Threading is a part of treatment options practiced by doctors in China. The Chinese translation of the technique is “one needle for two points.” Originally, the purpose of many Chinese threading techniques was to treat difficult and chronic conditions by connecting effective groupings of nearby points together to stimulate the affected area or energetics of those points. The number of points this procedure can be applied to is theoretically broad but in the average Western clinical practice somewhat small.

LI-20 can be threaded to the extra point bi tong for the treatment of sinusitis and allergic rhinitis with concomitant symptoms of nasal congestion or runny nose, facial itchiness, and swelling.

LI-20—in the nasolabial groove, at the level of the midpoint of the ala nasi. Bi tong—at the end of the nasolabial groove, superior to LI-20.

With a #1 gauge 30mm Seirin needle, thread the points by puncturing LI-20 subcutaneously towards bi tong. Connect the points transversely. Needle slowly, shallowly, and with control as you approach bi tong in the infraorbital area, threading the needle about 0.5 to 0.75 in. Do not obtain qi nor tonify nor disperse, just connect the points.

If the patient has a deep groove or wrinkle in this area, an intradermal needle can be chosen in place of needles. Select several 6mm Seirin intradermal needles and position them back to back from LI-20 to bi tong. Use splinter tweezers or forceps to insert the needles. Have the patient close their eyes or even better, cover their eyes with a small pillow or cotton balls in case you lose control of the minute needles that might accidentally fly towards the patient’s eyes.

In either case of using intradermal needles or a regular acupuncture needle, treat bilaterally. Retain the needles for 10 minutes. Remove the intradermal needle with tweezers or forceps. Pull out all of the needles slowly and press the skin with a clean cotton ball to close the holes to reduce infection and prevent bruising.

Use KI-6 for all of the common indications of KI-6 as the point of greatest yin of the body. It is indicated for laryngitis, pharyngitis, chronic sore throat, night sweats, hot flushes, diabetes, amenorrhea, declining vision in the aged, insomnia, neurasthenia, itching, and other symptoms of kidney vacuity, especially kidney yin vacuity.

Puncture the point with a #1 g 30mm Seirin needle 0.1 to 0.3 cun posteriorly and subcutaneously towards the heel. Do not obtain qi. The angle of insertion is considered a tonification technique as the point is needled in the direction of the meridian. Treat bilaterally. Retain the needle for 10 minutes.

If preferred, one 3mm intradermal needle may be inserted during treatment in place of the regular acupuncture needle. Insert and withdraw in the same manner as described under the discussion of LI-20.

Pain in the supraorbital region, redness, swelling and pain of the eyes, sinus or frontal headache, blurry vision, sinusitis, acute conjunctivitis, and allergy symptoms.

BL-2—on the medial extremity of the eyebrow, in the supraorbital notch. Yu yao—in the middle of the eyebrow, when one is looking straight ahead, the point is directly above the pupil.

Insert a #1 g 30mm needle and thread shallowly 0.1 to 0.2 in through BL-2 to yu yao. Do not obtain qi nor tonify nor disperse. Treat bilaterally. Retain the needle for 10 minutes.

This is an interesting treatment technique to activate the functions of these two powerful points. I use them frequently in this way to strengthen immunity and treat prolapses (viewed as weak connective tissue due to weakened immunity). They can be selected to treat cough, asthma, chest pain, bronchitis, and prolapses.

KI-27—in the depression on the lower border of the clavicle, 2 cun lateral to the ren channel. ST- 13—at the lower border of the middle of the clavicle on the mammillary line, 4 cun lateral to the ren channel.

With a #1 g 40mm Seirin needle, puncture the skin at KI-27 and slowly thread the needle subcutaneously and laterally towards ST-13. The needle will stimulate the ST-13 area. Keep the needle horizontally in the skin tissue due to the proximity of the lungs. Do not obtain qi or tonify or disperse. Simply connect the points as you thread the needle about an inch away from KI-27. Needle towards the lateral aspect of the body. Retain the needle 10 minutes. Due to its length, withdraw the needle slowly.

For anxiety, nervousness, constipation due to nervousness, palpitations, cardiac pain, irritability, mental disorders, hysteria, insomnia, pain in the hypochondriac region, dream disturbed sleep, and depression.

HT-7 alternative (Japanese) location—at the transverse crease of the wrist on the ulnar side of the tendon of the muscle flexor carpi ulnaris in the articular regions of the pisiform and the ulnar bones

Insert a #1 g 30mm Seirin needle 0.2 to 0.3 in under the tendon towards the standard Heart 7 location. This treatment may be performed bilaterally or just on the left side as heart energetics are more left-sided or if the physical problem is also left-sided. Do not obtain qi or tonify or disperse. This is a useful technique to use on patients who have arthritic deformities in the wrist area, thus making the standard Heart 7 hard to needle. Retain the needle for 10 to 20 minutes.

For local problems such as contracture of the wrist, arm, elbow, and fingers. Stimulates upper burner function.

Standard Chinese locations for both points. PC-6 can be found 2 cun above the transverse crease of the wrist between the tendons of the muscle palmaris longus and the muscle flexor carpi radialis. TB-5 is located 2 cun above the transverse crease of the wrist between the ulnar and carpal bones.

Insert a #1 g 30 or 40mm needle perpendicularly 0.8 to 1.2 in from TB-5 to PC-6. This is a deep insertion. Do not obtain qi or tonify or disperse. Instruct the patient not to move his/her hands because movement with the needle in this deep can cause pain. It is also possible for the needle to bend or break. The point may be treated unilaterally or bilaterally. Retain for five to ten minutes.

To use Lung 7 as a longitudinal luo point, that is, to direct the stimulus to the lung organ to treat problems of the lung organ or the proximal portion of the lung.

Standard Chinese location, 1.5 cun above the transverse crease of the wrist in the depression on the styloid process of the radius.

Insert a #1 or #3 g needle transversely and proximally, that is, up the arm. Obtain qi through lifting and thrusting in a transverse manner. When qi is obtained, tonify or disperse the needle depending upon the aim of treatment. The stimulus should be directed up the arm.

Paralysis, motor impairment of the lower extremities, appendicitis.

2 cun below ST-36 (zu san li).

Puncture the point subcutaneously with a #3 or #5 g 2 to 3 in needle from lan wei downward. Insert slowly and thread the needle through the skin. With a horizontal lift and thrust method, subcutaneously obtain a strong stimulus down the leg to treat the aforementioned conditions, which require strong stimulation.

For shoulder stiffness and motor impairment of the shoulder.

Standard Chinese locations for both points. ST-38: 8 cun below ST-35 (du bi), 2 cun below ST-37 (shang juxu) midway between ST-35 and ST-41 (jie xi). BL-57—directly below the belly of the muscle gastrocnemius, on the line connecting BL-40 (wei zhong) and tendo calcaneus, about 8 cun below BL-40.

Puncture ST-38 perpendicularly on the same side of the leg as the side of the affected shoulder problem. Then without looking for qi, insert the needle through the point in the direction of BL-57. Use a 3 in #3 or 5 g needle. When the required depth has been achieved, about 2 in into the leg, lift and thrust the needle slowly as you are in the thick musculature. At the same time have the patient lift and mobilize the shoulder. Lift and thrust the needle during the movement of the arm and then withdraw the needle.

The points and methods presented here are not only easy to do, and can augment your treatment style and options, but most importantly may offer gentle, effective medical care to your patients.