It is essential to learn to insert the needles skilfully. This takes a little practice; the technique is best learned by trying it out on oneself! (The forearm and side of the thigh are convenient sites to use.) The secret is to penetrate the skin QUICKLY, without hesitating (intradermal needling is generally painful). Seirin needles are very sharp and go in quite easily in most people, but in the case of the longer (50 mm) needles it is necessary to steady the shaft with a finger to stop it bending. Some people tend to spin the needle a little as they insert it with a slight drilling action. The skin is kept taut with the hand that is not holding the needle.
After the needle is inserted through the skin (perhaps to a depth of 15 mm, 1/2 inch) you should pause for a few seconds to assess the effect on the patient. There is normally a moment’s pain as the needle penetrates the skin but this should pass off quickly. If not, take the needle out and reinsert it a short distance away. Throughout, watch the patient’s face and keep asking what he or she is feeling.
If there is no particular effect after the initial insertion of the needle, try a little light stimulation. This consists in twirling the needle back and forth, with a watch-winding action. Two or three turns in each direction are enough at first; then stop and see what happens. If there is still no response, give a little more stimulation, perhaps a little more strongly.
At least on a first occasion, this is enough! Take the needle out. The whole sequence has lasted from 1 to 2 minutes, perhaps less. It may seem very little, but often it is quite enough.
Throughout the whole treatment process, you should keep asking the patient what he or she is feeling and watch his or her face to assess the effect. Always err on the side of doing too little rather than too much!