Why the hell are you putting needles there? LI-4

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If you have ever received acupuncture, chances are you have received this point. LI-4 is a common acupuncture and acupressure point across numerous Traditional Chinese Medicine protocols for acute pain and chronic conditions. It also is a great spot to find a trigger point if someone ever asks you to massage their hands.

This point is most recognized as a point that can help with headaches, and something you can do on yourself or on a friend by applying pressure to help relieve some of the symptoms. Not only that, it is used for improving sleep, reducing stress and lowering inflammation, which can have a wide array of effects throughout the body. This point is so powerful that it must be avoided during pregnancy as it can stimulate early onset of labour.

Here we will go into detail of the physiological mechanisms and anatomy as to why stimulating this point is so effective, and how many pain and performance therapists (such as chiropractors, physiotherapists, massage therapists and naturopaths) can use it in their practice.

Anatomically speaking, targeting LI-4 with acupuncture or acupressure stimulates the distal end of all 3 major nerves traveling through the upper limb; median nerve, ulnar nerve and radial nerve. This has a direct effect on 4 major nerve roots originating from the neck (C5-T1) and all 3 cords of the brachial plexus (medial, lateral and posterior). By influencing the nerve in one place can have a powerful effect on how the nerve functions (both motor activation and sensation) everywhere else it is connected to throughout the body.

Also in this area is the radial artery, which supplies a large portion of the circulation to the hand. Acupuncture specifically stimulates the local release of histamine (the same chemical associated with allergies) which causes the vessels in the area to open and dilate, increasing the blood flow / circulation. Locally this can help bring healing nutrients to the nerves discussed above, but also is the opening of the tap that allows the water to run and taking pressure off the internal part of the entire hose. This mild relief of pressure can be simplified as the small twist of the cap that lets enough air out to take pressure off the entire bottle. 

Finally, studies have shown that the stimulation of LI-4 using techniques like acupressure, acupuncture or electro-acupuncture (EA) has been shown to down-regulate inflammatory cytokines TNF-𝞪 and IL-6 in serum (blood) thereby inhibiting MPO activity modulating excessive inflammatory response. To put it more simply, stimulating this point lowers inflammation throughout the body which can have an immediate effect on pain, and influence conditions that result from excessive inflammation. 

In practice, we refer to points like this that modulate multiple systems and tissues as “high value nodes”. During a treatment, it can provide direct value to the condition or symptoms we are treating, or it can provide a supplementary effect by downregulating pain and inflammation, which allows us to do more in a different area of complaint. It is used frequently across multiple treatment protocols, but when used with purpose, this single point can have a massive effect on the body as a whole.

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