Acupuncture Point Cautions and Contraindications
GB 30
A radiating or electric sensation may travel to the foot, since this manifestation of de qi is indicated for cases of sciatica, it may be more readily induced location GB 30 1cun inferior to its normal position
TE 22
Avoid artery (Mao-Liang)
LU 7
Avoid cephalic vein
LU 5
Avoid cubital vein
LI 13
Avoid injuring the artery (CAM)
LU 8
Avoid puncturing the radial artery (CAM)
LU 9
Avoid puncturing the radial artery (CAM), no moxa (Mao-Liang)
HT 2
Avoid the brachial artery
CV 2-13
Can only be used with special caution for acupuncture and moxibustion treatment in pregnant women (Mao-Laing)
ST 42
Care should be taken not to puncture the dorsalis pedis artery which lies below this point
LR 12
Care should be taken to avoid penetrating the femoral vein (Deadman), the Plain Questions states that moxibustion is applicable, but needling is contraindicated at this point
ST 9 & 10
Care should be taken to avoid puncturing the carotid artery
TE 23
Classically contraindicated to moxa
LR 1
Contraindicated for pregnant women (before and after labour) when treated with moxibustion (Mao-Liang)
BL 60
Contraindicated in pregnancy
CV 1
Contraindicated in pregnancy
LI 4
Contraindicated in pregnancy
SP 6
Contraindicated in pregnancy
GB 33
Contraindicated to moxa in several classical texts
ST 2
Deep insertion along the foramen may injure the eyeball, manipulation by lifting and thrusting is contraindicated due to risk of damaging the infraorbital nerve which emerges from the foramen
SI 15
Deep insertion inferiorly, especially in thin patients, carries a substantial risk of inducing pneumothorax
ST 19
Deep insertion may injure the heart on the left or the liver on the right if either is enlarged
ST 11
Deep insertion may puncture the lungs
KI 11-13
Deep insertion will penetrate a full bladder which, therefore, should be emptied before treatment
CV 2-4
Deep insertion will penetrate a full bladder, which, therefore, should be emptied before treatment
CV 14 & 15
Deep insertion, especially in thin patients, may damage the left lobe of the liver or the heart if either is enlarged, oblique superior insertion towards the heart is contraindicated in all cases
LI 16
Deep medial insertion carries a risk of pneumothorax, particularly in thin patients
PC 1
Deep needling carries a substantial risk of causing a pneumothorax.
SP 12
Deep needling in a medial direction may puncture the femoral artery, and in a lateral direction, the femoral nerve
CV 5-7
Deep needling may penetrate the peritoneal cavity
KI 14-20
Deep needling may penetrate the peritoneal cavity
ST 28 & 29
Deep needling may penetrate the peritoneal cavity in thin patients or a full bladder
LI 17 & 18
Deep needling may puncture the carotid artery or jugular vein
SP 11
Deep needling may puncture the femoral artery.
KI 21
Deep needling, especially in this subjects, will puncture the liver on the right and the peritoneum on the left
ST 14-16
Deep or perpendicular insertion carries a substantial risk of puncturing the lungs
ST 18
Deep or perpendicular insertion carries a substantial risk of puncturing the lungs
ST 13
Deep or perpendicular insertion carries a substantial risk of puncturing the lungs or injuring the subclavian vessels
GB 22-24
Deep or perpendicular insertion may induce pneumothorax
ST 12
Deep or posterior insertion may damage the subclavian vessels or puncture the lung, contraindicated in pregnancy
SI 12
Deep perpendicular insertion, especially in thin patients, carries a substantial risk of inducing pneumothorax
BL 22 & 23
Deep perpendicular needling carries a risk of injuring the kidneys
BL 51 & 52
Deep perpendicular needling carries a risk of injuring the kidneys
LR 13
Deep perpendicular needling may damage and enlarged liver or spleen
LR 14
Deep perpendicular or oblique insertion carries a substantial risk of causing pneumothorax
LU 1 & 2
Deep perpendicular or oblique insertion carries a substantial risk of causing pneumothorax (Deadman), to avoid injuring the lungs, never puncture deeply towards the medial aspect (CAM and Mao-Liang)
BL 41-50
Deep perpendicular or oblique needling in a medial direction carries a substantial risk of causing pneumothorax
KI 23-27
Deep perpendicular or oblique needling may puncture the lung
KI 22
Deep perpendicular or oblique needling may puncture the lung and/or liver (Deadman), to avoid injuring the heart, deep insertion is not advisable (CAM), deep needling is contraindicated, so as not to injure the heart and lung (Mao-Liang)
GB 20
Deeper needling may damage the spinal cord (Deadman), in the centre of the deep portion is the medulla, correct angle and depth of needling are strictly demanded (Mao-Liang)
TE 17
If the needle is directed too anteriorly or posteriorly, pain will ensue and may cause discomfort on opening or closing the mouth for a while after treatment
ST 30
In thin patients, deep insertion in a superior direction may penetrate the peritoneal cavity or a full bladder, deep insertion in an inferior direction, in a male, may penetrate the spermatic cord
