Bladder Channel

Shangliao BL-31

Chinese: 上髎

Pinyin: Shàng Liáo

Location

In the 1st posterior sacral foramen, about midway between the posterior superior iliac spine (PSIS) and the 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, where Shaoliao BL-31 is located. 

Here is to identify the 4 sacral foramens and the corresponding points at the same time. First locate the 4th sacral foramen on the level of the superior end of the rima ani (sometimes a bit more superiorly or inferiorly).

Place the little finger on the 4th foramen, then the ring, middle and index fingers on a slightly V-shaped line in a superior direction, palpating for the depressions of the sacral foramens.

With the fingers in this position, the index finger will be resting on Shangliao BL-31 of the 1st foramen, the middle finger on Ciliao BL-32 of the 2nd foramen, the ring finger on Zhongliao BL-33 of the 3rd foramen and the little finger on Xialiao BL-44 of the 4th foramen. 

 

Main actions

  1. Regulates the Lower Burner and facilitates urination and defecation
  2. Resolves Dampness and regulates menstruation
  3. Benefits the lower back and legs

Indications

Malaria Vomiting Impotence Back pain Cold knee Knee pain Leukorrhea Infertility Bloody nose Lumbar pain Painful period Genitalia pain Uterus prolapse Seminal emissions Genitalia itching Urinary difficulty Defecation difficulty Irregular menstruation Alternating fever and chills Sensation of cold in the back

Needling

Vertically 0.7–1 cun. Or 1.5-2 cun through the foramen. 

Caution:Reducing Needling techniques are contraindicated during pregnancy, except for promoting labor. 

 

Commentary for Shangliao BL-31

'Liao' means crevice, thus BL-31, BL-32, BL-33 and BL-34 are called 'Siliao'(Four crevices) or 'Baliao'(Eight crevice since there are four crevices on each side). They are called so, due to their location in the four sacral foramina. 

Shangliao BL-31 (Upper crevice) is at the highest sacral foramina. Ciliao BL-32 (Second crevice) is at the second. Zhongliao BL-33 (Middle crevice) the third, while Xialiao BL-34 (Lower crevice) is the last one. 

All these four points share similar actions, but Ciliao BL-32 is the most important one with the widest indication. 

Shangliao BL-31 is comparatively less important. First of all, it regulates the Lower Burner and treats urination and defecation Difficulties. Kidney Deficiency is an important underlying pattern for this disorder, which is frequently seen in elderly and weak patients.

Furthermore, by removing Dampness from the Lower Burner, it is effective in treating gynecological disorders  such as dysmenorrhoea, infertility, irregular menstruation, itching and pain of the genitals as well as white, red and white leukorrhea. 

All these four points benefit the lumbar region, lower back and legs. They remove the Painful Obstructions from the Channel by invigorating the Qi and Blood. Ciliao BL-32 and Zhongliao BL-33 have the most effect on this action. 

Finally, BL-31 also strengthens Qi and promotes the Qi ascending so as to treat anus or Uterus prolapse, seminal emission and impotence.