How do Acupuncturist Choose Acupuncture Points (2022)

Our Washington DC acupuncture patients are a cerebral bunch. They get pain relief on the acupuncture table, but their minds want more: they want to know how we choose acupuncture points. Not an easy task, but we sum up our methodology for physical pain here. This article is dedicated to all of our curious patients.

How many acupuncture points are on the body?

According to Traditional Chinese Medicine, there are as many as 2,000 acupuncture points. Most Chinese acupuncture points are on or near neural structures. This suggests to many that acupuncture works at least in part by stimulating the nervous system in beneficial ways.

Sometimes the acupoints are called “meridian points.” This is because they are located along invisible pathways in the body that acupuncturists call “meridians.” These meridians are sometimes described as energy highways, conducting and circulating energy throughout the body.

Others believe that they are maps that allow acupuncturists to send therapeutic signals via the nervous system, helping to direct blood flow to problem areas. More on meridians below.

What are channels or meridians?

Acupuncture is a highly effective therapy for pain relief, but how do we choose where to put the needles? Let’s start with meridians, or channels (we will use these two terms interchangeably here.) Traditional Chinese medicine has divided the body into 12 major anatomical sections called meridians or channels Simply speaking, a meridian or channel refers to a grouping of certain blood vessels, nerves and muscles. Each of these meridians also includes associated acupuncture points (acupoints).

For visual simplicity, the graphic below represents the 12 major acupuncture meridians of the body as lines. The points along the lines are the acupoints associated with each meridian

How do Acupuncturist Choose Acupuncture Points (1)

The 12 major meridians of the body are named for the organ to which they connect, and are called:

  1. Lung
  2. Spleen
  3. Heart
  4. Kidney
  5. Pericardium
  6. Liver
  1. Large Intestine
  2. Stomach
  3. Small Intestine
  4. Bladder
  5. Triple Burner
  6. Gallbladder

How the acupuncturist selects acupuncture points for pain relief in 3 steps

We choose acupuncture points according to how Traditional Chinese Medicine describes the interrelatedness of different parts of the body. The process can be broken down into 3 steps.

Step 1: Identify the “sick” meridian

To treat any type of painful condition, we must first identify the precise location of the pain. Identifying the location of the pain will show us what meridian is being affected and needs to be focused on for treatment.

Once we’ve established where the pain is located, the acupuncturist can identify the affected meridian(s). For example, pain in the shoulder and upper back is associated with the Bladder meridian. The image below from Donald Kendall’s Dao of Chinese Medicine illustrates the muscle groups associated with the Bladder meridian.

How do Acupuncturist Choose Acupuncture Points (2)
(Video) How Acupuncturists Choose Points

Step 2: Identify the meridians that balance the “sick” meridian

Once the acupuncturist identifies the meridian associated with the painful area, we can move on to the next step, which is selecting a meridian that will balance the “sick” meridian.

Each meridian is balanced by 5 other meridians. These meridian relationships come from the classic Chinese philosophical and medical text called the I Ching.

This text ties together basic philosophical concepts with observations about the natural world and the human body. Dr. Richard Tan is one of the foremost teachers of I Ching-based acupuncture in the US.

Table of meridian relationships

Sick MeridianSystem 1System 2System 3System 4System 5System 6
LungSpleenBladderLarge IntestineBladderLiverLung
Large IntestineStomachLiverLungKidneyStomachLarge Intestine
StomachLarge IntestinePericardiumSpleenPericardiumLarge IntestineStomach
SpleenLungSmall IntestineStomachTriple BurnerHeartSpleen
HeartKidneyGallbladderSmall IntestineGallbladderSpleenHeart
Small IntestineBladderSpleenHeartLiverBladderSmall Intestine
BladderSmall IntestineLungKidneyLungSmall IntestineBladder
KidneyHeartTriple BurnerBladderLarge IntestinePericardiumKidney
PericardiumLiverStomachTriple BurnerStomachKidneyPericardium
Triple BurnerGallbladderKidneyPericardiumSpleenGallbladderTriple Burner
GallbladderTriple BurnerHeartLiverHeartTriple BurnerGallbladder
LiverPericardiumLarge IntestineGallbladderSmall IntestineLungLiver

Step 3: Choose the acupuncture points

Now that we have identified one or more balancing meridians, we are ready to select acupoints along them. How do we know where on the meridian to treat? Remember, a single meridian has numerous acupoints associated with it. The answer has to do with the Chinese system of “body imaging.”

