Acupuncture Point Cautions and Contraindications

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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


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