Zhibian BL-54

Chinese: 秩边

Pinyin: Zhì biān

Location

At the level of the 4th posterior sacral foramen, 3 cun lateral to the posterior midline. 

How to locate

First identify the Tuffier's line which connects the highest points of the iliac crest. The spinous process of the 4th lumber vertebra (L4) mostly falls on this line. 

Then palpate in an inferior direction, passing L5, and reach the most superior 1st sacral foramen. Palpate further to the 4th sacral foramen. 

Zhibian BL-54 is at the level of the 4th sacral foramen and 3 cun lateral to the posterior midline.

Points located between Fufen BL-41 and Zhibian BL-54 are in the lateral branch of the Bladder Channel, while these between Fengmen BL-12 and Baihuanshu BL-30 are in the medial branch.

Main actions

  1. Benefits the back and eases pain
  2. Regulates urination and treats haemorrhoids

Needling

Vertically 1.5–2 cun or 2–3 cun in the direction of the anus or the genital region, depending on the indication.

Commentary for Zhibian BL-54

Zhibian BL-54 is not used for its energetic function, but it is a very important local point to remove obstructions from the Channel, so that it treats lower back pain, especially if it spreads to the legs and buttocks as well. In this case, it should always be checked for tenderness. A long needle (at least 5 cm) should be used if it is tender. 

Ideally, the needling sensation should reradiate all the way down to the foot, then the single use of BL-54 is enough. Otherwise, other points can be needled to strengthen the effect. Furthermore, if the pain is caused by Cold or Dampness invading the Channel, moxibustion can be used together with needling.  

BL-54 also treats urinations issues and haemorrhoids.