SJ-5

Waiguan SJ-5

Outer Gate · 外关 · Wài Guān

Triple Burner Meridian

Luo-Connecting Point

Needle Depth

0.5–1.5 cun

Needle Angle

90° (Perpendicular), 45° (Oblique)

Body Area

Forearm

Location

2 cun above Yangchi TB-4 at the dorsal wrist joint space, between the radius and ulna.

Previous on channel

Yangchi SJ-4

Next on channel

Zhigou SJ-6

Main Actions

Expels Wind-Heat
Removes Obstructions from the Channel
Benefits the ears

Indications

Fever Mumps Ear pain Tinnitus Deafness Red eyes Eye pain Arm pain Headaches Dizziness Neck pain Stiff neck Elbow pain Wrist pain Ear itching Bloody nose Finger pain Hand tremor Sore throat Eye swelling Mouth ulcers Cracked lips Arm swelling Irritability Shoulder pain Arm paralysis Blurred vision Aversion to cold Tongue stiffness Elbow contraction Fingers stiffness Migraine headache Hypochondriac pain Swelling in the ears Bitter taste in the mouth Alternation of hot and cold feeling

Commentary

Waiguan TB-5 is a very important point. Some practitioners claim that it is able to expel all six Pernicious Evils (Wind, Heat, Cold, Dampness, Dryness and Fire). However, it is more widely used for removing Wind-Heat and releasing it from the Exterior. Typical symptoms are ear pain, fever, sore throat, slight sweating, aversion to cold and a Floating-Rapid pulse.

The above situation is when the Wind-Heat invades and reaches the Greater Yang Stage of the Six Stage Theory, or the Defensive Qi Level of the Four Levels Theory.

However, it is also widely indicated for Lesser Yang Stage when the Wind-Heat penetrates the Defensive Qi. It is half in the Exterior and half in the Interior, with manifestations like alternation of chills and fever, irritability, hypochondrial pain, bitter taste, blurred vision and a Wiry pulse.

This point is also able to treat Painful Obstruction Syndrome of the arm, elbow, wrist, finger, shoulder and neck, especially if the Obstruction is caused by Wind Invasion. It is effective in all the sinew and muscles along the Channel due to its Connecting-Luo point characters.

Furthermore, Waiguan TB-5 benefits the ears. When Exterior Wind-Heat invades the ears, it may cause an ear infection with symptoms such as tinnitus, deafness, ear pain, itching or swelling.

Waiguan TB-5 clears Heat in the Head as well, which leads to symptoms such as redness, pain and swelling of the eyes, stiffness of the tongue, mouth ulcers, cracked lips, nosebleed and mumps.

Finally, it subdues Liver Yang Rising, so as to treat dizziness, neck pain or headache (especially migraine headache).

Classical Sources

Ling Shu (Chapter on Channels): First mentions the point location as "2 cun above the wrist" (去腕二寸).

Zhen Jiu Da Cheng (Great Compendium of Acupuncture): "2 cun above the wrist between the two bones, opposite Neiguan" (腕后二寸两骨间，与内关相对).

Classical functions: The point name "Wai Guan" (外關) means "Outer Gate" - referring to how the point acts as a gateway for the San Jiao Qi to disperse outward, while preventing external pathogens from entering.

How to Locate

First identify Yangchi TB-4. Move the wrist in a relaxed way so that the joint space is more visible. TB-4 is located laterally to the joint space midpoint, in the depression between the tendons of the extensor digitorum and extensor digiti minimi muscle, which continues to the litter finger. Waiguan TB-5 is located 2 cun above Yangchi TB-4.

Caution

Moving the patient's hand or arm after needle insertion can result in a bent needle due to the location between radius and ulna. Avoid needling directly into the extensor digitorum communis tendon as this may cause sharp pain rather than the appropriate deqi sensation.

Needle Angle

90° (Perpendicular) / 45° (Oblique)

Depth Category

Medium

Standard Depth

0.5–1.5 cun

Needling Directions

Vertically or obliquely 0.5–1.5 cun. Caution: Movement of the hand or arm during needle retention may cause bending of the needle.

Expected Deqi Sensation

Local distention and soreness at the point, often radiating distally toward the fingertips or proximally up the arm toward the elbow. When needled through to PC-6, sensation may spread to both dorsal and palmar aspects of the forearm.

Moxibustion

Recommended

Duration: 10–15 minutes

Cupping

Questionable

Bloodletting

Recommended

Gua Sha

Questionable

Special Point Classifications

Luo-Connecting Point

Extraordinary Vessel Connection

Confluent Point opens to:

Yang Wei Mai (陽維脈)

Commonly Combined Points

Neiguan

Zulingqi

Hegu

Zhongzhu

Ermen

Classical Point Combinations

SJ-5 + GB-41 (Eight Confluent Points Pairing)

This is the classic paired confluent point combination for the Yang Wei Mai (Linking Vessel) and Dai Mai (Belt Vessel). Together they treat conditions affecting the outer canthus of the eye, ears, cheek, neck, shoulder, and hypochondrium. Particularly useful for Shao Yang disharmony patterns including temporal headaches, alternating fever and chills, and lateral body pain.

SJ-5 + LI-4 + DU-14 + LI-11 (Wind-Heat Release)

A powerful combination for releasing exterior Wind-Heat patterns presenting with fever, sore throat, headache, and slight sweating. This combination strongly clears heat from the Shao Yang and Yang Ming levels.

SJ-5 + PC-6 (Through-Needling Pair)

The Luo-Connecting point of the San Jiao paired with the Luo-Connecting point of the Pericardium. As the master points of Yang Wei and Yin Wei Mai respectively, this combination balances Yin and Yang throughout the body. Can be needled through from one point to the other.

SJ-5 + SJ-3 + SI-19 (Ear Disorders)

A distal point combination for treating ear problems including tinnitus, deafness, and ear infections. SJ-5 is particularly indicated for excess-type ear conditions.

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