Tianzhu (BL10): The Neck Point for a Stiff, Sore Back of the Neck

Where Tianzhu Sits

The points sit on the back of the neck, one on each side, in the groove on the outer edge of the two thick cords. Each one is about a finger-width below the bony edge of the skull and a little more than one thumb-width out from the centre of the neck.

This line is the longest on the traditional map. It begins at the inner corner of the eye and climbs over the forehead and the top of the head. Then it comes down the back of the skull and runs the whole length of the back in two parallel bands either side of the spine. From there it goes down the back of the legs to the outer edge of the little toe. Vietnamese and Chinese texts call it the Bladder channel. This is its tenth stop. It is the point where the line leaves the skull and starts down the neck.

The Vietnamese reference places it in the dip at the back hairline, on the outer side of the big tendon. It gives a quick way to find it: on the outer border of the large neck muscle, above the hairline, a little more than one thumb-width out from the centre of the neck. The international standard published by the World Health Organization in 2008 is more exact about the height. It puts the point level with the top of the second bone of the neck, in the dip outside the trapezius muscle. In practice the two descriptions land in the same groove. On most people it sits about a finger-width below the bony edge of the skull.

The "big tendon" is the thick cord you can feel either side of the centre of the neck. It is made of the long muscles that hold the head upright, with the edge of the trapezius running over them. The point is not on top of that cord but in the groove right outside it. Beneath the skin there are layers of strap-like muscles that tip the head back and turn it. Deeper sit the small muscles that rock the skull on the top of the spine. Deeper still, out of reach of any fingertip, runs one of the blood vessels that carry blood up to the brain. That is one reason this point is pressed gently and never pushed hard straight into the side of the neck.

The nerve supply explains the sensation. The skin here is served by nerves from the upper neck part of the spinal cord. Very close by, a larger nerve comes up out of the muscles and spreads over the back of the scalp (the greater occipital nerve). A gentle press often sends a dull ache up over the back of the head. A tingle that travels means you are on the nerve and should move aside.

Why This Spot

Every time you turn your head, nod or hold it level, the muscles under this groove do the work. They carry the weight of the head all day. When the chin drifts forward toward a screen, a book or a steering wheel, the load on them climbs sharply. This is where many people feel the deep, settled ache that makes it hard to look over a shoulder when reversing the car. The groove is also easy to find by feel. The cord on one side and the skull above keep the thumb in the right place.

In this tradition the name says what the spot is for: the Celestial Pillar. The head is described as heaven, the highest part of the body. The neck is the pillar that holds it up, and the bones at the top of the neck were once called the heavenly pillar bones. A pillar that is stiff or crooked cannot hold heaven level. So in this tradition the point is reached for when the neck will not turn, the head feels heavy, or the ache sits at the base of the skull.

In this tradition the point is also grouped with a few points around the neck that are described as gateways between the body and the head. Complaints that seem to be stuck in the neck, between the shoulders and the head, are the ones these points are said to address.

What the Old Texts Say About Tianzhu

The Vietnamese reference used by The Neuro Reset lists the uses that have come down through the tradition: pain at the back of the head, pain and stiffness at the nape, a wry neck that is pulled to one side, poor sleep and a hoarse throat. The first three still account for almost every reason someone reaches for this spot today. The last two are worth knowing about as part of the record. They are not promises.

What stands out in the older descriptions is how they are written for touch. They do not ask the reader to count bones. They ask the reader to find the hairline, feel for the big tendon and slip off its outer side. Anyone can do that with their own hands, sitting at a kitchen table. The modern international standard adds a bony landmark to pin down the height. If you follow the midline down from the bump at the back of the skull, the first bony knob you meet under your fingertip is the second bone of the neck. Its top edge marks the level. Then move out sideways to the outer edge of the thick cord.

The two descriptions differ by a few millimetres at most. That is less than the width of a fingertip, and much less than the difference between one person's neck and the next. This is why the method here does not rely on measurement alone. You find the area from the landmarks, then let the sting under the thumb tip tell you exactly where the point is. Old texts and modern standards both agree on the groove; your body tells you the spot inside it.

The tradition has also always handled the back of the neck with respect. Teachers kept pressure here light. They worked from the surface, aiming slightly upward toward the skull, rather than pushing into the side of the neck.

Points That Work With Tianzhu

The first partner is the pair of larger hollows a little higher and further out. Slide your thumb up from these points and outward along the bottom edge of the skull. It drops into a deeper hollow between the thick cord and the muscle that runs down from behind the ear. Those hollows are commonly used for a headache that wraps around toward the eyes.

The second partner is the single hollow in the centre, right under the skull. From the middle of the back hairline, go up about one thumb-width until the fingertip drops under the bony ledge. It is used for a stiff neck and a chilled, heavy feeling at the nape. It needs even lighter pressure than these points.

The third partner is on top of the shoulder. Find the halfway point between the bony knob at the base of the neck and the tip of the shoulder, on the top of the muscle ridge. It is used when neck stiffness runs down into the shoulders. Note that this shoulder point is traditionally avoided in pregnancy.

How to Find and Press Tianzhu

Getting Into Position

Sit at a table and rest your elbows on it, so your arms can stay up without tiring. Let the chin dip slightly to soften the cords. Spread your fingers over the back of your head and bring your thumbs to the neck. Your head now rests in your hands. If your shoulders do not allow this reach, ask a helper to stand behind you while you rest your forehead on your folded arms.

How to Find It

Put your thumbs on the back of the neck, either side of the centre, and feel for the two thick cords running up into the skull. Nod your head slightly forward and back and you will feel them tighten and soften. Now slide each thumb off the outer edge of its cord into the groove beside it. Come down about a finger-width from the bony edge of the skull. That groove is the area.