This system is familiar to many people in the form of foot reflexology, where the whole body is mapped onto the bottom of the foot, and the ailing part of the body is treated by manipulating the associated section of the foot. In acupuncture, a much broader range of body imaging is used.

Acupuncture body imaging is a correspondence where one part of the body is mapped onto another part of the body. For example you can “image” the torso onto the arm by transposing an image of the torso onto the arm. The graphic and chart below illustrate how this imaging is done.

Imaging—Head/Trunk to Limbs

How do Acupuncturist Choose Acupuncture Points (3)
Where needled on legPain in areas of Head & TrunkWhere needled on arm
Top of hipTop of headTop of shoulder
Hip jointNeck, jaw, base of skullShoulder
Upper legChest, mid-upper backUpper arm
KneeWaist, L2Elbow
Lower legLower abs, backForearm
AnkleGenitals, bladder, sacrumWrist
FootGenitals, coccyx, lower sacrumHand
ToeTesticles, anusFinger

Imaging—Head to Limbs

The head can also be imaged onto the arms and legs.

How do Acupuncturist Choose Acupuncture Points (4)
Where needled on legPain in head areaWhere needled on arm
Hip jointTop of headShoulder joint
Upper legForeheadUpper arm
KneeEye, earElbow
Lower legNose levelForearm
Ankle/footMouth levelWrist/hand
Toes Chin levelFingers

Imaging—Reverse Imaging

Reverse imaging is another body imaging technique.

How do Acupuncturist Choose Acupuncture Points (5)
(Video) The Science Behind How Acupuncture Helps Relieve Pain: A Doctor Of Chinese Medicine Explains
Where needled on leg (reverse)Pain in head or trunk areaWhere needled on arm (reverse)
ToeTop of headFinger
FootHead, base of skullHand
Lower legChest, mid-upper backForearm
KneeWaist, L2Elbow
Upper legLower abs, lower backUpper arm
Hip jointSacrum, genitals, coccyxShoulder
Top of hipTesticles, anusTop of shoulder

As a result of imaging and reverse imaging, acupuncture points can be selected from the knee down and elbow down to treat any pain condition in the body.

Imaging—Limb to Limb

We also have the option of imaging one limb onto another limb by using the standard imaging method or the reverse imaging method.

Imaging: limb to limb

How do Acupuncturist Choose Acupuncture Points (6)

Reverse imaging: limb to limb

How do Acupuncturist Choose Acupuncture Points (7)

(From Dr. Richard Tan’s Acupuncture 1, 2, 3)

Let’s take a look at a few case studies to see how this all works on a practical level.

A lower back pain case study as an illustrative example

A patient comes into the clinic complaining of pain in his lower back that is worse on the right side.

Step 1: Identify the “sick” meridian

First the acupuncturist asks the patient to identify the exact location of the pain. The patient points to the low back area on the right side.

(Video) How do I know which acupuncturist to choose?

Next the acupuncturist identifies what channels are affected. To do this we need to figure out which muscles are involved. In the area of the lower back we are mainly looking at the iliocostalis lumborum, quadratus lumborum, erector spinae and the multifidus muscles. These muscle groups are part of Bladder channel and the Kidney channel.

How do Acupuncturist Choose Acupuncture Points (8)
How do Acupuncturist Choose Acupuncture Points (9)

Step 2: Choose which channel(s) to treat

Now that we know what channels are being affected, we must choose which channels to needle based on the systems of relationships between channels. The channels related to the Bladder and Kidney channels according to the different systems are as follows:

Sick MeridianSystem 1System 2System 3System 4System 5System 6
BladderSmall IntestineLungKidneyLungSmall IntestineBladder
KidneyHeartTriple BurnerBladderLarge IntestinePericardiumKidney

In this instance, the Kidney channel appears on both lists, so it would be most convenient to choose to needle on the Kidney channel.

