The Angle, Direction and Depth of Acupuncture needle are the three factors that affect the acupuncture effect and safety. An acupoint is not a so-called “point” but a cubic three-dimension structure. A point on the skin is only a tip of the iceberg of the acupoint. The essential part of the acupoint is under the skin. Therefore it is very important to know how to stimulate the under-skin iceberg.

Angles: There are three kinds of angle that are usually used, the perpendicular (90 degree), the oblique (45 degree) and the horizontal (15 degree). Most acupoints in the trunk can be needled perpendicularly, while the acupoints in the scalp be punctured horizontally. However, there are some acupoints that can be needled at 70 degree, such as the Huatuo-Jiji points can be punctured at 70 degree toward to the spinal column. In addition, the same point can be needled in different angles according to the treatment purpose.  It is therefore safe to say that a right needling angle is the first step to attain a better and safe treatment effect. 

Direction: A right direction can be more important than a right angle. Generally speaking, needles can be put along the direction of a channel, according to the localization of the points.  But even the same point can be needled in different directions based on the purpose of treating different disorders. For example, Taiyang (EX-HN 5) can be used for the treatment of migraine, toothache, facial paralysis, etc. For migraine, needle can be inserted at 45 angle heading to the ear; for toothache and facial paralysis the needle should be inserted downwards under the zygomatic arc. Zhibian(BL-54) can be punctured perpendicularly for sciatica pain, but tilted into 70 degree for urinary bladder retention. Jiache (St-6) can be inserted toward the temporal region for treating temporomandibular joint disorder (TMJD), toward to the mouth for treating facial paralysis, toward the parotid for mumps and perpendicularly for toothache.

Depth: the depth of the point should be needled according to patient’s constitute, age, disease conditions, acupoint localizations or even the seasons when administrating needles. The old-aged people should not be punctured deeply, so the thin and week patients. Acupoints in the head, chest and upper back should be inserted shallowly while in the limbs can be inserted deeply. If the disease is inside the body, needles can be inserted deeply and vice verse. The interesting thing is that needle depth must be different because of the season change. That is because the Qi’s circulation in the body varies according to the alternation of the seasons. In winter and autumn, the Qi is usually hiding inside the body. Therefore, it can be needled deeply, while in the spring and summer, the Qi may stay underneath the skin, so the needling should be superficial. Of course, since deep needling usually produce strong feeling to the patients. For those who are afraid of the needles, shallow needling is a good choice.