Acupuncture
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EX-B-2
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.5 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Back — Upper (Thoracic), Back — Lower (Lumbar)
Location
This is a group of 17 point pairs. All of them are 0.5 cun lateral to the lower borders of the spinous processes of the 12 thoracic (Chest Jiali) and 5 lumbar vertebrae (Lumbar Jiali).
Main Actions
- Harmonizes the five Zang ang six Fu Organs
Indications
Commentary
The indications of these points depends on their actual locations.
The points between T1 and T4 are indicated for the Lung and upper limb disorders.
The points between T4 and T7 are indicated for the Heart disorders.
The points between T7 and T10 are indicated for the Liver and Gallbladder disorders.
The points between T10 and T12 are indicated for the Spleen and Stomach disorders.
The points between L1 to L2 are indicated for the Kidneys disorders.
The points between L3 to L5 are indicated for the Bladder, Large and Small Intestines, Uterus and lower limbs.
All above points treat herpes zoster as well as pain and stiffness of the local area.
Classical Sources
《素问·刺疟篇》(Suwen - Treatise on Piercing Malaria): "For the twelve types of malaria... also pierce below the neck alongside the spine, and it will certainly be cured." This is the earliest reference to paravertebral needling in classical literature.
《肘后备急方》(Zhou Hou Bei Ji Fang) by Ge Hong, Jin Dynasty: Records Hua Tuo's method for treating severe cholera: "Have the patient lie face down with arms extended... needle the points alongside the large bones of the spine, one cun from the spine." This text first explicitly named the location of Huatuojiaji points.
《素问·缪刺论》(Suwen - Treatise on Contrary Piercing): "When pathogenic qi lodges in the Foot Taiyang network, causing spasm, back tension, and flank pain, pierce starting from the neck, counting the vertebrae alongside the spine, pressing firmly where there is pain, needle three times on each side, and it will immediately cease."
How to Locate
Selects the Huatuojiaji EX-B-2 according to location of the disorders. Use C7 (the spinous process of the 7th cervical vertebra), T7 (the spinous process of the 7th thoracic vertebra) and L4 (the spinous process of the 4th lumbar vertebra) as reference points. All 17 pairs are 0.5 cun lateral to the lower borders of the spinous processes of the above vertebrae.
Caution
THORACIC REGION SAFETY: If located too far laterally in the thoracic region, the needle can penetrate the pleural cavity and cause pneumothorax. Maintain accurate positioning 0.5 cun from the spinous process. Perpendicular needling to vertebral lamina depth is generally safe when positioned correctly—the needle will contact the lamina before reaching dangerous structures. DEPTH CONSIDERATIONS: Needle depth varies significantly by region and patient body type. Cervical region: 0.3–0.5 cun; Thoracic region: 0.5–1 cun; Lumbar region: 1–1.5 cun. Thinner patients require shallower insertion. PREGNANCY: Use caution with lumbar and sacral Huatuojiaji points during pregnancy due to proximity to reproductive structures and potential for strong Qi movement. ANGLE: In the thoracic region, slight medial oblique angle (toward spine) is safer than perpendicular insertion in thin patients. Avoid lateral angulation which increases pneumothorax risk.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Medium
Standard Depth
0.5–1.5 cun
Needling Directions
0.5–1 cun vertically or better obliquely in a medial direction towards the spine, up to 1.5 cun in the lumbar region. The purpose of needling these points is to stimulate the local nerve roots. This means that the insertion angle has to be adapted to the patient’s anatomy. Never needle in a lateral direction. It is possible to apply electrostimulation.
Expected Deqi Sensation
Local distension, soreness, or aching sensation (deqi) typically felt deep in the paraspinal muscles. Needle sensation may radiate along the intercostal spaces or down the affected limb depending on the vertebral level. Patients may experience a warm spreading sensation or local heaviness. At lumbar levels, sensation may travel into the buttock, posterior thigh, or lower leg following dermatomal patterns.
Moxibustion
Recommended
Duration: 10–20 minutes
Cupping
Recommended
Bloodletting
Recommended
Gua Sha
Recommended
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