Acupuncture needles are extremely small, and very often completely painless going into the skin. We like to say that in general, if there is any ‘ouch’ at all, it is ‘less than having your hair pulled’. Many people do not even realize a needle has been inserted until they ask. There may be a sensation surrounding the needle once it is in place – a tingle, itch or heaviness; interesting but not painful. This is the Qi coming to the needle. If this happens it means the needle is in the right place and things are working! The needles are solid, not hollow, and nothing is ever injected through them. In the US it is mandatory to use only presterilized, single-use needles, which are then discarded and never re-used.