In my last post, I commented on LU 7 and the Three Scholars (33.13, 33.14, 33.15) which are a group of Master Tung's points located on the lung meridian and between LU 5 and LU 7. In addition to treating lung conditions, the Three Scholars are also effective for upper back pain in the UB meridian. In regards to myofascial lines, the points from LU 6 - LU 9 and the Three Scholars are on the Superficial Front Arm Line (SFAL). In this article, I want to elaborate on this topic and also discuss lung meridian points on the Deep Front Arm Line (DFAL) such as LU 10 and Xiao Jie (A.05). Additionally, I will cover some important manual therapies we can use when needling these points.
The point LU 10 and a Master Tung point called Xiao Jie (A.05) are both on the thumb and lung meridian, but these points are on the Deep Front Arm Line (DFAL). Similarly, the Tung points 22.01 and 22.02 are also on the thumb and have similar indications for lung disorders, and neck and upper back pain. While the points on the DFAL have similar indications to the more proximal points from LU 6 - LU 7, they do vary in effect since they are on a different myofascial line.
Some sources indicate that 22.01 and 22.02 should be used instead of 33.13 and 33.14 when pain is located higher in the neck and that the Three Scholars are preferred when the pain is in the lower cervicals and upper thoracics. Similarly, Xiao Jie can be effective for neck pain and back pain and is also indicated for chest pain.
Examining the myofascial lines we find that Master Tung's points the Three Scholars are on the lung meridian/SFAL but that 22.01, 22.02, and Xiao Jie are all on the DFAL. These points on the thumb tend to produce a stronger needle reaction and likely affect the neurological system more powerfully than the more proximal points. Additionally, Xiao Jie can be very effective for anterior shoulder pain, especially when trigger points exist in the pectoralis minor muscle or in cases of biceps tendinopathy. Xiao Jie is also indicated for chest pain, and the best results for treating this are found when the pectoralis minor muscle is in chronic contraction or in a state of pathology.
Xiao Jie can be very effective for anterior shoulder pain, especially when trigger points exist in the pectoralis minor muscle or in cases of biceps tendinopathy. Xiao Jie is also indicated for chest pain, and the best results for treating this are found when the pectoralis minor muscle is in chronic contraction or in a state of pathology.
When deciding between using the Three Scholars or 22.01, 22.02, or Xiao Jie, the first thing I want to determine is where the pain is located. If the pain is above C5 I will typically needle 22.01, 22.02, or just Xiao Jie alone. As 22.01 and 22.02 are very sensitive I don't like to use them on first-time patients or if a client is overly needle sensitive. Needling Xiao Jie and threading it towards 22.01 and 22.02 can achieve a similar result and tends to be more tolerable.
When the pain is located from C6 - T5 I will use the Three Scholars.
After choosing what needles to use and inserting the needles, I like to place my hands under the client's head and neck and use gentle pressure and myofascial release techniques. This can be as simple as holding points like UB 10 and GB 20. If I use 22.01, 22.02 or Xiao Jie, I may also slide my fingers up the neck and along the side of the cervical spine to reach the deep muscles of the neck. For neck pain and disorders, I will also frequently use Luo Zhen and TW 3 as this is a great point combination for neck pain. Since Luo Zhen and TW 3 are on the SBAL they will be able to influence the trapezius muscle and other regions of the SBAL. Typically, I needle the yang points on the opposite side from the pain and the lung points on the same side.
When using the above points, it is also useful to use traction and gently pull on the client's head and neck while holding pressure at the base of the skull. This will take compression off the nerves and can be very soothing for clients. I may also gently tilt the head while noticing any differences in the range of motion between the two sides. Gently rotating the head is also a part of my treatment protocol and allows for access to the SCM which often has trigger points in a variety of neck, head, and facial disorders.
When using the above points, it is also useful to use traction and gently pull on the client's head and neck while holding pressure at the base of the skull.
By using manual therapies with distal needling you can achieve even better results with your clients. I also find that they greatly appreciate the touch and sense of healing that comes from using acupressure and manual therapies. If you are not comfortable touching your clients in this way, you can also teach them to do simple movements of the neck while the needles are left in. Generally, having them do gentle extensions, flexions, tilts, and rotations is enough to add to the therapeutic effect.
My protocol when teaching clients the above movements is to have them do 10 repetitions of each movement in a sequence. After completing each of the movements for 10 repetitions, I ask them to rest in stillness for a couple of minutes and then repeat the exercises. I will then give them 10 - 15 minutes on their own to move through the exercises while my initial points are retained. After this first round, I will then check up on them and observe any changes in pain levels or muscular tension in the affected area. Often after the first 15 minutes, the pain has substantially decreased.
Additionally, if they are asleep when I come back into the room, I know that I have achieved a parasympathetic rebound, and that can add to the benefits of the treatment. If the client is still awake and the pain is still present or has only changed a little, I will then add a second round of needles. The points I choose will vary according to the patients' top three health concerns and overall pattern.
To read part 1 of this article follow this link, Lung 7 and the Three Scholars.
Learn how Master Tung's points on the hand relate to the lung meridian.
Learn more about Master Tung Acupuncture and Fascia