Ganshu (BL18): The Mid-Back Point Below the Shoulder-Blade Tips, for a Tense Back and Tired Eyes

Where Ganshu Sits

This point sits on the mid back, about two finger-widths out from the centre of the spine, a hand's width or so below the lower tips of the shoulder blades. It lies on the thick ridge of muscle that runs beside the spine. It is a common place for a hard, tense band that seems to tighten when you are worried, rushed or angry.

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, one for each organ in this tradition. This one, the eighteenth stop on the line, belongs to the liver.

The old texts place it below the ninth 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 ninth is the ninth bump of the upper back. The modern standard from the World Health Organization says the same: level with the lower border of the ninth thoracic spinous process, one and a half units out from the midline. A quick route: the lower tips of the shoulder blades usually sit level with the seventh bump, so this is two bumps lower. One and a half units is about the width of your index and middle fingers laid side by side.

Under the skin lies the wide, flat muscle that sweeps from the lower back up toward the armpit (the latissimus dorsi), and the lowest fibres of the broad shoulder muscle (the trapezius). Beneath them runs the long muscle that keeps the spine upright (the erector spinae). The skin here is served by small back branches of the ninth and tenth thoracic nerves. Deeper are the ribs, and on the right side, well inside and under the ribs, the liver.

Why This Spot

On the anatomical side, the muscles here hold the middle of the spine steady whenever you reach, twist or carry. People who stand at a counter for long hours or lean over a desk often build a tense, hard ridge at this level. The nerves from this part of the spine also wrap around the lower ribs toward the front. That is why tension here can come with a tight, pulled feeling along the sides of the ribs.

In this tradition, every organ has a transport point on the back, and this is the one for the liver. In Vietnamese and Chinese medicine, the liver is described as the organ that keeps everything flowing smoothly, both the body's energy and the mood. When that flow is held up, people feel tense and short-tempered, the sides of the ribs feel tight, the back holds a hard band of tension, and the eyes feel strained and dry. The old saying is that the liver opens into the eyes. That is why teachers reach for this point when someone describes a tense back and tired eyes together, often after weeks of stress.

The name says what it does. Gan is the liver; shu means to transport. Its Vietnamese name, Can Du, carries the same meaning.

What the Old Texts Say About Ganshu

The Spiritual Pivot, the Lingshu, from the Han dynasty, has a short chapter on the back transport points. It places the liver point at the ninth vertebra, below the diaphragm point at the seventh and above the spleen point at the eleventh. The chapter also gives a simple test: press the place, and if something inside answers or the ache eases, that is the point. That is the same thing you do when you hunt for the spot that stings.

The Systematic Classic of Acupuncture and Moxibustion, the Jiayi Jing, compiled by Huangfu Mi in the third century, fixes it below the ninth vertebra, one and a half units out on each side. That location has not changed since.

The Vietnamese handbook of points and channels by Ngô Trung Triều, published by Hồng Đức, follows the same count. Draw a line across the tip of the ninth bump, it says, and meet it with a vertical line one and a half units out from the centre. Most of its list is about the eyes: long-standing eye complaints, red and sore eyes, blurred or swimming vision. It also lists back pain, nosebleeds, and inflammation of the liver and gallbladder. Those organ problems need a doctor. What the list shows is how firmly this tradition ties the back point of the liver to the eyes. In the wider tradition, it is pressed and warmed for a tense mid back, a tight ache along the ribs, and eyes worn out by close work. That reputation rests on long use rather than proof.

Points That Work With Ganshu

The first partner sits two bumps higher, level with the lower tips of the shoulder blades, the same two finger-widths out from the spine. In this tradition the two are worked one after the other when the whole mid back feels tense or achy. A tennis ball moved a little upward reaches it in the same sitting.

The second is on the top of the foot, in the hollow between the bones of the big toe and the second toe, about two finger-widths back from the web. It is easy to reach in a chair and is one of the best known points in this tradition for tension, irritability and tired eyes. Pair it with this one when stress sits in both the back and the eyes.

The third sits at the base of the skull, in the hollow on each side between the two long muscles of the back of the neck. Pair it with this one for eye strain that comes with a stiff neck after reading or screens.

How to Find and Press Ganshu

Getting Into Position

Be honest with yourself about reach. Almost nobody can press the middle of their own back well with their hands. 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 while you find the landmarks, because raised arms move the shoulder blades.

How to Find It

Stand with your arms hanging. Reach across and behind with one hand, or ask someone at home, to find the lower tip of the opposite shoulder blade. Follow that level across to the spine; the bump there is about the seventh. Walk two bumps further down. The point lies on each side of the gap below that ninth 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, often on a hard, ropy band. 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. Let your breath out slowly as you lean in; a long sigh suits this point. 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 tension that builds over a busy or stressful day. After a long stretch of reading, sewing or looking at a screen, take a few minutes on the ball and rest your eyes at the same time. Before bed is a good time too, as part of winding down. Do not press in the middle of the night. If tension 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 change your eyesight, and it will do nothing for the liver as an organ. Pressing can ease a tense, tender back and give you a few minutes of relief, which is real and worth having. What changes tired eyes and a tense back over months is plainer: regular eye checks and the right glasses, looking into the distance every twenty minutes of close work, good light, walking most days, breaks from sitting, and some way to let off the day's stress. This point works best as one small part of that.

It is no substitute for a diagnosis. Get help at once for any sudden loss or blurring of sight, a curtain or shadow across your vision, a red, painful eye, or flashes with new floaters. See a doctor the same day for pain under the right ribs with fever or sickness, or yellowing of the skin or the whites of the eyes. Call emergency services for sudden mid-back or chest pain with chest pressure, breathlessness or sweating. See a doctor promptly for back pain after a fall, especially with thin bones, and for pain that is worse lying still at night or comes with weight loss you cannot explain.

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 back or belly 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 Ganshu (BL18) pressure point? Ganshu (BL18) lies on the mid back, about two finger-widths out from the centre of the spine, level with the ninth bump of the upper back. That is two bumps below the level of the lower tips of the shoulder blades. In Vietnamese it is called Can 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.

Why would a back point help tired eyes? In this tradition the liver is said to open into the eyes, and Ganshu (BL18) is the back point for the liver. That is why it is commonly used for eyes that feel dry, tired and strained after reading or screens. It is an old idea, not an eye test. Any sudden change in your sight needs a doctor at once.

Does pressing Ganshu do anything for my liver? No. The name reflects old ideas about energy and the back, not the liver organ you see on a scan. Pressing here does not test or change how your liver works. Liver problems need a doctor and blood tests.

How long should I press Ganshu? 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.

Is it safe to press over the ribs? Yes, for most people, because a tennis ball spreads the pressure over muscle. If you have thin bones or have broken a rib before, use a softer ball, lean in less, and ask your doctor first. Never jab a hard stick into the back.

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: BL18 · Ganshu · Liver Transport Point · Can Du.)