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Clinical Pearls for the Massage Therapist: Learning and Using Acupuncture Back-Shu Points

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By Mark Anthony Kestner, DC, FIAMA, CCSP, CSCS

Mark Anthony Kestner, DC, FIAMA, CCSP, CSCS, maintains a private chiropractic and acupuncture practice in Murfreesboro, Tenn. He is team chiropractor for a NCAA 1-A athletic program and treats amateur, recreational and professional athletes.

Imagine that while working with a new client you observe a mild, erythamatous dermatitis. She has broad areas of red, dry skin. You question her about it and she tells you that she has seen her primary care physician, a dermatologist and a cosmetician with little help. The redness started seven years previously, and she relates no association with any illness, food sensitivity, allergic reaction or other cause.
She says she has tried "lotions, potions, creams and screams." This is the actual history of a patient that came to see me for neck and back pain a decade ago. She did not expect me to be able to help her with her skin condition, as no one else had. Truthfully, I had no expectations of helping her with it either. I accepted her for treatment of her complaints of neck and low back pain.

As I examined her spine, I noticed that she had several specific areas of tenderness in her thoracic area not directly associated with her primary complaints of neck and low back pain. I had taken postgraduate seminars in kinesiology and trigger point therapy, so I treated the tender thoracic areas as well as her cervical and lumbar spine. After several spinal adjustments her complaints of neck pain and low back pain resolved, as did the other tender areas. I asked her to return for a follow up visit in one month.

When she returned, she asked me to examine her back. When I did, I saw that the skin had healed completely. Her dermatitis had disappeared. She asked me what I had done to "cure" the dermatitis. That was my introduction to the back-shu points of acupuncture. As I searched to discover the reason for her healing response, I discovered that the points I had been treating manually were associated with the lung and liver meridians. Specifically, the points were known as the back-shu points for those meridians, otherwise known as associated points.

For each of the twelve primary energy meridians that flow throughout the body, there are two powerful points located along each side of the spine. These points lie on the bladder meridian, and link to the Du or governing vessel meridian. Chi is infused into the corresponding organ meridians through these points. There is a close association between these points and the spinal ganglia. Meridian points have been shown to affect the functioning of the neurological system. When an organ is impaired, or the respective meridian is blocked or deficient, it is common for the back-shu point to be tender. It is also possible that you will observe a solitary pimple or other skin reaction at the point. For this reason, the back-shu points are also considered to be of diagnostic significance.

As you work with your client, it is a simple matter to routinely examine and palpate the back-shu points. Note any that are tender or show other signs of reaction. Any that are reactive should be stimulated. The points can be stimulated in a number of ways. Obviously to an acupuncturist, proper needling can be applied. For those who are not trained acupuncturists, non-needle methods include brisk circular rubbing, tapping, using a tei-shin, acupressure, warming and vibration. Manual stimulation does not need to be lengthy; in fact, brief stimulation is usually effective.

If there are no apparent reactive points, it is good practice to routinely stimulate all back-shu points. Since the body is innately intuitive and self-balancing, the stimulation will accomplish general stimulation of chi flow.

Now, the question remains, did my stimulation of those points result in this lady's healing and if so, what do the lung and liver points have to do with dermatitis? The first answer is "definitely maybe." The only intervention that she received during this time was my treatment. The fact that a chronic condition of seven years duration healed immediately following stimulation of the back-shu points certainly suggests that the treatment had a cause-effect relationship.

Why were the lung and liver points related? The lung meridian is often treated in skin disorders. Dry skin, itchiness, rashes and chronic skin disorders may be related to problems associated with the lung meridian. The association with the liver point is less obvious. The liver in acupuncture stores the blood and is associated with overall movement of chi. Although not typically directly associated with skin conditions, the liver can be involved with any situation that involves disturbance of the flow of chi.

The elegant simplicity of learning and using the back-shu points is that by stimulating the points, you can help the body to balance itself. It will be beneficial for you to continue to learn more about how to use meridian points and work closely with an acupuncturist in your area. The back-shu points are a great way to directly affect the meridian system while you continue to learn more complex procedures. Include the back-shu points in your work with every client.


Kaptchuk, Ted J. The Web that Has No Weaver: Understanding Chinese Medicine.

Xinong, Cheng. Chinese Acupuncture and Moxibustion (Revised Edition).

Mark Anthony Kestner, DC, FIAMA, CCSP, CSCS
Murfreesboro, Tennessee

Published: May 9, 2005

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