Acupuncture Points Notebook

Location Guides:

: Jianwaishu : Outer Shoulder Shu

SI-14 : Hand Taiyang Small Intestine 14

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 13 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

Location:
3 cun lateral to the lower border of the spinous process of T1 (Taodao Du-13). The medial border of the scapula is at 3 cun when relaxed.

Needling:
Oblique medial insertion 0.5 - 1 cun

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


TCM Actions:
Activates the channel and alleviates pain
Expels wind and cold and benefits the shoulder and scapula

TCM Indications:
  • Pain of the shoulder and scapula with cold sensation extending to the elbow, chills and fever accompanied by neck rigidity and inability to turn the head, generalised painful obstruction.

    Neuroanatomy:
    Superficial Innervation: Dorsal scapular from ventral ramus of C5
    Dermatome Segment: C6

    Trigger Point Associations:
    Muscle: Middle trapezius and middle levator scapulae (deep)
    Myotome Innervation: Trapezius: Motor - accessory nerve (CN XI), Sensation - dorsal rami of C2 - C3; Levator scapulae: Cervical nerve (C3 - C4) and dorsal scapular nerve (C5)
    Location Notes: A second levator scapulae trigger point may be located directly above this point, between Jianjing GB-21 and bailao
    Pain Referral Pattern:
    \nMiddle trapezius: to midline around spine at levels of neck and scapula
    \nLevator scapulae: directly superior to this point to the posterior neck and medial portion of the trapezius with some spillover to the medial border of the scapula and the posterior lateral joint of the scapula (around Naoshu SI-10)
    Indications: Myalgia in shoulder region ; Shoulder and neck pain


    Reference Notes: (click to display)