LI-10 (Shou San Li) Arm Three Li

What does LI-10 Shou San Li do?

LI-10 Shou San Li is a channel point of the Large Intestine channel of Hand Yang Ming on the upper forearm, and its work is overwhelmingly local and regional: it moves qi and blood through the arm, opens the channel and eases pain. It carries no five-shu, yuan, luo, xi-cleft, meeting or command classification in Sacred Lotus sources & references — it is a plain channel point, and that plainness is worth stating, because its name invites the assumption that it is something grander.

• Activates the channel and alleviates pain — the primary recorded action and the reason for most of its clinical use. It is applied to pain, stiffness, weakness and numbness anywhere along the Large Intestine channel from the hand to the shoulder.
• Regulates qi and blood in the arm — the action behind its use in the muscular complaints of the forearm and elbow, where the tradition reads the problem as qi and blood failing to move through the local channel.
• Benefits the sinews and the elbow — the recorded basis for its long-standing use in painful elbow conditions, of which lateral epicondylitis (tennis elbow) is the modern name.
• Harmonises the intestines and the Stomach — a Yang Ming action carried in our own record, behind the classical indications of abdominal pain and diarrhoea. It is a secondary use of the point and it should be read as secondary; LI-10 is not a digestive point in the way its same-named counterpart on the leg is.
• Dispels wind from the face and head — the channel action behind the classical indications of toothache and swelling of the cheek, delivered along the Large Intestine channel to the face at its far end.

Source: Sacred Lotus sources & references (channel record; the absence of any point-category classification queried directly; existing action record — the broken list markup in that record corrected here); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 111; Chinese Acupuncture & Moxibustion, p. 142; cross-referenced against multiple online sources.

What is LI-10 Shou San Li used for?

LI-10 is used first and foremost for the arm — pain, weakness and restricted movement from the shoulder to the hand, and painful elbow conditions in particular. A smaller group of classical indications reaches the abdomen and the face along the Yang Ming channel. The indications recorded in Sacred Lotus sources & references are set out below. They describe traditional use, not proven treatment.

• Pain and restricted movement of the upper limb
• Pain of the elbow, including lateral elbow pain (tennis elbow)
• Pain of the shoulder and upper back
• Weakness, numbness or atrophy of the arm
• Hemiplegia and paralysis of the arm following windstroke
• Stiff or strained neck
• Abdominal pain
• Diarrhoea
• Toothache
• Swelling of the cheek
• Swelling and pain of the throat, recorded in the classical lists
• Scrofula and nodular swellings of the neck, recorded in the classical lists

Source: Sacred Lotus sources & references (existing indication record); Chinese Acupuncture & Moxibustion, p. 142; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 111; cross-referenced against multiple online sources.

How is LI-10 Shou San Li used in practice?

Shou San Li lies on the outer, thumb-side of the forearm, two cun below the crease of the bent elbow, on the line running from the elbow crease down to the wrist. Our two sourced location records agree closely, and both fix the point by the same landmark: it is measured down from LI-11 Qu Chi at the elbow crease, along the line towards LI-05 Yang Xi at the wrist. It sits in the bulk of the forearm extensor muscles, which is why it is often tender in people whose elbow pain comes from gripping and lifting, and why it is one of the more reliably palpable points on the arm.

Which points is LI-10 combined with?

• With LI-11 Qu Chi — the essential local pairing, and by a wide margin the most common. LI-11 sits two cun above at the elbow crease, and the two are used together for elbow pain, arm pain and arm weakness. A data-mining analysis of 42 clinical studies of acupuncture for lateral epicondylitis found the most strongly supported acupoint pair in the whole literature to be LI-11 with LI-10, and identified Ashi points, LI-04, LI-11, LI-10 and SJ-05 as the core point set for the condition (J Pain Res 2026;19:583466, PMID 41938221).
• With LI-04 He Gu — the Source point of the same channel at the hand, added to extend the treatment down the whole channel and for the facial and throat indications.
• With SJ-05 Wai Guan — on the opposite, inner-back aspect of the same forearm; the pair covers both sides of the limb and appears among the core points in the epicondylitis literature above.
• With LI-15 Jian Yu and LI-11 — the Large Intestine channel sequence used for hemiplegia of the arm and for shoulder pain, working from shoulder to forearm.
• With Ashi points at the elbow — tender points found by palpation, which the epicondylitis literature records as the single most frequently needled target of all, more often than any named point.
• With cupping over the neck and shoulder — a Chinese clinical report describes acupuncture at Shousanli LI-10 combined with cupping therapy for a strained or "cricked" neck (Zhongguo Zhen Jiu 2011;31(6):566, PMID 21739713); the record is a short clinical note without a control group.
• With ST-25 Tian Shu and ST-36 Zu San Li — the additions made when the abdominal and diarrhoea indications are the target rather than the arm. Here LI-10 is the assistant and the Stomach-channel points carry the treatment.

