華佗夾脊 : Huatuojiaji : Hua Tuo's Paravertebral Points

Location Guides:

Classifications:

Paravertebral points (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)
Trigger points (Travell & Simons, 1998, Trigger Point Manual) at levels of C5 and C7

Meetings:

Meeting of Extra Back/Waist with Bladder Divergent

Location:

0.5 - 1 cun lateral to the depressions below the spinous processes of the twelve thoracic vertebrae and five lumbar vertebrae. In clinical practice the points located 0.5 - 1 cun lateral to the depressions below the spinous processes of the seven cervical vertebra are also used as additional Huatuojiaji points.

Needling:

Perpendicular-oblique insertion towards the spine, 0.5 - 1 cun.
The intention of needling these point is to stimulate the appropriate spinal nerve. The superficial location, depth and angle of needling are chosen to give easiest access to these points.

TCM Actions:

Regulates and harmonises the five zang and six fu

TCM Indications:

• C1 - C7 treats disorders of the neck
  
• T1 - T4 treats disorders of the lung and upper limb
  
• T4 - T7 treats disorders of the heart
  
• T7 - T10 treats disorders of the liver and gall bladder
  
• T10 - T12 treats disorders of the spleen and stomach
  
• L1 - L2 treats disorders of the kidneys
  
• L3 - L5 treats disorders of the bladder, large and small intestines, uterus and lower limbs
  
• All the Huatuojiaji treat herpes zoster at the level of the affected segmental nerve and pain and stiffness in the local area

Neuroanatomy:

Superficial Innervation: Rami of spinal nerves

Dermatome Segment: C3 - S3, depending on level

Trigger Point Associations:

Muscle:
C5 & C7: Spenius cervicis deep to trapezius

Pain Referral Pattern:
C5 upper splenius cervicis: To outer canthus of eye.
C7 lower splenius cervicis: To top of trapezius and base of neck

Indications:
Pain in back, neck, head or eyes depending on location

Martial Applications & Effects of Injury:

See Montaigue, Dim Mak Locations, Taijiworld.com for explanation of effects.

Notes:

The Bladder Divergent channel travels along the Huatuo points between Pangguangshu Bl-28/S2 and Xinshu Bl-15/T5 (Cecil-Sterman, 2012, Advanced Acupuncture).

According to Ma, Ma & Cho (2005) these points can be used for their segmentary actions on dermatome and myotome and sections as well as effects on the organs they innervate. Their list is as follows:

Dermatomes, myotomes and sclerotomes:
Upper extremity (including shoulder): C4 - T1
Lower extremity (including hip): T12 - S3
Trunk: Regular segmental pattern from C5 - S2
Diaphragm (myotome only): C1 - C5
See diagrams of dermatome segments and sepecific myotome actions (below) for details.

Organs:
Heart: C2 - C5, C8 - T5
Lungs: C2 - C5, C8 - T7
Spleen: C2 - C5, T5 - T9
Stomach: C2 - C5, T4 - T10
Duodenum: C2 - C5, T4 - T11
Pancreas: C2 - C5, T4 - T11
Liver/Gallbladder: C2 - C5, T4 - T9
Proximal Colon: C2 - C5, T4 - L1
Distal Colon: T11 - L2
Kidney: C2 - C5, T9 - L1
Bladder: T10 - L2, S1 - S4
Uterus: T10 - L2, S1 - S4

Specific mytome actions:
(Magee, 2006, Orthopaedic Physical Assessment, 4th ed.)
C1/C2-neck flexion/extension
C3-neck lateral flexion
C4-shoulder elevation
C5-shoulder abduction
C6-elbow flexion/wrist extension
C7-elbow extension/wrist flexion
C8-thumb extension
T1-finger abduction
L2-hip flexion
L3-knee extension
L4-ankle dorsi-flexion
L5-great toe extension
S1-ankle plantar-flexion
S2-knee flexion

According to Jeffrey Yuen (2005, The Eight Extraordinary Vessels) these points are on the third trajectory of the Du mai as it travels down the sides of the spine until L2 where it moves out to Shenshu Bl-23 and enters the Kidneys.

Lad and Durve (2008) in Marma Points of Ayurveda locate a point called Krikatika at the Huatuojiaji points level with C2. They associate them with Prana Vayu, Udana Vayu, Kledaka Kapha and Avalambaka Kapha and have the following actions:
- Benefits the head, neck and and ears
- Relieves pain locally, relieves headaches
- Relieves tension, stress and emotions
- Benefits the lungs and stimulates bronchodilation

They locate a further eight points (4 each side) at the Huatuojiaji points level with C3-C6 called Griva, associated with Tarpaka Kpha, Bodhaka Kapha, Kledaka Kapha, Udana Vayu, Apana Vayu, Samana Vayu and Pachaka Pitta with the following actions:
- Relieves pain locally, relieves headaches
- Relieves stress and tension
- Enhances circulationof plasma and lymphatic fluid
- Benefits the throat
- Regulates thyroid and parathyroid functions

Another six points (3 each side) called Prushtha or Antar Masa are located at the Huatuojiaji locations level with T3, T4 and T5, or Feishu Bl-13, Jueyinshu Bl-14 and Xinshu Bl-15. They are associated with Prana Vayu, Vyana Vayu, Udana Vayu, Sadhaka Pitta and Avalambaka Kapha and have the following actions:
- Regulates functioning of heart and lungs
- Relieves bronchospasm and lung congestion
- Relieves local pain
- Calms the mind, releases stagnant emotions

Another marma point called Vrukka level with T12 or Weishu Bl21 is associated with Apana Vayu and Vyana Vayu and has the following actions:
- Regulates the functioning of the kidneys, adrenals and bladder
- Regulates glomerular function (renal filtration)
- Pacifies renal pain and low backache.

They also note that the Huatuojiaji from T10-T12 are used to treat disorders of the spleen and stomach, and those at L1-L2 for kidney disorders.

Kukundara is another point located at the Huatuojiaji level with L5 and Guanyuanshu Bl-26. It is associated with Apana Vayu and Vyana Vayu and has the following actions:
- Benefits kidney and bladder functions
- Regulates colon activity
- Relieves pain locally
- Balances apana vayu

Reference Notes:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here