Step 3: Choose the acupuncture points

The Kidney channel traverses the medial aspect of the leg so we will transpose an image of the torso onto the leg, imaging the lower back onto the ankle/lower calf area.

How do Acupuncturist Choose Acupuncture Points (10)
How do Acupuncturist Choose Acupuncture Points (11)
Where needled on legPain in areas of Head & TrunkWhere needled on arm
Top of hipTop of headTop of shoulder
Hip jointNeck, jaw, base of skullShoulder
Upper legChest, mid-upper backUpper arm
KneeWaist, L2Elbow
Lower legLower abs, backForearm
AnkleGenitals, bladder, sacrumWrist
FootGenitals, coccyx, lower sacrumHand
ToeTesticles, anusFinger

First, we will needle along the Kidney channel in the lower leg area on the left side. Remember, most pain travels along a contralateral pathway, so we will start with needling on the opposite side from the pain. If the patient does not observe an effect, we will then needle the Kidney channel on the same side as the pain.

At this point, the patient should be noticing an alleviation of the pain. If no relief is obtained, we will then begin to utilize the channel relationships to choose another channel to place needles on until we get the desired therapeutic result.

Acupuncture: a very results-oriented approach to pain relief

The results of these needle placements are very effective, oftentimes creating immediate pain relief, increased range of motion, and muscle relaxation that is empirically evident to both the patient and practitioner. (Our admin staff enjoys watching patients test out their newfound range of motion at the checkout counter.)

In the introduction to his book, Acupuncture 1, 2, 3, Dr. Richard Tan quotes a traditional medical saying regarding the effectiveness of acupuncture: “Li Gan Jian Ying.” This translates as “Stand a pole under the sun, and you should immediately see its shadow.” This statement reminds us that when the acupuncture point selection is accurate, the results should be obvious and instantaneous.

(Video) Get to Know these Acupuncture Point "Generalizations"

So how does acupuncture needling actually relieve pain?

Acupuncture research is limited, and as a result, the physiological mechanism by which acupuncture alleviates pain is undetermined. Many theorize that acupuncture helps to “retrain” the nervous system and brain, resulting in:

  • pain reduction,
  • muscle relaxation,
  • injury healing.

Needling certain points is a way to communicate with the brain via the nervous system. Certain points will inform the brain to increase blood flow and a range of healing agents to the ailing area. See our article on Acupuncture for Pain Relief for the full story.

Why specific points work to alleviate pain in specific areas of the body is not yet fully understood. It is an area for further research and exploration. As acupuncture integrates further into western culture, our hope is that scientific research will make strides into understanding more precisely how it works.

Our bodies have great potential for healing. Acupuncture is a modality that unlocks that potential, thereby offering a powerful, effective option for lasting pain relief.

What to do if you’re struggling with physical pain

If you live in the Washington DC area and are looking to heal pain naturally, we can help. Here’s what you can do:

  • Read more about our acupuncture sessions.
  • Let us help you find out if your health insurance policy will reimburse you for our services. Just fill out our short online Acupuncture Benefits Verification Form.
  • Give us a call at (202) 297-7404 or Schedule an appointment online.

Nadia Bouhdili

Nadia was the previous co-owner and operations manager of Transformational Acupuncture.


How do acupuncturists choose points? ›

Inactive acupuncture points are chosen according to their anatomical locations, underlying neural pathways, corresponding Chinese meridians, proximity to verum acupoints and role in treating diseases [18,19,21,23].

How do acupuncturists know where to put the needles? ›

You'll lie down or sit on a table, and the acupuncturist will put needles into various points on your body, called meridians. These are energy channels in the body. Through thousands of years of learning, traditional Chinese medicine has compiled very complete and complex systems of meridians.

