Xiaxi (GB43): The Fourth-Toe Web Point for Ringing Ears, Side Headaches and a Sore Outer Foot

Where Xiaxi Sits

This point sits on the top of the foot, at the edge of the web of skin between the fourth toe and the little toe.

The line it belongs to runs down the side of the body like a seam. It starts at the outer corner of the eye, circles around the ear, zigzags across the side of the head, crosses the top of the shoulder and runs down the side of the ribs. It passes the hip, travels down the outer thigh and the outer leg, crosses in front of the outer ankle and runs along the top of the foot to end at the fourth toe. Vietnamese and Chinese texts call it the Gallbladder channel. This is its forty-third stop, the next to last, at the toe web.

The old texts place it between the little toe and the toe next to it. The World Health Organization's 2008 standard puts it more exactly: on the top of the foot, between the fourth and fifth toes, right behind the edge of the web, where the paler skin of the web meets the skin of the top of the foot. Look closely and you can often see that line. The web skin is a shade lighter and finer.

Underneath, the point lies between the joints at the base of the fourth toe and the little toe. A small muscle that spreads and steadies the toes lies between the bones, and the thin tendons that lift these two toes run on either side. The skin is served by small branches of the superficial fibular nerve, the nerve that runs down the outer front of the leg and spreads over the top of the foot. Those branches come from the fifth lumbar and first sacral roots. A small artery runs along the web, and you may feel it beat under a fingertip.

Why This Spot

On the anatomical side, this web is thin, well supplied with nerve endings, and squeezed hard in shoes that are narrow across the toes. The little toe often curls under the fourth toe in later life, and the skin between them gets tight, hot and sore. That makes the area easy to feel and quick to respond to light pressure. It is also easy to reach with the foot across your knee.

In this tradition the point carries a clear role. It is the spring point of its channel, near the start of the flow, where the old texts describe the flow as still small, bubbling up from the ground. The Classic of Difficulties says spring points govern heat in the body. On this channel the spring point is also the water point, and water is said to feed wood, the element of this channel. So teachers describe it as a point that cools and steadies the whole line. Heat or tension on this line is said to show up as ringing in the ears, headaches at the temples, dizziness, red eyes and an ache along the ribs, and those are the problems this point is listed for. The name, Pinched Stream, describes the narrow gap between the two toes, like a stream running through a tight ravine.

What the Old Texts Say About Xiaxi

The Lingshu, the Spiritual Pivot, a Han-dynasty text, lists the key points along each channel from the toes upward. In its chapter on these root points, it says the flow of this channel slips into the Pinched Stream, places the point between the little toe and the toe next to it, and names it a spring point. The location has stayed the same through centuries of copying.

The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for ringing in the ears, headache, dizziness, pain in the chest, and pain along the nerves between the ribs. Notice the pattern. Every entry sits on the line of the channel: the ear, the side of the head, the ribs. The point is at the toe, but it is used for the far end of the line.

The handbook's finding method is plain. Press the tips of the fourth toe and the little toe together, and take the point at the head of the crease between them, on the top of the foot. That is the method used on this page.

In the wider tradition, this point is one teachers reach for when ringing in the ears comes on with a tight, hot, pounding head, and when a headache sits at the temple and the side of the head. That reputation rests on long use rather than on trials. It tells you the point was trusted, across many generations, for problems along the side of the head that become more common with age.

Points That Work With Xiaxi

The first partner is on the same line, a little further back. From the web, slide your finger back along the gap between the fourth-toe bone and the little-toe bone until it stops in a dip where the two bones meet, in front of a tendon. It is commonly paired with this one for headaches at the side of the head and a tight, sore outer foot.

The second is on the back of the hand, the mirror of this point. Make a loose fist and find the knuckles of the ring finger and little finger. The point is in the dip between those two bones, right behind the knuckles. In this tradition it is used with this one for ringing ears and tight neck and shoulders.

The third is at the ear. Open your mouth wide and feel the small flap of cartilage in front of the ear hole; a hollow opens right in front of it. In this tradition it is the local point for the ear, and it is paired with this distant one when ringing is the main complaint.

How to Find and Press Xiaxi

Getting Into Position

Sit on a firm chair and lift one foot onto the opposite knee, so you can see the top of the foot and the toes. If that is hard on the hip, rest the foot on a low stool in front of you and lean forward, or sit on the bed with the knee bent and the foot flat. Let the toes relax.

How to Find It

Look at the top of the foot and find the web of skin between the fourth toe and the little toe, the last web on the outer side of the foot. Press the two toes together with your other hand. A short crease forms between them. The area is at the end of that crease, on the top of the foot, where the web turns into the skin over the joints. If you let go of the toes, it sits right behind the edge of the web.

