📌 UB-40 vs. UB-60 for Back Pain

If your patient presents with back pain, when should you use UB-40 and when should you use UB-60?

Lately I've been working on expanding the Daily Acupuncture Facts newsletter and turning it into a continuing education course. While I was doing that, this topic of back pain came up, so I thought I'd share it with you here...

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The Urinary Bladder channel runs down the back on each side of the spine, so points on the UB channel are often used for back pain.

Two of the most famous points are UB-40 and UB-60. But when should you choose one over the other?

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UB-40 (委中 wěi zhōng)

UB-40 is located on the back of the knee (midway between the tendons) and is a Gao Wu Command Point for disorders of the lumbar region and back.

(The Four Command Points first appeared in the Glorious Anthology of Acupuncture and Moxibustion by Gao Wu. These were considered the four most useful points on the body.)

It's also a Ma Dan-Yang Heavenly Star Point. Here it is indicated for lumbar pain with inability to straighten up, severe lumbar pain that radiates up the back, and difficulty bending and stretching the knee.

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UB-60 (昆侖 kūn lún)

UB-60 is located between the lateral malleolus and the achilles tendon. It is also a Ma Dan-Yang Heavenly Star Point, indicated for cramping of the lumbar region and sacrum.

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So what's the difference?

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Upper vs. Lower

Even though Ma Dan-Yang seems to use both points for lumbar pain, many sources say that UB-40 is better for pain in the lower back, while UB-60 can be used for pain anywhere on the back (from the neck down to the coccyx).

When using UB-40 for low back pain, it is best used when the pain is unilateral or bilateral, but not when the pain is on the midline along the spine.

For pain in the middle and upper back, or for occipital headache, UB-60 is often combined with SI-3.

(Don't get this confused with SI-3 + UB-62, which are the master and couple points for the Du Mai.)

Acute vs. Chronic (and Excess vs. Deficiency)

In A Manual of Acupuncture, Deadman says that UB-40 is equally effective for acute or chronic lumbar pain.

Maciocia, however, says that UB-40 is better for acute back pain, while UB-60 is better for chronic back pain.

He even says that UB-40 should not be used on cold and deficient patients because the point has a draining effect to cool the blood.

According to Deadman, for acute lumbar sprain, UB-40 can be needled or bled on the affected side (or both sides if the pain is bilateral). And for back pain due to Kidney deficiency, UB-60 can be through-needled to join KI-3.

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Summary of Uses

So to sum it up:

• UB-40: low back pain, acute cases, excess conditions
• UB-60: anywhere on the back, chronic cases, deficiency conditions

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And just kind of a side-note, the names of these points are interesting.

UB-40 (委中 wěi zhōng) means "center of the crease," which is just a description of its location.

UB-60 (昆侖 kūn lún) is named after the Kunlun mountains, which are the source of the Yangzi river. The Yangzi river is the longest river in China, just like the Urinary Bladder channel is the longest channel on the body. So the lateral malleolus is like the Kunlun mountains, and the UB channel is the river that flows from them.