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Upper 4

Upper 4 follows the Large Intestine Yangming Channel and is located 2 cun proximal to the transverse crease of the wrist, on the border of the radius on the side of the thumb. To locate Upper 4, ask the patient to hold the forearm vertically in front of the body, with the palmar side facing the body, and find this point on the border of the radius.

Upper Body Conditions in Region 4

Includes diseases on the head (vertex and parietal), ears, anterior shoulders, lateral chest, and upper limbs:

  • Head - vertex and parietal: parietal headache, temporomandibular joint (TMJ) pain/disorder, facial paralysis [b]
  • Ears: tinnitus, impaired hearing, auditory hallucinations [a], Meniere's disease[b], earache [a]
  • Shoulders - anterior: frontal shoulder pain, frozen shoulder [b], neck-shoulder syndrome [b]
  • Chest - lateral: lateral chest pain (below the axilla)
  • Upper limbs: elbow pain, thumb pain
  • Other: training injuries with pain in the upper body of Region 4 [b]

WAA Upper

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

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

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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.