Lung 1 & Anterior Shoulder Pain

Lung 1 and lung 2 are associated with the anterior shoulder and are located just above the coracoid process of the scapula. When patients have anterior shoulder pain in the area of LU 1 and LU 2, it is essential to determine if the muscles that attach to the coracoid process are involved in the pathology. The short head of the biceps, coracobrachialis, and pectoralis minor all insert on the coracoid process and are related to both lung 1 and lung 2.

Not all points on the lung meridian will work the same, as the lung meridian moves through two myofascial arm lines. The picture below shows both the Superficial Front Arm Line (SFAL) and the Deep Front Arm Line (DFAL). The points on the SFAL between LU 6 and LU 9 have a strong effect on the pectoralis major, neck, and upper back. However, points like LU 5 and LU 10 will effect the DFAL, pectoralis minor, and the anterior shoulder.

For patients that complain of anterior shoulder pain in the area of lung 1 and lung 2, we can use points like LU 5, LU 10, and Xiao Jie (22.13) to benefit the DFAL and its myofascial structures. I prefer to start with Xiao Jie or LU 10 as the distal points have a strong influence on the muscles at the opposite end of the meridian. However, in some cases bleeding lung 5 may be most effective, and especially in cases of visible blood stagnation in the region of LU 5.

Common Points for Shoulder Joint Pain

There are many points that can be used for shoulder pain. In TCM it is first necessary to determine what part of the shoulder is affected before we select what points to use. For syndrome differentiation we can begin by dividing the shoulder into three sections corresponding to the meridians and muscle fibers of the deltoid. The image below shows the anterior, lateral, and posterior portions of the shoulder.

Anatomography, WikiMedia Commons, https://commons.wikimedia.org/wiki/File:Deltoid_muscle_top10.png

Traditionally we think of the anterior section as corresponding to the lung meridian, the lateral section to the large intestine and triple warmer meridians, and the small intestine to the posterior region.

Stomach 38 is a well known point for treating the shoulder and typically works best for anterior and lateral shoulder pain. In cases in which ST 38 does not treat the anterior shoulder, it can often be best to use points like Xiao Jie, SP 9, Shen Guan (77.18), or even LV 3. From a meridian based perspective points on the spleen and liver channels can treat symptoms in the lung meridian. This is because the spleen and lung are connected via the anterior relationship of the tai yin meridians. The lung and liver meridians are also connected through system 5 of Dr. Tan's systems and the horary cycle.

Applying the anatomy of the myofascial lines to meridian theory, we find that the spleen and liver meridians are both on the Deep Front Line (DFL). Points on the SP and LV meridians share many similar functions such as treating shoulder pain, PMS, reproductive disorders, and pelvic conditions. In Master Tung style acupuncture and the Balance Method we use point combinations like SP 9, 77.18, SP 6, LV 3, LV 4, and LV 5 to treat the shoulder. The spleen and liver points work in a very similar way for treating the shoulder as they are both on the DFL.

In Master Tung style acupuncture and the Balance Method we use point combinations like SP 9, 77.18, SP 6, LV 3, LV 4, and LV 5 to treat the shoulder. The spleen and liver points work in a very similar way for treating the shoulder as they are both on the DFL.

The DFL and Spleen Points

For many shoulder joint conditions the points on the leg such as ST 38, SP 9, 77.18, SP 6, and LV 3 will often be sufficient to resolve the condition. However, if these points do not produce results, or give only partial benefits, it is often necessary to consider what arm meridians and fascial lines to use.

There are many points on the arms for treating the shoulder and these include LI 4, Ling Gu, Xiao Jie, SJ 3, SJ 5, and more. If the deltoid muscle is primarily affected Ling Gu and SJ 5 can be good points to use. Additionally, points on the opposite deltoid from the painful shoulder also produce good results. For anterior shoulder pain it is essential to distinguish between problems in the deltoid muscle, and conditions affecting the muscles that attach to the coracoid process. If pain presents at LU 1 and LU 2 and is increased by palpating the coracoid process, Xiao Jie (22.13) can be one of the best points to use. Biceps Tendinopathy is also a condition that may benefit from using Xiao Jie or other lung meridian points on the DFAL

By understanding how myofascial anatomy corresponds to the meridians acupuncturists can improve their point selections and see better clinical results.

Learn more about Acupuncture for the Neck, Shoulders, and Upper Back.

In Joy,

Jim Spears M.S.