Small Intestine Meridian
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SI-14
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–0.8 cun
Needle Angle
45° (Oblique)
Body Area
Back — Upper (Thoracic), Shoulder
Location
3 cun lateral to the lower border of the spinous process of the 1st thoracic verrtebra (T1), on the vertical line drawn from the levator scapulae muscle.
Main Actions
- Opens the Channel
- Expels Wind
Indications
Commentary
The function of Jianwaishu SI-14 is quite similar to this neighboring point Quyuan SI-13. It opens the Channel by removing the Obstruction. Therefore, it treats symptoms like pain in shoulder, scapula, arm and elbow. It is also effective when the patients are not able to turn their neck.
It should always be checked for sensitivity on pressure in case of shoulder issues.
In additional to that, it is also able to expel Wind in general, so as to treat Painful Obstruction Syndrome (Bi Syndrome) by Exterior Wind Invasion.
Classical Sources
《针灸甲乙经》 (The Systematic Classic of Acupuncture and Moxibustion): "肩外俞，在肩胛上廉，去脊三寸陷者中" (Jianwaishu is located on the upper border of the scapula, 3 cun lateral to the spine, in the depression).
《中医词典》 (Dictionary of Chinese Medicine): This classical text documents the point as treating shoulder and back soreness, neck stiffness, torticollis (stiff neck), and cold pain in the elbow and arm.
How to Locate
The levator scapulae muscle originates on the upper aspect of the medial border and the superior angle of the scapula. In this area, it is often myogelotic and therefore well defined and often sensitive to pressure (trigger point). Jianwaishu SI-14 is located just superior to the actual muscle insertion. It is not located on the scapula, in contrast to Quyuan SI-13.
Caution
This point is located over the thoracic cavity. Perpendicular or deep needling carries a substantial risk of pneumothorax (collapsed lung), especially in thin patients. Always needle obliquely toward the lateral direction at a shallow depth (0.5–0.8 cun). Avoid perpendicular insertion. Extra caution is required when treating thin or frail patients where less tissue separates the skin from the pleura.
Needle Angle
45° (Oblique)
Depth Category
Shallow
Standard Depth
0.5–0.8 cun
Needling Directions
0.5–1 cun vertically or obliquely in a medial direction. Caution: Pneumothorax.
Expected Deqi Sensation
Local soreness and distension spreading across the scapular region. The sensation may radiate toward the shoulder or along the upper back. Some patients experience a dull ache extending to the neck area.
Moxibustion
Recommended
Duration: 10–20 minutes
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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