Geshu (BL17): The Mid-Back Point Level With the Shoulder-Blade Tips, for Aching and Hiccups

Where Geshu Sits

This point sits on the mid back, about two finger-widths out from the centre of the spine, at about the level of the lower tips of the shoulder blades. It lies on the thick ridge of muscle that runs beside the spine, at the place where many people feel a dull, nagging ache after a day of standing at the sink or bending over a table.

It belongs to the line that Vietnamese and Chinese texts call the Bladder channel. That line begins at the inner corner of the eye, runs over the top of the head, and comes down the back in two tracks on each side of the spine. The inner track, about two finger-widths from the centre, carries a row of points linked to the organs in this tradition. This one, the seventeenth stop on the line, is linked to the diaphragm, the dome of muscle you breathe with.

The old texts place it below the seventh vertebra, one and a half units out from the spine. They count from the vertebra just under the big knob at the base of the neck, so the seventh is the seventh bump of the upper back. The modern standard from the World Health Organization says the same: level with the lower border of the seventh thoracic spinous process, one and a half units out from the midline. When you stand with your arms hanging, the lower tips of the shoulder blades usually sit at this level. One and a half units is about the width of your index and middle fingers laid side by side.

Under the skin lie the lower edge of the broad, flat shoulder muscle (the trapezius) and the edge of the wide muscle that sweeps down from the armpit to the back (the latissimus dorsi). Beneath them runs the long muscle that keeps the spine upright (the erector spinae). The skin is served by small back branches of the seventh and eighth thoracic nerves. Deeper, the ribs curve out from the spine, and on their inner surface, a little lower, the diaphragm takes hold.

Why This Spot

On the anatomical side, this is a hinge of the back. Above it, the ribs hold the upper back fairly stiff. Below it, the spine begins to bend more freely toward the waist. Strain tends to gather at such a hinge. When the upper back rounds with the years and the lower back stiffens, the muscles at this level work hard to hold you upright, and they answer with a dull ache that seems to sit right behind the lower ribs. The nerves at this level also run around the chest wall, which is why tension here can feel like a tight band around the lower chest.

In this tradition, every organ and some key tissues have a transport point on the back. This is the one for the diaphragm, the partition between the chest and the belly. The diaphragm is described as a gate that must open and close smoothly. When it is held tight, people feel hiccups, a catch in the breath, a fullness under the ribs, or a band of tension around the lower chest. This point is also one of the eight meeting points of the old texts, the place where blood is said to gather. That is why teachers reach for it when a back ache feels fixed and stabbing in one place.

The name says what it is. Ge is the diaphragm; shu means to transport. Its Vietnamese name, Cách Du, carries the same meaning.

What the Old Texts Say About Geshu

The Spiritual Pivot, the Lingshu, from the Han dynasty, has a short chapter that lists the back transport points. It places the diaphragm point at the seventh vertebra, between the heart point above and the liver point below. The same chapter gives a simple way to check: press the place, and if something inside answers or the ache eases, you have found it. That is what you are doing when you hunt for the spot that stings.

The Classic of Difficulties, the Nanjing, written a little later, names eight meeting points in its forty-fifth difficulty, one for each of the body's main tissues. It says that blood meets at this point. For that reason the point became a favourite for aches that feel fixed, sharp and stubborn, the kind this tradition links to blood that does not move freely.

The Vietnamese handbook of points and channels by Ngô Trung Triều, published by Hồng Đức, follows the classic count. Draw a line across the tip of the seventh bump of the upper back, it says, and meet it with a vertical line one and a half units out from the centre. It lists the point for hiccups, vomiting from nerves, spasm of the diaphragm, back pain, sweating too easily or at night, poor appetite, and certain blood conditions. Those blood conditions need a doctor and blood tests, not pressing. The rest of the list fits the picture: a gate between chest and belly that has grown tight.

Points That Work With Geshu

The first partner sits higher and further out, level with the fourth bump of the upper back, about four finger-widths from the spine, right against the inner edge of the shoulder blade. In this tradition it is used with this one when the ache spreads from the mid back up into the area between the shoulder blades. Cross your arms over your chest to open the space, and a tennis ball reaches both.

The second sits on the centre line of the spine at the same level as this point, in the small gap below the seventh bump. The three spots, centre and both sides, sit in a row. In this tradition they are worked together when the whole mid back aches or feels tight.

The third is on the inside of the forearm, about three finger-widths up from the wrist crease, between the two tendons in the middle. It is easy to reach in a chair. Pair it with this one for hiccups, a queasy stomach, or a tight feeling across the lower chest.

How to Find and Press Geshu

Getting Into Position

Be honest with yourself about reach. Almost nobody can press the middle of their own back well with their hands, especially with stiff shoulders. That is normal. Stand with your back to a wall, feet about a foot out from it, knees soft, and use a tennis ball between your back and the wall. A stick with a rounded end, reached over the shoulder or around the waist, is another way. Let your arms hang loosely, because raising them moves the shoulder blades and changes your landmark.

