BL-40 (back pain, knee pain, hot flashes)

BL-40, Wei Zhong (Middle of the Crook), is located in the center of the back of the knee. It’s the Ruler of the Lower Back, so I often use it to treat lumbar problems. It’s also great for deep knee pain and to cool the Blood* – try it if you’re overheated next summer, or if you’re suffering from hot flashes. Other good points for lower back pain: LV-3, GB-34, Du-4.

BL-40, the Ruler of the Back.

*Remember: The Chinese concept of “Blood” is different from your physical blood. I am not talking about your literal circulatory system. :)

Yin & Yang

*Note – some parts of this discussion were previously published in the Stroke article.

Chinese Traditional Medicine (TCM) goes back to 2000 BC in its current form, and in its antiquity goes back at least 5,300 years! It’s based on energy movement throughout the body along specific paths or “channels.” Acupuncture works by manipulating energy at points where that energy flows near the surface. There are about 1000 distinct points all over the body, each with their own unique qualities. I came to acupuncture as a profession when it was the only thing that could stop my back pain after a severe car accident (I’m now completely recovered). When I first started studying I was a little skeptical – I was a hard-core scientist and figured the map of channels was an elaborate way to memorize nerves and other anatomical landmarks. The more I studied, though, the more I came to see that this is a completely different system of physiology.

After years of seeing the power of this odd system at work – on skeptical humans, on animals, on “impossible cases” – my current belief is that this is a form of energy we just can’t explain yet. If you told a 16th century doctor that you could see inside the human body without cutting it, you would be declared a witch. Now, any x-ray or ultrasound technician has that ability. NIH has been funding research into measuring energy flow along the channels. It’s only a matter of time before TCM becomes part of our accepted science of medicine.

We’ve all heard of Yin and Yang (pronounced to rhyme with Pin and Pong, by the way). They are tossed around in popular culture a lot, generally with a superficial understanding of them as two sides of a whole. I’ve even seen them likened to Superman and Clark Kent! In Chinese medicine, however, they have a very specific meaning.

Think of Yin as being the moist, nourishing, quiet, still, internal, “feminine” aspect of your being. Yang is the other side of the coin: It’s the loud, bright, moving, motivating,expanding, “masculine” side of you. See how the white Yang is rising, while the black Yin is descending? Note also that each contains a bit of the other: They are incomplete without the other half of the pair. There is a delicate balancing act between the two types of energies, and they influence each other. When Yin and Yang separate (in a raging fever, for example) the patient will die.

Yin/Yang: Each contains and is dependent on the other to create a whole.

Think of an animal, or a baby crawling on all fours. As applied to anatomy, the front and lower parts of the body are Yin. The back and upper body are considered more Yang.  On the limbs, inside surfaces are Yin and the outside aspects are Yang. Acupuncture treatments must be planned out so they contribute to balance. For example, if someone has a headache, we don’t just use local needles on the scalp. We use points on the hands and feet to distribute the input to the body. There’s a great point on the sole of the foot that will draw excess energy down, which helps a lot with Yang-rising types of headache.


Yin and Yang energies must work together, and should give and take throughout the day. Yin predominates at night, while Yang rules the day. Some hormonally based examples may be helpful: A woman going through menopause is Yin deficient. Her Yang, no longer held in check by her Yin, causes hot flashes, night sweats, and dryness of the skin and other bodily fluids. To ease this “change of life,” we start by using acupuncture points to clear excess heat (the symptoms). Other points act to nourish the Yin (the cause). These treatments are surprisingly powerful for stopping hot flashes.

Likewise, a man as he ages will suffer from Yang deficiency. This is readily identified in the case of erectile dysfunction and decreased libido. Other symptoms can include lower back pain and a general loss of vigor.  In this case, we use acupuncture points that activate the Yang. Some acupuncturists use moxabustion (burning mugwort, an herb in the sage family) to warm and stimulate the Yang, although most modern clinics (mine included) are now using infrared heatlamps. Using modern technology eliminates the chance of burns and makes for a wonderfully relaxing session.

Most patients feel some immediate relief when acupuncture is used to balance Yin and Yang, but longer term hormonal changes will require multiple treatments.

This is a simplified explanation, of course. Masters of Chinese medicine study for years to understand the subtle interplay of Yin, Yang, and the channels. It’s a fascinating tradition with a lot to teach us about the human body.

LI-4 (headache, arm or facial pain, infection, hot flashes)

LI-4: Hegu. This point is astonishingly useful for a wide variety of complaints, but don’t use it if your patient is pregnant!

Large Intestine 4 is the acupoint most well-known by the general public. I first had it taught to me by a riding instructor when I was a kid living in rural Virginia. The name for this point is Hegu, “Joining Valley,” which is a reference to its anatomical location on the back of your hand, in that fleshy area between the thumb and forefinger. Feel around – it’ll be tender if you need it – but the easiest way to find it is to squeeze your thumb against your hand. The highest point of the muscle is where you want to press. Use firm, gentle pressure for 10-20 seconds with a healing intention. Try both sides.

Hegu, or Joining Valley, is a tremendously useful point. It moves stagnation, so you can use it to clear pain and stiffness anywhere in the upper body. Hegu will be particularly effective along the LI channel, which runs from the nail of the forefinger, along the forearm to the lateral (outside) elbow, up the arm and across the shoulder, eventually crossing the upper lip to end at the opposite side of the nose. Shoulder and elbow pain, carpal tunnel, and (of course) headaches are common uses. It’s specifically the Ruler of the Face, so it’s doubly powerful for frontal headaches, eye pain, sinus blockage, and tooth pain. It also releases heat and is part of a point combination for fighting viral or bacterial infections. If  you are prone to hot flashes, this point could be your new best friend. Also use LI-11, pictured here, to clear heat.

And by the way… the leading cause of headache is dehydration. Drink a glass of water!

WARNING: Because Hegu is a moving point, DO NOT use it if you are pregnant or bleeding. It can induce a miscarriage or increase blood loss. On the other hand, if you are overdue and want to evict your baby, this is a great way to do so, along with some other points (assuming everyone is healthy and it’s not a complicated pregnancy!). It will usually increase menstrual flow if the patient is having her period. If you have a severe headache paired with sudden loss of motor control or speech, get to a hospital immediately. DO NOT use LI-4 until you are sure you are not having a hemorrhagic stroke (bleeding inside the brain). This goes for head injuries, too!