Now probe it with a rounded-tip pressing tool, or the tip of your thumb with the nail cut short. Move slowly in small steps around the end of the web, toward each toe and a little back. Most of it will feel like ordinary skin and tendon. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. If the little toe curls under the fourth toe, gently hold it straight with your fingers while you probe.

How to Press It

Keep the tip of the tool or thumb on the stinging spot and rub in small circles, about the size of a fingernail, roughly one each second. Aim the pressure down into the gap between the two toe joints and slightly back toward the ankle, not forward into the web. Hold the toes with your other hand so they stay still. Keep the tip on the same spot; do not let it slide off onto the little toe.

How Much Pressure

Sharp under the tool is right. That small sting tells you that you are on the point, and here it is usually strong. The test comes when you lift off: the sting should fade within moments. If the pain stays after you lift the tool, spreads, or the web turns swollen, hot or red, stop and leave it for several days. If you are holding your breath or pulling the foot away, you are pressing too hard. Ease off until you can breathe slowly through the sting. This point needs less force than most.

How Long

Work each foot for one to three minutes. In the first sessions keep to about one minute, because the web is often very tender at the start. As the days go on, add a little time, up to three minutes. Do both feet, even when the ringing or the headache is on one side only. Once or twice a day is plenty. Pressing longer does not add benefit; it mostly adds soreness.

When to Do It

Late afternoon suits a headache at the side of the head that builds through the day, and an outer foot that aches after walking. Evening, before bed, suits ringing in the ears, which often seems loudest when the house is quiet; press, then settle with soft background sound. Do not press in the middle of the night. If ringing or an aching foot wakes you, pressing then tends to wake you further. Keep the pressing for the day and the evening.

What This Won't Do

It will not restore hearing or stop ringing in the ears. Lasting ringing often goes with hearing loss from age or noise, with wax, with jaw and neck tension, or with some medicines, and the right help may be a hearing test, a hearing aid, a change of medicine, or a sound program from an audiologist. A point between your toes cannot out-argue any of that. Pressing is best used as a calm, gentle habit alongside that help, not in place of it. The same goes for headaches and a sore foot: shoes with room for the toes, rest from screens, water, sleep and regular movement do more of the work.

It will not replace a diagnosis either. A sudden loss of hearing in one ear, with or without ringing, needs a doctor within a day or two, because early care matters. Ringing in one ear only, ringing that beats in time with your pulse, or ringing with dizziness, a feeling of fullness or new weakness in the face, needs to be checked. A sudden, severe headache, or a headache with weakness, confusion or trouble speaking, needs emergency care. Pain in the chest is never something to press for; get help.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy, or over a web that is cracked, blistered or itchy with athlete's foot. Leave the area alone with a recent toe fracture, a fresh sprain, unexplained swelling, or a pin or screw under the skin. If you take blood thinners, bruise easily, have a bleeding disorder, or have reduced feeling in your feet, use lighter pressure, keep sessions short, check the skin afterward, and talk to your doctor first.

Stop at once if the pain stays after you lift off, spreads, or if the area becomes swollen, hot or red. Nothing here requires you to push through pain. 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 Xiaxi (GB43) pressure point? Xiaxi (GB43) sits on the top of the foot, at the edge of the web between the fourth toe and the little toe. Press those two toes together and look at the end of the crease they make; the point is there. In English it is called the Pinched Stream; in Vietnamese, Hiệp Khê.

How long should I press Xiaxi? One to three minutes on each foot. 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 feet, even if the ringing or the ache is on one side.

Will it stop the ringing in my ears? No one can promise that. In this tradition the point is commonly used for ringing ears, especially ringing that comes with a tense, hot head or headaches at the side of the head, and some people find the ringing seems less intrusive after a calm session. Ringing that lasts needs a hearing check, and a sudden loss of hearing needs a doctor within a day or two.

Why press a toe for an ear problem? The line this point belongs to runs from the outer corner of the eye, around the ear, down the side of the body and out to the fourth toe. In this tradition, points at the far end of a line are used for trouble at the other end. It is an old idea based on long use, not on trials, and it is best seen as one gentle part of a wider plan.

Is this the same as the point higher up between the same toes? No. The higher point, Zulinqi (GB41), sits further back on the top of the foot, in the dip where the bones of the fourth and little toes meet. Xiaxi sits forward at the web itself. They are on the same line and are often worked one after the other.

The web is very sore. Is that normal? A sharp sting under the tool is expected here, because the web is thin and full of nerve endings. It should fade within moments of lifting off. If the soreness stays, or the skin between the toes is red, cracked or itchy, leave it alone and look after the skin first.

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: GB43 · Xiaxi · Pinched Stream · Hiệp Khê.)