Quantity
LOBAS, large quantities of needles in a single session | can often turn a floaty experience into an endurance test, for the Top and the bottom)
Placement
More sensitive/painful parts of the body - face or head, feet, and hands, etc.
Size
Larger gauge needles, also in conjunction with flesh hooks and skewers, longer length needles)
Intensity (External Force or Intense Manipulation of the Needle
Impact play over or on them
Twisting or Pulling on them
Hanging weights from them
Using the needle as an anchor for bondage to something or someone
Suspension