Jianwaishu (SI14): The Upper Back Point for a Stiff Shoulder Blade and Neck

Where Jianwaishu Sits

This point sits on the upper back, about four fingers out from the spine, above the inner upper corner of the shoulder blade. It is level with the gap right below the first spinal knob under the big knob at the base of the neck.

The line it belongs to starts at the outer tip of the little finger. It runs up the little-finger side of the hand and forearm, passes behind the inner elbow, climbs the back of the upper arm and arrives at the shoulder. There it zigzags across the shoulder blade, crosses the upper back toward the spine, then rises up the side of the neck to the cheek and ends in front of the ear. Vietnamese and Chinese texts call it the Small Intestine channel. This point is its fourteenth stop, the outermost of the two it places on the upper back.

The landmarks are bone. When you bend your head forward, the largest knob at the base of the neck stands out. That is the top of the seventh neck vertebra. The next knob below it belongs to the first vertebra of the chest. The World Health Organization's 2008 standard places this point level with the lower edge of that second knob, three body-units out from the midline. Three units is about the width of four fingers held together, and on most people it brings you to the line of the inner edge of the shoulder blade. The Vietnamese handbook by Ngo Trung Trieu places it in the dip above the shoulder blade, three units from the spine.

Underneath, three layers lie on top of one another. On the surface is the wide, flat muscle that shapes the top of the shoulders and the upper back (the trapezius). Below it is a strap muscle that lifts the shoulder blade toward the neck (the levator scapulae), which attaches right at the corner you are aiming for. Deeper still lies a small muscle that pulls the shoulder blade toward the spine (the rhomboid minor). All three work hard when you sit at a screen, carry a bag on one shoulder, or hold your arms out to knit, cook or drive.

The skin here is served by small branches from the back of the spinal nerves, from the lowest roots of the neck and the first roots of the chest. That is why tension here often feels like it belongs to the neck as much as to the back.

Why This Spot

On the anatomical side, this corner is where the shoulder blade hangs from the neck. The strap muscle that lifts the shoulder blade pulls on it constantly, especially when the head pokes forward or the shoulders creep up with worry or cold. Over years, the area becomes a common seat of that knotted, ropey feeling people describe as a stiff shoulder. It often feels tender to the touch even before you press with any intent.

In this tradition the point is a transport point for the outer shoulder, a place where the flow of the channel is said to cross over the shoulder blade on its way to the neck. Points on this stretch are commonly used for local stiffness, for pain that pulls between the shoulder and the neck, and for a shoulder that will not move freely.

The name says where it sits. Jian is the shoulder. Wai is outer. Shu means a transport or passing place. Its neighbour closer to the spine is the Middle Shoulder Transport; this one is the outer of the two. The Vietnamese name, Kiên Ngoại Du, carries the same three ideas.

What the Old Texts Say About Jianwaishu

The point is recorded under this name in the Systematic Classic of Acupuncture and Moxibustion, the Zhenjiu Jiayi Jing, compiled by Huangfu Mi in the third century. That book places it on the upper back, above the shoulder blade, three units from the spine. The location has hardly changed since. Modern standards add only that it sits level with the lower edge of the first chest vertebra.

The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for pain in the shoulder joint, pain over the shoulder blade, and stiffness. It is a short and practical list, and every entry is local. This is a point the old writers used for the place it sits on, and for the neck and shoulder around it.

The same book gives a way to find it by its neighbours. It places this point level with the point on the spine below the first chest vertebra, three units out to the side, and halfway between two other points on the shoulder blade. For home use, the plainer method in this page works better: the big knob at the base of the neck, one knob down, four fingers out.

In the wider tradition, teachers often work this point together with its neighbour closer to the neck and the point on top of the shoulder, as a small group for stiffness that spreads across the upper back. That habit comes from long use rather than proof. It tells you the point was trusted by many hands for the kind of shoulder stiffness that follows a lifetime of carrying, leaning forward and holding tension in the upper back.

Points That Work With Jianwaishu

The first partner is its close neighbour. From the big knob at the base of the neck, drop into the gap right below it and move out sideways about three fingers. That point sits a little higher and closer to the spine than this one. In this tradition it is commonly used with this one for a stiff neck and an aching upper back, and you can work the two in one movement.

The second sits on top of the shoulder. Find the midpoint between the big knob at the base of the neck and the bony tip of the shoulder. The point lies on the highest part of the muscle there, the spot that so often feels like a knot. It is used with this one for stiffness that spreads across the top of the shoulders.

The third sits on the spine itself, in the gap right below the big knob at the base of the neck. It is used with this one when the whole back of the neck and upper back feel tight, cold or tired.

How to Find and Press Jianwaishu

Getting Into Position

Sit upright on a firm chair with your feet flat. Let both shoulders drop and your arms hang or rest on your thighs. If you are using a hooked tool, hold it with the hand on the opposite side and let the hook rest over your shoulder. If someone is helping, sit facing away from them with your head bent slightly forward.