How many acupuncture points do you need for your body? ›

Traditional Chinese medicine practitioners believe the human body has more than 2,000 acupuncture points connected by pathways or meridians. These pathways create an energy flow (Qi, pronounced "chee") through the body that is responsible for overall health.

Why do some acupuncture points hurt more than others? ›

Some points are just more sensitive than others! The fingers and toes have a higher concentration of nerve endings near the surface of the skin, so points on the extremities are naturally more sensitive than those closer to the center of the body.

What is the most powerful acupuncture point? ›

Of the close to 1,000 acupuncture points on the body, the point identified as 'YINTANG - Hall of Impression' stands out for its use in the relief of a number of health discomforts.

Are acupuncture points bilateral? ›

Twelve of these major meridians, commonly referred to as "the primary meridians", are bilateral and are associated with internal organs.

What does it mean when acupuncture points bleed? ›

The categories of acupuncture points that are the most common to bleed are those that have shallow depths of insertions such as ear acupuncture points, scalp points, and jing (well) points.
Bleeding Techniques: Ancient Treatment for Acupuncture Physicians.
PointsBleeding MethodClinical Conditions
Spider veinsSpot prickingOn the face for sinus congestion
36 more rows
Jul 12, 2016

What does it mean if acupuncture point hurts? ›

This may be a sign that the treatment is working and the acupuncture point is being activated. You may also feel a heavy or electric sensation. Feelings of warmth may arise at the acupuncture points. If you feel anything that's a severe or sharp pain, you should let your acupuncturist know.

What does it mean when you bleed after acupuncture? ›

Your chances of bleeding or bruising from the needles may be increased if you have a bleeding disorder or if you're taking blood thinners. Have a pacemaker. Acupuncture that involves applying mild electrical pulses to the needles may potentially interfere with a pacemaker's operation.

What pressure point makes you fall asleep instantly? ›

The Anmian point is found just below the ear, where the neck and jaw line connect. It should be held for 15 to 20 minutes with the index and middle finger, to bring on deep and restful sleep.

What should you not do after acupuncture? ›

So, what should clients avoid after acupuncture? Clients should avoid strenuous exercise, caffeine, junk food, alcohol, cold temperatures, digital screens, and, where possible, stressful situations.

Can acupuncture release muscle knots? ›

Can acupuncture release trigger points? Yes. Acupuncture releases trigger points by finding the most tender and tight band of muscle and using an acupuncture needle to poke the muscle and get it to involuntarily contract.

What happens if you leave acupuncture needles in too long? ›

Nothing serious will happen to you if acupuncture needles are left in for a too long. You might feel tired as over stimulation of the points can drain your energy. Currently there is no statutory regulation of acupuncture so anyone can pick up a needle and insert it and call it acupuncture.

What happens if an acupuncture needle goes too deep? ›

If an acupuncture needle goes too deep then there is a risk that it can either puncture an organ such as a lung or gallbladder, or it hits a nerve or blood vessel causing pain and discomfort. However, this is very rare especially when the acupuncture professional has been trained competently.

How can you tell if acupuncture is working? ›

The following are the most common signs indicate your acupuncture treatment is working.
  • Sign 1: Pain Relief. ...
  • Sign 2: Improved Sleep Pattern. ...
  • Sign 3: Eating Better. ...
  • Sign 4: Circulating Well. ...
  • Sign 5: Elimination Properly. ...
  • Sign 6: Breathing Easy. ...
  • Sign 7: A Sense of Emotional Wellbeing. ...
  • Sign 8: Uneventful Menstruation.

What are the 4 gates in acupuncture? ›

The 4 gates is an acupuncture point combination consisting of 2 different points needled bilaterally. One point, Large Intestine 4 (Hegu), is on the dorsum of the hand. The other point, Liver 3 (Taichong), is on the dorsum of the foot. This point is great to use for many different conditions.

