I totally agree with you that connection is of utmost importance.
I recently met a practitioner who was getting great results with Sa’am using teishin on her pediatric patients. I
started out using .18 and .25 needles with enough outstanding results to convince me to learning more. But I also
had enough failures, and at least 1 case where needle gauge clearly made all the difference, to make me want to
reduce the variables and follow the system as closely as possible to the way Toby teaches it and practices it.
I am surprised how comfortable larger needles can be as I have been my own guinea pig. My self proclaimed
sensitive patients are tolerating them just fine.
Binding the fascia doesn’t have to be a crude practice at all, like you have mentioned. My experience is that a
thicker needle often the needle grabs with a tiny rotation or sometimes almost no stimulation at all.
Toby definitely has finesse with the large needles. The patients I’ve seen him treat were peaceful and calm under
his care for the most part.
Toby says that who is needling is of utmost importance. By extension, maybe how comfortable the practitioner
making connection with his/her tools makes a big difference too.
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Donley: April 18, 2019, 4:28am
As a total newbie to Sa’am (only 4 treatments so far) I am intrigued with all the qiological episodes and all the
conversations in here. I have been wondering though, Are you guys needling freehand or with guide tubes? How
long are the needles you are using (aside from the Jing Wells)?
Thanks for the stimulating conversations!

michaelmax: April 18, 2019, 1:18pm
KristinWisgirda:
Toby says that who is needling is of utmost importance. By extension, maybe how comfortable the practitioner
making connection with his/her tools makes a big difference too.
Indeed I’ve found this to be true. If I’m comfortable and feel a sense of ease in needling “difficult” points, then the
patient will also have more ease. If I nervous about it or mention this will hurt then it is a less positive experience
all around.
How we are affects our patients. And it is our job as acupuncturists to “do our job.” Which means learning to get
comfortable with needles and a style of needling not that “we like” but rather that is “right and helpful for the
patient.”

dcantor: April 18, 2019, 6:04pm
@Donley for me, I’ve been mostly free-handing, and usually use 40mm and 30mm

ngmatthews: October 4, 2021, 5:15pm
After attending the workshop in Seattle with Toby, I switched from Red Seirins to Purple, which I think are 32 g.
Sometimes I’ll use browns. I use 30 mm with guide tubes for a lot of points, and 15mm freehand for points like Bl
66 and SI2 where I really want to get a very flat transverse angle. I don’t do a lot of twirling, because it seems like
Seirins don’t pick up fascial threads very well. I get strong Qi on all my insertions. Mostly I am threading needles
about 1/4 to 1 inch or more very transverse, like 15 degrees. I am happy with the results. Sometimes I’ll use red,
yellow, or blue 15 mm Serins on SI 2 and Bl 66 but I actually think that smaller gage needles can feel sharper to
the patient. I had used only Red Seirins for 15 years till I studied with the Engaging Vitality folks. Then I switched
to Light Greens, but they don’t really provide the Qi needed for Saam. After being treated by a friend who used a
lot of Purples painlessly, I realized that thinner is not necessarily more comfortable. Toby does not use Seirins that I31/01/2024, 11:22Thoughts on Needle Gauges – Sa’am Clinical Insights – Qiological Community
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know of and I hope to get as good technique as he has so I can use other brands painlessly. For now, I’ll stick to
Seirins.

Donley: April 22, 2019, 2:30am
Thanks for your insights @dcantor & @ngmatthews . I’m about to place a new order of TeWa needles so your
methods are nice to know.

michaelmax: April 25, 2019, 9:45pm
the non-coated needles make it easier to grab the muscle fibers and bind them up.

Adina_Kletzel: June 20, 2019, 8:54pm
Can someone please recommend an excellent brand of non-coated needles to use and also where I can order then in
the States?
THank-you so much!

ngmatthews: October 4, 2021, 5:15pm
Seirins are not coated. Everyone has them. I get them from Lhasa.

dcantor: June 25, 2019, 8:36pm
I believe seirins are silicone coated, no?

ngmatthews: October 4, 2021, 5:15pm
I spoke to a rep at Lhasa about this. He said that Seirin stopped coating their needles a long time ago.31/01/2024, 11:22Thoughts on Needle Gauges – Sa’am Clinical Insights – Qiological Community
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Adina_Kletzel: July 7, 2019, 10:08am
Hi,
Until Toby arranges an order of the needles using his specs what brand of needles do you recommend that I order
and from where?
Thank-you

KristinWisgirda: July 8, 2019, 12:23am
The thickest I have been able to find in stock are from Lhasaoms: Kingli .35mm diameter x25mm length, .30mm
diameter x13mm length for jing wells-; Huato 40x40s. I use tubes and haven’t researched needles for free handing.
When I run low, I’ll look around to see what other options are around.
I do sometimes use .22mm or .25mm diameter for jingwells and .30 diameter for body points on sensitive patients.

Taran: July 8, 2019, 1:24am
Golden Needle has EACU CB .40×25, .40×40, .40×50, .40×60 in stock. I have not worked with these needles, so I
cannot vouch for them.