Acupuncture
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EX-B-8
Needle Depth
0.5–1.0 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Back — Sacral, Back — Lower (Lumbar)
Location
This point is directly below the spinous process of the 5th lumbar vertebra (L5).
Main Actions
- Tonifies the Kidneys
- Opens the channel locally
Indications
Lower back pain
Lumbosacral pain
Leg pain
Sciatica
Lower limb paralysis
Dysmenorrhea (painful menstruation)
Irregular menstruation
Metrorrhagia (uterine bleeding)
Metrostaxis (abnormal bleeding)
Enuresis (bedwetting)
Urinary retention
Malpresentation of fetus
L5/S1 disc problems
Post-traumatic paraplegia
Commentary
Shiqizhuixia EX-B-8 is an important extra point located on the posterior midline at the lumbosacral junction. Its Chinese name literally means "below the seventeenth vertebra" – in traditional TCM counting, starting from the first thoracic vertebra (T1) as "one," the fifth lumbar vertebra (L5) is counted as the seventeenth vertebra. The point was first recorded in Sun Simiao's Qianjin Yifang (Supplement to the Thousand Gold Prescriptions) during the Tang Dynasty.
Clinically, this point is highly valued for two main categories of conditions: musculoskeletal disorders of the lower back and gynecological problems. For lower back pain, it is especially effective when there are issues at the L5/S1 junction, including disc problems. For gynecological conditions, it excels at treating dysmenorrhea (menstrual cramps) and irregular menstruation. The point's location near the sacrum gives it a strong influence on the pelvic organs and the lower limbs.
Both needling and moxibustion are commonly used at this point. Moxibustion is particularly recommended for cold-type dysmenorrhea and deficiency-type lower back pain. The point works synergistically with Ren Mai points (Guanyuan, Zhongji) and Bladder channel points in the sacral region (especially the Eight Liao points) for comprehensive treatment of pelvic and lumbar conditions.
Classical Sources
《千金翼方》 (Qianjin Yifang - Supplement to the Thousand Gold Prescriptions): First classical text to document this point, indicating its use for lumbar and gynecological disorders.
《类经图翼》 (Leijing Tuyi - Illustrated Supplement to the Classified Canon): This Ming Dynasty text formalized the name "Shiqizhui" (Seventeenth Vertebra) for this point, reflecting the traditional vertebral counting system where T1 is the first vertebra.
How to Locate
Locate the Tufffier's line, which connects the two most superior points on the iliac crest. It generally intersects with the spinous process of the 4th lumbar vertebra (L4). Then palpate in an inferior direction to the next vertebra (L5) and locate Ex-B-8 below the border of its spinous process, at the lumbosacral joint.
Caution
Use gentle needling technique as the point is located at the lumbosacral junction between L5 and S1. During pregnancy, use with caution or avoid strong stimulation due to the point's proximity to the uterus and its traditional use for gynecological conditions. Ensure proper patient positioning (prone) for accurate location and safe needling.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Medium
Standard Depth
0.5–1.0 cun
Needling Directions
0.5–1 cun vertically to the skin or obliquely in an inferior direction.
Expected Deqi Sensation
Local distension and soreness at the lumbosacral junction, often with a spreading sensation to the sacral area or down toward the buttocks. For dysmenorrhea treatment, patients may feel warmth radiating to the lower abdomen.
Moxibustion
Recommended
Duration: 5–15 minutes; or 3–7 moxa cones
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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