CV 9-13
In thin patients, deep needling may penetrate the peritoneal cavity
SP 13 & 14
In thin patients, deep needling may penetrate the peritoneal cavity
SP 15
In thin patients, deep needling may penetrate the peritoneal cavity, deep needling at this point may penetrate a substantially enlarged liver
SP 16
In thin patients, deep needling may penetrate the peritoneal cavity, deep needling at this point may penetrate a substantially enlarged spleen
GB 25 & 26
In thin subjects, deep needling may penetrate the peritoneal cavity
ST 22-27
In thin subjects, deep needling may penetrate the peritoneal cavity
ST 20 & 21
In thin subjects, deep needling may penetrate the peritoneal cavity, deep needling on the right may penetrate an enlarged liver
GB 3
It is traditionally emphasized that deep needling should be avoided at this point
TE 21
Many classic sources prohibit moxa at this point in cases of discharge of pus from the ear
HT 1
Medial insertion towards the chest may puncture the lung
GB 39
Movement of the patient's ankle after needling can result in a bent needle
TE 5 & 6
Movement of the patient's arm or hand after needling this point can result in a bent needle
ST 1
Needle should be inserted slowly without lifting, thrusting or rotating, immediately on withdrawal of the needle, press firmly with cotton wool for about 1min to prevent hematoma, this needling method should not be attempted by those who have not had appropriate clinical supervision
LI 3
Needle with hand in a loose fist with all the metacarpal bones lying in the same plane
BL 1
Needling at this point should not be attempted by those who have not had appropriate clinical supervision (Deadman), moxa is forbidden (CAM), not advisable to lift and thrust the needle, to avoid bleeding press the puncture for a while, moxa is contraindicated on this point (Mao-Liang)
CV 8
Needling is contraindicated at this point
CV 22
Needling this point should not be attempted by practitioners who have not have appropriate clinical experience under supervision (Deadman), correct angle and depth of needling should be stressed, so as not to injure the lung and related arteries and veins (Mao-Liang)
GB 1
No moxa
LI 20
No moxa (Mao-Liang)
SI 18
No moxa (Mao-Liang)
ST 8
No moxa (Mao-Liang)
SI 14
Perpendicular insertion, especially in thin patients, carries a risk of inducing pneumothorax
TE 15
Perpendicular insertion, especially in thin patients, carries a substantial risk of inducing a pneumothorax
GB 21
Perpendicular insertion, especially in thin patients, carries a substantial risk of inducing pneumothorax, contraindicated in pregnancy
SP 17-21
Perpendicular insertion, especially in thin patients, carries a substantial risk of inducting pneumothorax
BL 11
Perpendicular needling carries a substantial risk of causing pneumothorax
BL 12-21
Perpendicular or oblique needling away from the spine carries a substantial risk of causing pneumothorax
GV 1
Perpendicular puncture easily injures the rectum (Mao-Liang)
BL 10
Puncture in a medial or upward direction is forbidden to avoid injuring the medulla (Mao-Liang)
ST 41
The anterior tibial vessels and nerve lie deep to this point
PC 3
The brachial artery and veins lie deeply, just medial to this point
PC 6 & 7
The median nerve lies directly under this point and needling commonly induces a significant electric sensation, this is an acceptable manifestation of de qi, but once elicited, further manipulation is inappropriate and may damage the nerve
GV 15
The spinal canal lies 1.25-1.75cun deep th the skin surface, varying according to body build, deep perpendicular insertion is strictly contraindicated, as is superior oblique insertion towards the brain (Deadman), upward oblique or deep puncture is forbidden, the point is near the medulla in its deep portion and correct angle and depth of needling should be strictly enforced (Mao-Liang/CAM)
GV 3-14
The spinal canal lies between 1.25-1.75cun deep to the skin surface, varying according to body build
GV 16
The spinal canal lies between 1.25-1.75cun deep to the skin surface, varying according to body build, deep perpendicular or oblique superior insertion is strictly contraindicated (Deadman), deep puncture is forbidden, deep underneath is the medulla and caution is needed when needling this point (Mao-Laing/CAM)
BL 40
The tibial nerve, popliteal artery and vein lie deep to this point
HT 7
The ulnar artery and nerve lie adjacent to this point
SI 8
The ulnar nerve lies deep to this point
ST 17
This point is contraindicated to both needling and moxa, and is used simply as a reference point
GV 23
This point is prohibited in infants with metopism (CAM)
GV 21
This point should not be needled in infants whose fontanelle has not yet closed
GV 22
This point should not be needled in infants whose fontanelle has not yet closed (Deadman), this point is prohibited in infants with metopism (CAM/Mao-Liang)
SI 13
Too medial an insertion or deep medial oblique needling may puncture the lung
ST 5
Vigorous manipulation is contraindicated to avoid damaging the facial artery and vein