How to Find It

Stand with your arms hanging. Reach across your chest and behind with one hand, or ask someone at home, to find the lower tip of the opposite shoulder blade, the point where its two edges meet. Follow that level across to the spine. You should land on or just below the seventh bump of the upper back. The point lies on each side of the gap below that bump, two finger-widths out from the centre.

Place the ball there and lean back into it slowly. Shift in small steps, a little up, down, in and out. Much of the area will feel like ordinary pressure on muscle. One spot will sting: a small, sharp, pinpoint tenderness deep under the ball, sometimes on a ropy cord of muscle. That spot is the point. Hunt for the spot that stings, because that is the one. Two balls tied in a sock let you work both sides at once, with the spine resting in the gap between them.

How to Press It

Once you are on the stinging spot, stay on it. Bend and straighten your knees a little, so the ball rubs in small circles about the size of a coin, roughly one each second, without rolling away. With a stick, hold the handle steady, place the rounded tip on the spot and make the same small circles. For hiccups, breathe out slowly and fully while you press, then pause before the next breath in. Do not press on the bony bumps of the spine.

How Much Pressure

A sharp sting under the ball is right. Stay on it. When you step away, it should fade within moments. If the pain stays after you lift off, spreads, or the area turns swollen, hot or red, stop and leave it for several days. Stop at once for any pain that wraps around the ribs or brings numbness. If you are holding your breath, you are pressing too hard to keep going. Step your feet a little closer to the wall, so less of your weight goes into the ball, until you can breathe slowly through the sting while staying on the spot.

How Long

One to three minutes on each side. Keep the first sessions to about a minute, because the mid back is often more tender than expected and can feel bruised the next day. Add a little time over the following days, up to three minutes. Work both sides, even when only one complains. Once or twice a day is plenty. Longer sessions bring more soreness, not more benefit.

When to Do It

Late afternoon suits the ache that builds after standing at the counter, gardening or carrying shopping. After a meal that leaves you full and tight, a few minutes later in the evening is pleasant. For hiccups, use it when they start. Before bed is a good time too, as part of winding down. Do not press in the middle of the night. If an aching back wakes you in the small hours, getting up to lean on a wall will only wake you further. Keep the pressing for the day and the evening.

What This Won't Do

It will not undo changes in the spine or reshape a rounded back. Pressing can ease tight, tender muscle and give you a few minutes of relief, which is real and worth having. What changes a mid back over months is plainer: walking most days, gentle twisting and stretching, breaks from sitting, carrying loads close to the body, and a chair that supports your back. This point works best as one small part of that.

It will do nothing for your blood or your blood count, and it is no substitute for a diagnosis. Call emergency services at once for sudden mid back or chest pain with pressure in the chest, breathlessness, sweating, sickness, or pain spreading to the arm or jaw. See a doctor promptly for hiccups that last more than two days, for trouble swallowing, for pain after a fall, especially with thin bones, for pain that is worse lying still at night, and for pain with fever or weight loss you cannot explain. A painful rash in a strip around one side of the chest also needs a doctor quickly.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the area alone after a recent rib or back injury or fall, with a known fracture, after recent chest or back surgery, or with unexplained swelling or a lump. If you take blood thinners, bruise easily, have thin bones or have broken a rib before, use a softer ball, lean in less, keep sessions short, and ask your doctor first. Never jab a hard stick into the ribs.

Stop at once if pain stays after you lift off, spreads, or brings tingling, numbness or trouble breathing. Nothing here requires you to push through pain that lingers. For the full list of cautions and the situations where pressing on yourself is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Geshu (BL17) pressure point? Geshu (BL17) lies on the mid back, about two finger-widths out from the centre of the spine, level with the seventh bump of the upper back. With your arms hanging, that is the level of the lower tips of the shoulder blades. In Vietnamese it is called Cách Du.

How do I press a point in the middle of my back? Most people cannot reach the middle of their own back well with their hands, and that is normal. Stand with your back to a wall and lean on a tennis ball placed over the spot. Two tennis balls tied in a sock sit on both sides of the spine at once. A stick with a rounded end, reached over the shoulder or around the waist, also works.

Can Geshu (BL17) help hiccups? In this tradition Geshu (BL17) is the back point for the diaphragm, the muscle that jumps when you hiccup, and it is commonly used for hiccups that will not settle. Many people find that pressing it while breathing out slowly helps. Hiccups that last more than two days need a doctor.

What does diaphragm point mean? The diaphragm is the dome of muscle under the lungs that you breathe with. In this tradition it has its own point on the back, at the level where it attaches inside the lower ribs. The name describes the level, not a promise of what pressing will change.

How long should I press Geshu? One to three minutes on each side. Keep the first sessions to about a minute, then add a little as the days go on, up to three. Once or twice a day is enough. Work both sides, even if only one side aches.

My mid back pain comes with chest tightness. Is that this point? Do not guess. Sudden pain in the mid back or between the shoulder blades with chest pressure, breathlessness, sweating or sickness needs emergency help at once. Only press Geshu (BL17) for a familiar muscular ache that changes when you move or stretch.

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: BL17 · Geshu · Diaphragm Transport Point · Cách Du.)