Q: I’ve had two acupuncture sessions recently, my first ever. I’ve found that the needles put in my toes are really painful and just wondered if this could be indicative of anything? I should add I’m 9 months pregnant. 

A: At the risk of sounding facetious we would be quite surprised if needles in the toes didn't hurt. While the vast majority of points on the body (there are 365 main ones and dozens of recognised 'extra' points) do not cause much sensation when they are used, the ones near the toenails and at the base of the toe can fee disproportionately painful when they are needled. We say 'painful' but in many cases it isn't quite pain so much as a very intense feeling which seems altogether too much for what is a small needle.

 Part of the explanation for this comes from the way that the energy of the body circulates. The anatomical position is very similar to that famous Da Vinci cartoon of the man with his arms and legs outstretched. When energy travels to the ends of the arms and legs and returns it has a kind of slingshot effect as it recoils, which means that points on the extremities have a great deal of kinetic potential. When they are needled it is like a surge of energy. What people often describe as a dull ache or mild tingling for most points can feel like a very large nail sending a shockwave along the limb. Fortunately it is usually very shortlived, and most people acknowledge that the short measure of discomfort is more than offset by the benefits of treatment.

However, if it really more than you can take at this stage of your pregnancy then your practitioner should be able to use other less painful points to achieve much the same effect, or use the tried and trusted ways of making treatment more benign - fewer needles, shallower insertion, less manipulation.

Hope all goes well with the birth!