Probe inside it slowly with the thumb tip. Most of the tissue will feel firm and mildly tender. One small spot will sting. It is a sharp, pinpoint tenderness under the thumb tip that fades as soon as you lift off. That spot is the point. The two sides are often different. One may sting sharply while the other barely does. If you feel a tingle over the scalp, numbness or dizziness, lift off and move a few millimetres aside.

How to Press It

The method has three steps. Find the area, probe inside it until one spot stings, then rub that spot in small circles. Use the tip of your thumb with the nail cut short, or a pressing tool with a rounded tip. With your fingers spread over the back of your head, the thumbs have a steady base to work from. You can work both sides together or one at a time.

Aim the pressure slightly upward, toward the skull, and a little inward toward the cord. Never push hard straight into the side of the neck. Keep the circles small, no wider than a grain of rice, and slow. A helper can do the same with two thumb tips while you rest your head on your arms.

How Much Pressure

Gentle. The sting tells you that you are on the spot, and it is enough. There is no need to chase it harder. Watch your body as you go. If you are holding your breath, clenching your jaw, or your shoulders have crept up toward your ears, ease off. Sharp under the thumb tip is right. Stop if the pain stays after you lift off, if it spreads, or if the area turns swollen, hot or red. Stop at once for electric or numb sensations, dizziness, nausea or blurred vision.

How Long

One to three minutes on each side. In the first sessions stay close to one minute, then add a little as the days go on. Once or twice a day is plenty. Work both sides even when only one is stiff, because the neck is a pair of pillars. Give a little more time to the side that stings more.

When to Do It

Mornings suit a neck that wakes up stiff and will not turn. A short round in the afternoon helps after long reading, sewing, driving or screen work. A gentle round in the hour before bed can help the neck settle. Do not press in the middle of the night. If neck pain wakes you, keep the neck warm and supported, change position slowly, and leave the pressing for the morning or the next evening.

What This Won't Do

It will not change why the neck is stiff. In people over fifty that is usually wear in the neck bones and discs, years of looking down at close work, a pillow that is too high or too flat, or one sleeping position held night after night. Pressing a groove at the back of the neck does not undo any of that. Raise the screen, check the pillow, take the breaks and turn the head gently through its range each day. Then this point has something to add. On its own it is a comfort measure, and it will not promise you an unbroken night.

It will not replace a diagnosis either. Call for help immediately for a sudden, severe headache unlike any before, or a headache with fever and a stiff neck. Do the same for neck pain with confusion, slurred speech, a drooping face, double vision, or weakness or numbness in an arm or leg. Do not sit pressing your neck. See a doctor promptly for neck pain after a fall or accident, for pain that runs down an arm with numbness or a weak grip, and for dizziness when you turn or tip the head back. The same goes for neck pain that worsens week on week, or comes with fever or unexplained weight loss.

Safety First

Leave this point alone after a recent neck injury, a fall onto the head or whiplash, and after neck surgery until your surgeon clears it. Do not use it if you have been told the top of your neck is unstable, as can happen with long-standing rheumatoid arthritis. Never press hard straight into the side of the neck, and ease off at once if you feel dizzy or light-headed. If you take blood thinners, bruise easily or have a bleeding disorder, use lighter pressure and keep sessions short. Do not work over skin that is broken, infected or inflamed.

Stop if the pain stays after you lift off, spreads, or the area turns swollen, hot or red, and stop for any electric, numb or tingling sensation. Nothing here asks you to push through pain. For the full list of cautions and situations where self-applied pressure is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Tianzhu (BL10) pressure point? Tianzhu (BL10) is a pair of points on the back of the neck. Feel the two thick cords running up either side of the centre into the skull. Slide off the outer edge of each cord into the groove beside it, about a finger-width below the bony edge of the skull. There is one point on each side.

How hard should I press Tianzhu (BL10)? Gently. Probe until one spot stings, then hold the pressure at that level and rub in small circles, tipping slightly upward toward the skull. Never push hard straight into the side of the neck. If you feel dizzy, light-headed or sick, ease off at once.

Can I press both sides of Tianzhu (BL10) at once? Yes. Cradle the back of your head in your hands with your fingers spread over the skull and your thumbs on the two points. Press both thumbs in the same small circles. Many people find this steadier than working one side at a time.

How is Tianzhu (BL10) different from the hollows higher up under the skull? The hollows higher up sit right under the skull's edge, further out toward the ears. These points sit a little lower and closer to the middle, on the outer edge of the thick cords. The higher hollows are commonly used for headache; these are used more for a neck that will not turn.

I feel a tingle over my scalp when I press. Is that right? No. Lift off and move a few millimetres aside. A nerve that spreads over the back of the scalp comes out of the muscles near here. The right feeling is a sharp, pinpoint sting under the thumb tip that fades when you lift off, not a tingle that travels.

Can I use Tianzhu (BL10) if neck pain wakes me in the night? Not in the middle of the night. This method keeps pressing to the daytime and the hour before bed. If the neck wakes you, keep it warm and supported, and leave the pressing for the morning or the next evening.

Other Points in This Library

Each of these sits within reach of the same hand. They are often worked in the same sitting.

This page shares general information about a traditional practice. It is not medical advice and does not replace what your doctor has given you. If you are pregnant, managing a health condition, or unsure whether this applies to you, check with your doctor first.

The whole inner edge of the foot, laid out on one page with photographs, is in The Foot Map — the free book. For every point in this library, see the full pressure point index.

(Point shown: BL10 · Tianzhu · The Celestial Pillar · Thiên Trụ.)