*4.4.1 Manipulation*

After inserting the needle, if the needle is directly inserted into the muscle, the patient will feel soreness, and the practitioner's hand that is holding the needle may also feel the resistance at the same time. In this case, the practitioner should pull the needle handle with the thumb, index finger, and middle finger slowly backward out of the muscle layer and back to the subcutaneous layer.

After confirming the needle tip is inside the subcutaneous layer, the practitioner can put down the needle body, and then prepare for the manipulation. During which, the practitioner holds the needle with the right hand and pushes the needle forward along the subcutaneous layer. It is better to raise the needle tip slightly up when pushing so that the tip is slightly tilted, making sure the needle does not penetrate into the muscle layer. When the needle is being pushed forward, the skin is lined up. During the process, if the patient feels sudden tingling or the practitioner feels sudden resistance, it is usually because the needle tip penetrates the blood vessel wall. Therefore, the needle manipulation process should be as slow as possible. When the practitioner feels the resistance before the patient feels pains, it is better to quickly withdraw the needle slightly, and then adjust the needle direction upward or downward to avoid causing pains to the patient.

**Figure 4.** *Gesture for holding inserting device.*

#### **Figure 5.**

*Before inserting the needle, the positional relationship between the inserting device and the skin.*

Generally, it is suggested to go as deep as all soft tube being under the skin. In some other cases, if the needle is inserted near the side of the finger joint or other facet joints, the soft tube need not be fully embedded subcutaneously.

#### *4.4.2 Sweeping movement*

### *4.4.2.1 Manipulation*

When the needle is in the correct position, with the left hand fixing the soft tube seat, the practitioner can use the right hand to recede the core needle and fix the protuberance of the soft tube seat in the slot of the core seat. At this time, the needle tip is no longer exposed outside but has returned to the soft tube, almost in line with the soft tube.

Then it is ready to perform sweeping movement. The inner nail margin of the right thumb and the middle finger is used to hold the core base, the index finger and the ring finger are separated on the left and right sides of the middle finger, and the tip of the thumb is fixed on the skin as the fulcrum. The index finger and the ring finger sweep in a seesaw-like sector one after the other. The scope of sweeping movements is better to be as large as possible, with stable speed and enough power, and sweeping rhythm should be slow so as to avoid the feeling of numbness, swelling, and pain. During the sweeping process, it is suggested to use the right hand to operate, while the left hand cooperates with reperfusion approach (**Figure 7**).

**31**

**Figure 8.**

*Types of sweeping movement.*

sweeping.

**Figure 7.**

*The swaying movement.*

accompanied.

**4.5 Reperfusion approach**

*Fu's Subcutaneous Needling: A Novel Therapeutic Proposal*

*DOI: http://dx.doi.org/10.5772/intechopen.84251*

*4.4.2.2 Types of sweeping movement*

divided into the following two categories:

According to different ways of swinging the needle, the sweeping movement is

a.Horizontal sweeping movement: The sweeping action of the needle tip is at the same horizontal level, which can save strength and is used more often. It can be used in most cases. Right now, with the cooperation of reperfusion approach,

b.Sweeping movement in an elliptical circle: The solid needle moves clockwise or counterclockwise under the skin to perform a circular or oval movement, appli-

Each needling point can be swept for 2 minutes with a frequency of 200 times per minute. Practitioner can check and assess muscle tension after 30 seconds of

During the FSN manipulation, reperfusion approach targeting PTMs is

horizontal sweeping is mostly used during clinical practice.

cable for intractable diseases (see **Figure 8**).

*4.4.2.3 Time and frequency of sweeping movement*

**Figure 7.** *The swaying movement.*

*Acupuncture - Resolving Old Controversies and Pointing New Pathways*

Generally, it is suggested to go as deep as all soft tube being under the skin. In some other cases, if the needle is inserted near the side of the finger joint or other

When the needle is in the correct position, with the left hand fixing the soft tube seat, the practitioner can use the right hand to recede the core needle and fix the protuberance of the soft tube seat in the slot of the core seat. At this time, the needle tip is no longer exposed outside but has returned to the soft tube, almost in line with

Then it is ready to perform sweeping movement. The inner nail margin of the right thumb and the middle finger is used to hold the core base, the index finger and the ring finger are separated on the left and right sides of the middle finger, and the tip of the thumb is fixed on the skin as the fulcrum. The index finger and the ring finger sweep in a seesaw-like sector one after the other. The scope of sweeping movements is better to be as large as possible, with stable speed and enough power, and sweeping rhythm should be slow so as to avoid the feeling of numbness, swelling, and pain. During the sweeping process, it is suggested to use the right hand to operate, while the left hand cooperates with reperfusion approach (**Figure 7**).

facet joints, the soft tube need not be fully embedded subcutaneously.

*After inserting, the right hand is fixed, and the left hand pinches the needle.*

*Before inserting the needle, the positional relationship between the inserting device and the skin.*

**30**

*4.4.2 Sweeping movement*

*4.4.2.1 Manipulation*

the soft tube.

**Figure 5.**

**Figure 6.**
