Back-Shu Points

Shu-Mu Combination: The most important clinical application is pairing Back-Shu points with their corresponding Front-Mu points. This "front-back" combination treats both the Yin and Yang aspects of organ disorders. For example, combine BL-20 Pishu with LR-13 Zhangmen for Spleen disorders, or BL-23 Shenshu with GB-25 Jingmen for Kidney problems.

Yuan-Shu Combination: Combining a Back-Shu point with the Yuan (Source) point of the same organ enhances tonification effects for deficiency conditions. For instance, BL-13 Feishu with LU-9 Taiyuan for Lung Qi deficiency causing chronic cough and breathlessness.

Needling Technique: Due to their location near the spine, Back-Shu points require careful needling. Points above T12 are typically needled obliquely (0.5-1 inch toward the spine), while points below T12 can be needled slightly deeper (1-1.5 inches). The classical texts suggest that moxibustion is often preferred over needling for these points, particularly for tonification.

Five Zang Shu Points Protocol: Needling all five Zang Back-Shu points (BL-13, BL-15, BL-18, BL-20, BL-23) together is a powerful protocol for general constitutional support, chronic fatigue syndrome, and conditions involving multiple organ deficiencies.

Chronic Internal Conditions: Back-Shu points excel in treating long-standing organ disorders such as chronic respiratory conditions (BL-13 Feishu), digestive weakness (BL-20 Pishu, BL-21 Weishu), and kidney deficiency patterns (BL-23 Shenshu). Research has shown effectiveness in treating chronic fatigue syndrome, insomnia, and gastrointestinal disorders.

Emotional and Mental Disorders: Because the organs house the spiritual aspects (Shen) in TCM theory, Back-Shu points are valuable for emotional regulation. BL-15 Xinshu calms the Heart-Shen for anxiety and insomnia; BL-18 Ganshu soothes Liver Qi for emotional frustration and depression.

Modern Applications: Contemporary research has demonstrated neurophysiological correlations between Back-Shu point locations and the segmental distribution of sympathetic nerves innervating the corresponding organs. Stimulating these points has been shown to affect visceral organ function, including bronchial dilation, changes in heart rate, gastric motility, and bladder contractions.

The Back-Shu points are unified by their location on the Bladder meridian's first lateral line (1.5 cun from the spine) and their function as direct access points to the internal organs. Each point is named after its corresponding organ followed by "Shu" (俞), meaning "transporting." They are arranged vertically along the spine in a pattern that roughly mirrors the anatomical position of the organs they affect—Lung at the top, Bladder at the bottom.

Clinically, these points are selected based on which organ system requires treatment. They are most commonly used for chronic internal conditions, especially deficiency patterns. A traditional mnemonic helps practitioners remember their locations: Lung at T3, Pericardium at T4, Heart at T5, Liver at T9, Gallbladder at T10, Spleen at T11, Stomach at T12, Triple Burner at L1, Kidney at L2, Large Intestine at L4, Small Intestine at S1, and Bladder at S2.

The Back-Shu points are often combined with their corresponding Front-Mu points (Shu-Mu combination) for enhanced therapeutic effect, representing one of the most classic point combination strategies in acupuncture.