10. SHENSHU (B-23), WEIZHONG (B-54), KUNLUN (B-60)

 

Main effect and clinical purpose

 

This is another points-combination in existence for at least 400 years. This combination was first mentioned in the "Great Compendium of Acupuncture and Moxibustion", written by Yang Jizhow in 1601, as was combination number 8, above (61).

 

It is structured on the principle "one point above - two points below, on the same meridian" (see chapter B, number 6).

 

It is perhaps the most popular combination to treat low back pain, of any etiology. it may definitely be of great value even in cases of middle and upper back pain, with the addition of some other local points.

 

Points discussion

 

Shenshu is the Back-Shu point of the kidneys. It is a very strong point, and one of the most frequently used in clinical practice.

 

Shenshu's traditional functions include:

• Regulates Kidney-Qi.

• Strengthens the lumbar vertebrae, and knees.

• Benefits the ears and eyes.

• EliminatesDamp.

It thus reinforces Kidney Qi in all Kidney syndromes: Kidney-Qi-Xu, or not firm, Kidney-Yin Xu and Kidney-Yang Xu.

 

It is a well-known fact in T.C.M that Kidney-Qi is the actual source of all the energetic activities of the body. Kidney-Qi is the Prenatal Qi, as well as the storage of all reserves of Postnatal, acquired-Qi.

 

It is also the source of Yang-Qi, as the Fire of Ming-Men resides between the two Kidneys.

 

Shenshu, as the Shu point of the kidneys, is in close contact with the organ itself. It has probably the best Influence over the kidney function, and is therefore utilized in any diseaseinvolving the organ itself.

 

But, besides diseasessuch as: nephritis, renal calculi, nephroptosis, or bladder diseases, the physiologic spectrum of kidney function is so broad, that Shenshu is also applied in many other pathologies. This may include: skeletal problems, sexual problems, haematogenesis (since the kidneys are very much involved in this, too), aging diseases, gastrointestinal, hormonal, and other problems.

 

In this points-combination context, Shenshu is applied due to two of its manifold qualities:

 

A. As a local strong point in the lower back, which, like any local point, helps regulate local functioning and resolve local Qi stagnation. This is especially so when its indications do demonstrate low-back pain.

 

B. Manyetiologies of low-back pain stem from Kidney-Xu, leading to either skeletal deformations, or muscular impairment in the lower back.

 

Thus, these qualities make Shenshu the first choice local point forlow-back pain.

 

Weizhong, according to chapter four of the "Spiritual Axis" (Ling Shu), connects behind the knee with its Bladder meridian, as its "Lower Uniting Point". The Bladder channel connects with the Kidney meridian via the Yin-Yang coupled meridians law.

 

The course of the Bladder meridian passes through the lower back, and influences it.

 

Moreover, in the classics, Weizhong is regarded as one of the Six Main Points classification, recorded as follows: "Take Sanli for the belly and abdomen, Weizhong for the waist and back, Liehchueh for the head and neck, Hegu for the face and mouth, Neiguan for the heart and thorax, and Sanyinjiao for the lower abdomen".

 

Therefore, two indications of this point show:

• Relaxes tendons and invigorates collaterals.

• Benefits the lower back and knees, and strengthens the waist.

The other two indications may well be listed here, being:

• Clears Heat from the blood.

• Dispels Summex-Heat Evil (Pathogen).

From the above data we can see that even 3000 years ago, Weizhong was the first-choice distal point, as often as Shenshu the local point, to treat low-back pain.

 

It is used therefore to treat acute back sprains, or inflammations of lower back tendons and muscles, or, just as often, Xu conditions of chronic low-back pain, or weakness, etc.

 

Weizhong is also a very important point in the treatment of sciatica. It is located upon the trunk of the sciatic nerve behind the knee, and its stimulation may cause an electric shock sensation all along the sciatic nerve – up tp the toes. As we have mentioned in the case of Neiguan(P-6) (see under case Number 6), this electric-like sensation helps propagate the Qi along the channel, and to resolve various stagnant focuses, along it. The very distinct sensation that Weizhong produces, is thus considered the cause for its great efficacy in the treatment of low-back pain and sciatica.

 

Kunlun is another point on the Bladder channel, whose indications also say: "To relax the sinews and muscles and benefit the lower back".

 

It is very much used in the treatment of low-back pain and sciatica, as much as stiff neck, and head problems related to Wind.

 

Since "Dispersing the Wind and clearing the channels" is its other indication, Kunlun is mainly used in low-back pain related to Wind-Bi. Wind-Bi is a form of wandering rheumatism, which may affect various parts of the body consequently. In the posterior part of the body, it is most often seen in people suffering alternately from stiff neck, or stiff back, or buttocks, etc. In such cases the addition of Kunlun to the formula is very rewarding.

 

The law of "One point above, two points below" is very pertinent in the case of low-back pain. The Bladder meridian energy flows in a distal direction from the back. Shenshu serves as thelocal point that activates and invigorates the flow of Qi in the lower back, while the other two points attract the Bladder energy downward, enhancing and accelerating its flow.

 

Beside this principle, all the three points serve in mutual assistance to benefit the lower back, and relax muscles and tendons there, as their indications imply.

 

In addition, Shenshu has a more fundamental task, which is to act directly on the kidneys, which are the organ responsible for the lower back.

 

Needling sequences, manipulation and stimulation

 

In very acute cases that involve pain, it is advisable to start with the most powerful distant point. Thus, Weizhong is usually the first point, then Shenshu and lastly Kunlun.

 

In acute sprain of the lower back, Weizhong is utilized while the patient is standing. It is manipulated in sedation, as much as the patient can tolerate, while he, or she, is asked to gently rotate the waist. This type of procedure is often performed in acute, painful conditions of various parts of the body. A point is strongly manipulated while the patient is askedto rotate and manoeuver his painful joint (62).

 

In acute hot conditions Weizhong is frequently bled with the pyramid needle. This is done especially if congested veins are visible in the vicinity of Weizhong.

 

Another popular method is to apply cups on Shenshu, with or without needles. Also recommended is the application of cupping on Weizhong in the case of painful knee, related to lowback pain. This is usually done after the needles have been withdrawn (63).

Electrical stimulation of the points is also possible and often seen in the clinic, in cases of low-back pain. Usually the right side is stimulated by one line and the left side by another line. It is performed by a dispersion wave.

 

Herbal equivalent

 

Radix Duhuo (Angelica pubescens) has very similar qualities to point Kunlun. It is in the category of Wind-Damp expelling herbs, and its indications are:

• Expels Wind-Damp that causes painful obstruction.

• Alleviates pain caused by the former indication.

• Channels entered are Kidney and Bladder.

• Used to treat low-back pain, and leg pain.

• Also treats headache and toothache because of Wind-Cold-Damp.

With the addition of Herba Assri cum radice (Xi Xin), and Radix Gentiana Macophylla (Qin Jiao), it constitutes a classic formula to treat soreness, pain and numbness in the neck and back, and lower extremities due to Wind-Damp-Bi.

 

With the addition of Radix Dispaci (Xu Duan) this formula imitates our points-combination very closely, as Xu Duan plays the role of point Shenshu. Xu Duan tonifies Kidney-Qi and Yang, and it strengthens the sinews and bones.

 

Xu Duan also promotes and invigorates blood circulation and is therefore useful even in cases of low-back pain due to trauma, and blood stagnation. In this, Xu Duan imitates the mutual effect of both Shenshu and Weizhong.