Points Database

Location Guides:

: Jianjing : Shoulder Well

GB-21 : Foot Shaoyang Gall Bladder 21

Classifications:
Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)
Homeostatic point 3 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

Meetings:
Meeting of Gall Bladder with San Jiao, Stomach and Yang Wei Mai

Location:
Midway between Dazhui Du-14 and the top of the acromion, at the crest of the trapezius muscle.

Needling:
Posterior oblique insertion 0.5 - 1 cun. Pinch up the muscle with one hand and insert with the other to get deeper into the muscle without running the risk of inducing a pneuomothorax.

Warning:
Perpendicular insertion, especially in thin patients carries a substantial risk of inducing a pneumothorox. Contraindicated in pregnancy.


TCM Actions:
Regulates qi, activates the channel and alleviates pain
Transforms and lowers phlegm and dissipates nodules
Benefits the breasts and expedites delivery

TCM Indications:
  • Stiffness and pain of the neck, pain of the shoulder and back, inability to raise the hand and arm, hemiplegia.
  • Loss of speech following windstroke, windstroke, wind-taxation, the five taxations and the seven injuries, steaming bone disorders, Kidney deficiency lumbar pain.
  • Cough and dyspnoea, rebellion of qi, mania-depression, redness of the face.
  • Scrofula, goitre, leg qi ascending to attack the Heart, pain of the Spleen.
  • Difficult or prolonged labour, inversion counterflow of the arms and legs following miscarriage, retention of the placenta, uterine bleeding.
  • Breast pain, breast abscess, breast milk does not flow, furuncles and carbuncles.

    Neuroanatomy:
    Superficial Innervation: Supraclavicular nerve from C3 and C4
    Dermatome Segment: C3, C4
    Deeper Structures: Neuromuscular junction of spinal accessory nerve (CN IX) into trapezius muscle

    Trigger Point Associations:
    Muscle: Upper trapezius 1
    Myotome Innervation: Motor - accessory nerve (CN XI), sensory - dorsal rami of C2 - C3
    Pain Referral Pattern: Superiorly along the trapezius into the occiput and to a lesser degree across the side of the head to the temple and the angle of the mandible
    Indications: Shoulder, arm and neck pain ; Headache ; Stiff neck ; Cardiac syndromes

    Notes:
    Very common point in the treatment of tight neck and shoulders.

    One of the 18 tender spots used in the diagnosis of fibromyalgia (Wang, Acupuncture and Traditional Chinese Medical Approaches for Fibromyalgia, Acupuncture Today, vol.6 no.3, 2005).

    Named "shoulder well" due to its location on the shoulder and its ability to open all the Jing Well points of the fingers, especially when cupped (Yuen, 2004, Divgent Channels, p.77). Huantiao GB-30 (or Fengshi GB-31 if the client feels uncomfortable with cupping on their buttocks) does this for the lower Jing Well points.

    In ayurvedic medicine:
    Ansa marma point
    Size: 1/2 angula (cun)
    Structure: Ligament
    Effect of Injury: Disability (vaikalyakar marma)
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, Marma Shastra)

    Lad and Durve (2008) in Marma Points of Ayurveda call this point Urdhva Skandha and associate it with Prana Vayu, Udana Vayu, Vyana Vayu, Avalambaka Kapha and Shleshaka Kapha.

    They give the following functions:
    - Relieves local pain
    - Relieves stiffness in the shoulder
    - Facilitates the flow of prana into lungs and upper chest
    - Relieves occipital headaches
    - Relieves stress, calms the mind
    - Releases stagnant, unexpressed emotions

    In Tibetan medicine:
    Moxa point (AMNH, Tibetan Medical Paintings)

    In Thai massage:
    Acupressure point (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)



    Reference Notes: (click to display)