Once inserted, the needles are left in place between 5 and 45 minutes.
To 'add energy into the system' (for depleted/yin states), needles can be manipulated by:
Quickly rotating with the fingers
Applying a nearby heat source
Infra-red heat
Moxibustion - burning of the herb mugwort
Attaching an electrical stimulator device
Needles can be used to sedate excess (yang states) by dabbing the coiled handle with alcohol, or leaving it in place for a few minutes then removing.