Ultrasound Visualization of Radial Nerve Excursion during Acupuncture

Objective: Nerves are likely to be contacted by needles somewhat regularly during acupuncture treatments. However, the effects of this are not well-known or described. The aim of this article is to describe the effects of acupuncture needling to the radial nerve in a single healthy subject. Materials and Methods: In this experiment, conducted at an academic medical center (Washington University School of Medicine in St. Louis, St. Louis, MO), ultrasound-guided acupuncture needling was performed to the radial nerve of one of the authors (C.-T.T.) in the upper arm at acupoint LI 13. The main outcome measures sought were ultrasonic visualization of the nerve during acupuncture needling and the sensations experienced during acupuncture needling of the nerve. Results: The radial nerve was seen to "roll" out of the way when it was needled. Two De Qi responses were elicited en route to the nerve, but, during nerve contact and penetration, minimal-to-no sensation was experienced. Conclusions: Healthy nerves can show side-to-side excursion when needled, and providers and patients cannot know reliably whether or not a nerve has been contacted or penetrated based on the sensations the patient experiences.