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  • Wrist-Ankle Acupuncture
    Lower 4
    • Musculoskeletal / Neurologic

Lower 4

Location
Lower 4 follows the Stomach Yangming Channel and is located at the front of the ankle between the tibia and fibula. It is midway between the tibial anterior crest and the fibular anterior border, 3 cun above the frontal crease of the ankle. With your thumbs, feel the borders of the two bones and find the point in between the borders.
Indications

Lower Body Conditions in Region 4

  • Lower body pain: lateral lumbar pain [a], anterior thigh muscle soreness [a], meralgia paresthetica, knee pain, dorsal foot pain, toe pain [a]
  • Sensory disturbances of the lower limbs: for example, numbness and sensitivity
  • Motor disturbances of the lower limbs: for example, paralysis and tremor
  • Other: training injuries with pain in the lower body of Region 4 [b]
Techniques

WAA Lower

Insert the needle at a 5 to 30-degree angle and slowly push the needle forward subcutaneously for 1.5 cun towards the knee, parallel to the leg.

If the problem is distal to the point (for example, on the foot or toes), insert the needle in the opposite direction towards the ankle. In this case, move the insertion point away from the ankle slightly so there's sufficient room to push the needle forward without hurting the joint.


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Remarks
Lower 4 is a frequently used point in treatment.

References for WAA point indications

*Point indication references:

  • Zhang, X. (1991). Wrist and Ankle Acupuncture Therapy (H., Jin, & W., Qiao, Trans.). Journal of Chinese Medicine, 37, 5-14.
  • [a] 张心曙, 凌昌全, 周庆辉 (2002). 实用腕踝针疗法. 人民卫生出版社.
  • [b] 凌昌全，周庆辉，顾伟 (2017). 腕踝针. 上海科学技术出版社.