How to Find It

Bend your head forward and run your fingertips down the back of the neck until you meet the largest knob at its base. Below it is a smaller knob. Find the gap right below that second knob. From there, move out sideways about four fingers. Your fingers should rest above the inner upper corner of the shoulder blade, on firm, ropey muscle. That is the area.

Probe it with a rounded-tip pressing tool, or have a helper use the tip of their thumb with the nail cut short. Move in small steps around the area. Much of it may feel tight or lumpy. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. If you feel tingling or numbness down the arm, lift off and move slightly.

How to Press It

Keep the tip on the stinging spot and rub in small circles, about the size of a fingernail, roughly one each second. Aim the pressure straight in and slightly down, toward the front of the body, not toward the neck. Do not dig in under the edge of the shoulder blade. Keep the tip on the same spot; do not let it slide along the muscle.

How Much Pressure

Sharp under the tool is right; that small sting tells you that you are on the point. When you lift off, the sting should fade within moments. If the pain stays after you lift the tool, if it spreads, or if the area turns swollen, hot or red, stop and leave it for several days. Stop at once for any tingling or numbness down the arm. If your shoulder creeps up toward your ear, or you are holding your breath, the pressure is too strong. Ease off until you can breathe slowly through the sting.

How Long

Work each side for one to three minutes. In the first sessions keep to about one minute, because tight upper back muscles are often most tender at the start. As the days go on, add a little time, up to three minutes. Do both sides, even when only one shoulder complains. Once or twice a day is plenty. Pressing longer does not add benefit; it mostly adds soreness.

When to Do It

Morning suits a neck and shoulder that are stiff on waking. Late afternoon suits tension that builds after desk work, driving, reading or housework. Before bed is a good time too, as part of winding down, when you want the shoulders to drop. Do not press in the middle of the night. If a stiff neck or aching shoulder 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 remove the reason your shoulder blade and neck are stiff. With the upper back, the reason is often posture: the head carried forward, the shoulders rounded, long hours at a screen or behind the wheel. Wear in the neck joints, a shoulder that has lost movement, poor sleep position and plain worry all play a part too. A point on the upper back will not change any of that on its own. Pressing works best alongside the plain things: short breaks to roll the shoulders, a screen raised to eye level, a pillow that supports the neck, and gentle stretches.

It will not replace a diagnosis either. Neck pain after a fall or a car accident needs to be checked before you press anything. So does a stiff neck that comes with fever, headache and sensitivity to light, which needs urgent attention. Numbness, tingling or weakness down the arm points to a nerve root in the neck and needs to be seen. Pain between the shoulder blades that comes on suddenly with chest pressure, breathlessness or sweating is an emergency; call for help. Pain that worsens week on week, wakes you every night, or comes with weight loss you cannot explain belongs with a doctor.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the area alone after a recent neck or shoulder injury, with unexplained swelling, or over a plate, pin or implant. Press gently if you have thinning bones, and never with a sharp jab. If you take blood thinners, bruise easily, have a bleeding disorder, or have reduced feeling in your arms, use lighter pressure, keep sessions short, and talk to your doctor first. If a helper presses for you, ask them to start light and let you guide the pressure.

Stop at once if the pain stays after you lift off, spreads, or if the area becomes swollen, hot or red. Stop too for any tingling, numbness or weakness down the arm. 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 Jianwaishu (SI14) pressure point? Jianwaishu (SI14) sits on the upper back. Find the large knob at the base of your neck, then the next knob below it. From the gap right under that second knob, move out about four fingers to the side. You land above the inner upper corner of the shoulder blade. In English it is called the Outer Shoulder Transport; in Vietnamese, Kiên Ngoại Du.

I cannot reach my own upper back. What can I do? Use a hooked or S-shaped pressing tool with a rounded tip, which lets you reach over your shoulder and press with your arm relaxed. Or ask someone you trust to find the spot and press with the tip of their thumb. Lying on a small ball is less precise, so keep it for a general loosening rather than this exact spot.

How long should I press Jianwaishu? 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 shoulder aches.

How is it different from the point closer to the neck? Jianzhongshu (SI15) sits a little higher and closer to the spine, level with the gap under the big knob at the base of the neck. Jianwaishu (SI14) sits one knob lower and further out, above the corner of the shoulder blade. They are neighbours on the same line and are often worked together.

Can I press it with a sore, stiff neck? In this tradition Jianwaishu (SI14) is commonly used for stiffness that spreads from the neck to the shoulder blade. If the stiffness came from a fall or an accident, comes with a fever and headache, or with numbness or weakness down the arm, see a doctor before pressing.

Should the sting spread down my arm? No. The sting should stay under the tip and fade when you lift off. A dull ache that spreads a little into the shoulder is common in tight muscles, but tingling or numbness down the arm is not. Lift off and leave the area alone if that happens.

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: SI14 · Jianwaishu · Outer Shoulder Transport · Kiên Ngoại Du.)