What acupuncture point is behind the knee? ›

Zusanli (ST36)

This point is located below the kneecap, roughly 3 inches below and 1 inch away from the center of the body. To massage this point: Place two fingers on one of the zusanli points. Apply gentle but firm pressure to the point with both fingers.

What are the most common acupuncture points? ›

Some commonly used acupuncture points include:
  • Large Intestine Channel: LI4, Hegu. ...
  • Lung Channel: LU7, Lieque. ...
  • Stomach Channel: ST36, Zusanli. ...
  • Spleen Channel: SP6, Sanyinjiao. ...
  • Gallbladder Channel: GB20, Fengchi. ...
  • Liver Channel: LV3, Taichong. ...
  • Pericardium Channel: PC6, Neiguan. ...
  • Heart Channel: HT7, Shenmen.
Aug 11, 2016

Where is the acupuncture point for sciatica? ›

The Lower Back Point

The Lower Back Point is also known as the 'Sea of Vitality'. Like the Stomach Point, applying pressure to this point offers effective pain relief from lower back pain as well as sciatica.

How many points is the liver meridian? ›

The Twelve Regular Meridians

The Liver Meridian originates at the lateral aspect of the big toe at Liv-1 Dadun Large Pile, and follows the dorsum of the foot to Liv-4 Zhongfeng Mound Center, anterior to the medial malleolus.

What happens if an acupuncture needle hits a vein? ›

In some cases, the needles may hit a blood vessel, such as a vein or artery (very rare), or even a nerve. If a needle hits a vein, you will likely feel a pinching sensation, and there will be some bleeding. Your therapist will provide pressure to the wound to stop the bleeding, once the needle is removed.

What should you not do before acupuncture? ›

Avoid Caffeine Before Your Appointment

Do not drink coffee for at least two hours before your acupuncture treatment. Because it is a stimulant, coffee increases your body's fight-or-flight response, something which acupuncture seeks to lessen.

What does it mean when you bruise after acupuncture? ›

Slight bruising at the needling site is also very common after acupuncture. This happens due to the collection of blood at the site where the needle punctures the skin. Bruising lasts longer than soreness, but still, there is nothing to worry about it.

What do different acupuncture points mean? ›

Cardinal Points – Certain acupuncture points are known as cardinal points; they are specific for a particular condition or area. For example, P6 is specific to the respiratory system, while TW5 is specific to the ear. ST36 increases energy, GB34 affects the bones and GB20 affects memory and mental processes.

What are the most common acupuncture points? ›

Some commonly used acupuncture points include:
  • Large Intestine Channel: LI4, Hegu. ...
  • Lung Channel: LU7, Lieque. ...
  • Stomach Channel: ST36, Zusanli. ...
  • Spleen Channel: SP6, Sanyinjiao. ...
  • Gallbladder Channel: GB20, Fengchi. ...
  • Liver Channel: LV3, Taichong. ...
  • Pericardium Channel: PC6, Neiguan. ...
  • Heart Channel: HT7, Shenmen.
Aug 11, 2016

What are crossing points in acupuncture? ›

These are points where two or more meridians intersection. They are mainly distributed on the face, head and trunk; the crossing points on the facial and head regions usually belong to the yang meridians, while the points on the trunk belong to yin meridians.

What are empirical points in acupuncture? ›

Acupuncture points are often selected simply by their clinical indications. Within this category are the empirical points that are often used within treatments regardless of the system you are using to choose points. Examples are ST 36 for Qi Deficiency, SP 1 for uterine bleeding, or ST 40 for dampness in the body.


1. Acupuncture Point Selection - Online Course!
(Acupuncture Masterclass)
2. Special Needling Techniques - Every Acupuncturist Should Know
(Acupuncture Masterclass)
3. How to choose an acupuncture school confidently!
(Alyssa Dazet LAc DiplOM, The 6-Figure Acupuncturist)
4. Common acupuncture points - leg
(Norris Health)
5. Recording Acupuncture Meridians and Points
(Jasmine Software)
6. Acupuncture Point Combinations by David Hartmann
(naturmed-tv- Akupunktur-TCM-Videos)

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