The Evolution of the Acupuncture Needle

By Hannah Fries /

The Evolution of the Acupuncture Needle

Say the word “needle” and someone within earshot is likely to cringe. That is, unless, they know the gentle, yet powerful magic and wonder of the acupuncture needle

In tracking the evolution of the acupuncture needle from its origins to its present day incarnation, we inevitably survey the history of acupuncture itself. There are, as is true of most ancient practices, gaps in the story, unknowns that will likely forever remain mysteries. But, we have a general notion of how things went…

The Surprising Neolithic Origins of Acupuncture

“Acupuncture is presumed to have its origins in blood ritual, magic tattooing and body piercing associated with Neolithic healing practices. The Neolithic origin hypothesis is supported by the presence of nonfigurative tattoos on the Tyrolean Ice Man [Ötzi]–an inhabitant of the Oetztal Alps in Europe–whose naturally preserved 5,200-year-old body displays a set of small cross-shaped tattoos that are located significantly proximal to classical acupuncture points."

Many of his 61 tattoos were located at or near acupuncture points traditionally used to treat conditions such as arthritis, heart disease, digestive disorders, and osteochondrosis - all of which Ötzi evidently suffered from. All of this suggests that acupuncture existed long before its emergence as a medical practice in Asia some 2000 years later. This therapeutic tattooing style of acupuncture is still practiced by several cultures, including the Kayan people of Borneo, whose markings resemble those of Ötzi's. It is also prevalent in Tibet, where medicinal herbs are blended into the tattoo inks.

history of acupuncure needles

From Stones to Steel: the Tools of Acupuncture 

Tools used for acupuncture, tattooing, bloodletting, piercing, and abscess draining share similarities and it is possible that initially they may have been the same.” 

In the Neolithic Era (when Ötzi lived), stone and bone needles constituted the first acupuncture tools. In ancient China, stones (i.e., Bian stone) were shaped into therapeutic tools with sharp tips or edges used in bloodletting, incising, and acupressure; these might be viewed as the predecessors to modern acupuncture and gua sha tools. Animal bones and horns, bamboo, pottery, and later metal - such as bronze, iron, tin, copper, gold, and silver - were used to fashion early needles. 

“Usage of bronze needles is dated to 800 BC from the Zhou dynasty, while the gold needles were made during the Han dynasty, around 200 BC.… Reportedly in more recent times spikes of acacia and whitethorn have been used in folk medicine.” 

Ancient Chinese practitioners had nine types of metal needles, originally utilized just over 2,000 years ago. The ‘nine needles’ - explained in the Yellow Emperor’s Classic of Internal Medicine - included: 

  1. a large needle to puncture aching joints and drain interstitial fluid, 
  2. a long needle to penetrate thick muscles and treat chronic rheumatism, 
  3. a filiform ‘threadlike’ needle (this is the primary type currently utilized for acupuncture), 
  4. a round sharp needle to prick swiftly and discharge pus, 
  5. a sword-like needle to drain abscesses and perform surgical procedures, 
  6. a three-edged needle to puncture veins (bloodletting), 
  7. a blunt needle (with a tip like a millet seed) to press along the meridians (‘acupressure’), 
  8. a cylindrical needle with a round tip for massaging, 
  9. and an arrowhead needle to prick superficially and bloodlet

The Modern Acupuncture Needle

The needles of today may be similar in appearance and application to those of the past, but they differ considerably in material, manufacturing, size, and quality. China began using steel in the fourth century AD. Modern needles are, by and large, standardized and sterile single-use disposable filiform needles made of stainless steel. They vary in length (from about 13 to 130 mm) and width (aka gauge, from about 0.12 to 0.50mm). A blind Japanese acupuncturist named Waichi Sugiyama invented the guide tube In the 17th century, which allowed for the production of even thinner needles. And in 1995, the FDA designated acupuncture needles as medical instruments.

Today, there are many different brands of needles for acupuncturists to choose from. In selecting our preferred needles, we take into account: quality and type of materials used (in the needle shaft, handle, and lubricant), sharpening and sterilization methods, production and packaging facilities, and quality control standards. Style of treatment and patient comfort are also essential considerations in needle choice, as the needles used can impact the experience and outcome of treatments. 

The needle is to the acupuncturist as the wand is to the magician, and is wielded just as preciously. 

Our primary and powerful instrument has undergone numerous adaptations since the Stone Ages, and has cycled in and out of the embrace of popular culture across the globe. The acupuncture needle has been modernized alongside the devices of Western medicine, and will undoubtedly continue to evolve with the needs and ingenuity of those who value it.

Hannah Fries is a California-based licensed acupuncturist and herbalist (L.Ac.), writer, and Integrative Body Psychotherapy allied professional. She seeks to discover & alchemize the psycho-emotional and spiritual roots of disharmony in the physical body to help her clients transform the obstacles that interfere with their innate healing capacity. Find out more about Hannah and her work on her website at https://www.friespirit.com or on Instagram @friespirit.

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