Acupuncture Point Treatment Plan - General Point Selection Rules
Within the field of acupuncture there are many styles, or schools of thought, and each of these schools contains within it unique diagnostic tools and theories which lead the practitioner to appropriate acupuncture point selection and treatment methods. This page discusses some of the basic Traditional Chinese Medicine methods for choosing appropriate treatment points.
In general, the selection of treatment points is based on the multiple uses and actions of various points. They can be used locally to treat specific conditions, reduce inflammation in an area, etc. or distally which are often chosen based on broader acupuncture theory and by utilizing the acupuncture point categories.
Acupuncture Point Selection
Before selecting acupuncture points for treatment you should already have established a diagnosis based on Chinese Medicine principles. The diagnosis is drawn from utilizing TCM diagnostic examinations such as the tongue and pulse among others. Some general tcm diagnoses and their meanings are found here or read our more detailed TCM Diagnostic Patterns section. One of the benefits of Chinese Medicine is the inherent flexibility of the system. With this, however, comes the need to reduce many treatment options into the most effective set of points. Many of the point selection guidelines below will overlap when you choose points in an effective manner. In other words, if the condition you are treating can be treated with points where the local and distal points you are using are paired in some way and indicated clinically for the condition you are treating you can treat with a very small number of points.
Local Area Point Selection:
Local area points are generally used to reduce inflammation, ease pain, and to improve the circulation of Qi and Blood in a specific area. For example, in the case of low back pain you may use the huatuo points to treat inflammation and pain near a herniation. One may choose local points by area as described above or by the clinical usage of the point. In the example of low back pain this would include points such as UB 23 which is useful locally and as it is the Back Shu point of the Kidney it is useful for all chronic/acute low back issues. Treatment area point selection may also include the addition of adjacent and/or distal points.
Adjacent Point Selection
Adjacent points are chosen due to their proximity to the area of injury or for the clinical significance. For example, CV 17 for disorders of the breast, lung, or throat areas. Another example would be using TH 5 for issues of the wrist, hand and/or fingers.
Distal Point Selection
Distal points are chosen by either clinical usage, by their relationship to points you are using locally, or in relation to one of many synergistic point groupings such as extraordinary vessel master/couple pairings. For example, in the case of asthma you may use Dingchuan as a local point, and LU 7 and KD 6 which both have valid clinical usages as distal points individually. Additionally, LU 7 and KD 6 are the yin qiao and ren mai extraordinary vessel pair which may further strengthen the clinical effect of using these points.
Acupuncture Point Selection Based on Symptomology
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. Additionally, points are used from empirical pairings such as SI 3 and HT 6 for nightsweats.
Acupuncture Point Selection Based on TCM Diagnosis
Within this group you select points based on your tcm diagnosis. For example, someone experiencing Chronic Fatigue Syndrome may have a TCM diagnosis of Yang Deficiency with Qi Stagnation. You would then choose points to build the Yang energy of the body (KD 3, KD 7, UB 23) and to resolve Qi stagnation (LI 4 and LV 3 as the "four gates" pairing used empirically to move qi within the body).
Acupuncture Point Selection Based on Meridian/Body Pairings
Within this group you can choose points as Yin/Yang pairs. For example, SP 6 and ST 36 for Blood Deficiency. Each point individually is clinically valid, but they are related as the Stomach Meridian is the yang pair of the Spleen which is yin. You may also choose points based on hand/foot meridian relationships. These pairings such as Tai Yang are illustrated on our meridian chart, found here. An example would be using SI 3 and UB 62 for low back pain. The Small Intestine and Urinary Bladder meridians are the Tai Yang meridian as well as the yang qiao mai and du mai extraordinary vessel pair. Related to the hand/foot meridian relationships is the symmetry or cross-needling method. Here you may choose points on the opposite side of the body such as LI 4 on the (R) side to treat a problem with the (L) index finger. You may also choose points on the opposite part (i.e. top and bottom) of the body in addition to it being on one side or the other. For example, if a trauma is in the area of PC 4 on the (R) side you could needle LV 5 on either the (R) or (L) side of the body depending on the theories you are using. In addition to the basic pairings and point selection guidelines, point choices are often driven by the many point categories which are covered in detail here.