The usual position of UB-58 Bladder 58 is 7 cun proximal to the external malleolus between the lateral gastrocnemius and the soleus muscles.
However, there are several other important points nearby, including the preceding point on the Bladder channel, Bladder 57, and one of the ‘extra’ points, about 1 cun inferior to Bladder 57.
Usually Bladder 57 lies 1 cun inferior and 1 cun lateral to Bladder 57.
Needling UB-58 Bladder 58
Either perpendicularly or obliquely, between 1 and 1.5 cun.
Typically, an electric sensation downwards towards the outer malleolus. As you lift the needle, the sensation may travel upwards to wherever there is pain. (It helps if you know about needling and needle sensation!)
However, in the case of acute back pain, the point can produce strong deqi sensation and be quite sore.
In my experience, the stronger the deqi, the faster and more effectively the point works.
There are two main situations this point is good for, though once you understand them you’ll appreciate how useful it can be in a huge range of conditions.
The first is its ability to harmonise top and bottom, or yang and yin, or upper and lower parts of the body, especially the back of the body.
Upper conditions include vertigo; congestion of the nose; pain in the head or nose; insanity; pain or rigidity in the back of the shoulder – along the Small Intestine channel, for example.
These are mainly caused by full or excess conditions though I don’t see why the point might not help the same conditions if due to deficiency, but I never seem to think of using it for the latter. The point can also be used for external wind.
Lower conditions include sciatica; haemorrhoids, including bleeding haemorrhoids, nephritis, cystitis, lower back and sacral pain
UB-58 Bladder 58 seems especially effective when the upper symptoms are excess (as in hot, phlegm, damp, fullness) and those in the lower area are deficient; cold or weak.
Such weakness can lead to bleeding haemorrhoids, for which this point is well-known.
The second is its ability to open the channel and enable obstruction or external pathogenic factors to escape. To work best, these would have to lie along this channel or its sister channel, the Small Intestine.
Ischial bursitis and hamstring tendinopathy – though other points were used too, but this was the main point
Authorities often list Feiyang as being great for sciatica, especially when the pain lies on or between the Bladder and Gallbladder channels.
However, if there is sciatica, I find I get even faster improvement if I add huato-jiaji points beside the spine where on palpation I find acute tenderness, pain or tension.
Like Stomach 38, which is used for shoulder pain, especially along the front of the shoulder or Large Intestine channel, Bladder 58 is particularly good for pain on the back of the shoulder.
These two points are quite close to one another in the leg and theoretically one could use one needle to reach both points at the same time.
Personally, I find this a great point for low back pain when there is an acute – excess – syndrome existing with a deficient syndrome underlying it. However, it took me a lot of experimentation, then some lectures, to work out how to use it for this properly.