Where does LI-10 sit among its neighbours on the channel?

The forearm stretch of the Large Intestine channel between the elbow and the wrist holds several points that a reader will find hard to separate. LI-11 Qu Chi, at the outer end of the elbow crease, is the He-Sea point of the channel, a Sun Si-miao Ghost point and a Ma Dan-yang Heavenly Star point — a major point for heat, skin disease and the whole arm, and much more widely used than LI-10. LI-09 Shang Lian and LI-08 Xia Lian lie between LI-10 and LI-11 and are used far less. LI-06 Pian Li is the Connecting point of the channel, further down the forearm, linking to the Lung channel. LI-05 Yang Xi is the River point at the wrist and the far end of the measuring line by which LI-10 is located. Against all of these, LI-10's distinguishing feature is not a classification but a position: it lies in the muscle belly rather than at a joint or a bony landmark, and it is the point of choice when the complaint is in the muscle.

Source: Sacred Lotus sources & references (location records, channel sequence, and the LI-04, LI-05, LI-06, LI-09, LI-11, LI-15, SJ-05, ST-25 and ST-36 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 111; Chinese Acupuncture & Moxibustion, p. 142; PubMed PMID 41938221, 21739713; cross-referenced against multiple online sources.

Where is LI-10 located?

• A Manual of Acupuncture (p. 111): On the radial side of the forearm, 2 cun distal to Quchi L.I.-11, on the line connecting Quchi L.I.-11 with Yangxi L.I.-5.
• Chinese Acupuncture and Moxibustion (p. 142): On the line joining Yangxi (LI-5) and Quchi (LI-11), 2 cun below the cubital crease.

How is LI-10 Shou San Li needled in the textbooks?

Reference record only — this sets out what the standard texts document, not instruction for a reader. Sacred Lotus sources & references record perpendicular insertion of 0.8 to 1.2 inch at LI-10, with moxibustion noted as applicable. Deadman & Al-Khafaji record a comparable perpendicular range. That depth is generous by the standards of the forearm, and the reason is simply that the point lies in a thick belly of muscle rather than over bone or a joint.

• Angle documented: perpendicular into the muscle of the outer forearm.
• Depth documented: approximately 0.8–1.2 cun — deeper than most forearm points, and bounded by muscle thickness rather than by any hazard beneath.
• Moxibustion: documented as applicable.

What are the safety considerations at LI-10?

LI-10 is a low-hazard point and should be described plainly as one rather than have a generic warning attached to it. It is not over the thorax, not over an abdominal organ, not near the eye, and not over a great vessel. It carries none of the organ-injury cautions that attach to points such as GB-21 over the apex of the lung, REN-15 below the breastbone or LIV-14 over the liver, and it is not among the points the classical texts restrict in pregnancy. What is documented at it is local, and it is worth stating precisely.

• What the needle passes through. Skin and subcutaneous tissue, then the muscle bellies of extensor carpi radialis longus and brevis, with brachioradialis immediately to the thumb side and supinator lying deeper. The floor of the region is the radius.
• The nerve of the region. The deep branch of the radial nerve passes through the supinator muscle in this part of the forearm on its way to become the posterior interosseous nerve. It lies deep to the plane the recorded depth describes, and it is the structure that accounts for the radiating or electric sensation sometimes reported at deeper forearm points. The radial recurrent artery runs in the same region.
• The electric sensation is a signal, not a target. A review that traced the history of needling sensations, collated reported cases of acupuncture-related nerve injury and examined which sensation scales include the electric shock concluded that a sudden electric-shock sensation is caused by the needle entering a nerve directly and should be treated as a warning sign of possible peripheral nerve injury rather than as a mark of correct technique (Neural Plast 2020;2020:8834573, PMID 33204248, PMC7655260). That review is about needling generally and is recorded here because a deep forearm point is one of the places the distinction arises.
• Risk in proportion. A meta-analysis of prospective clinical studies estimated serious adverse events across all acupuncture at approximately 1 per 10,000 patients and about 8 per million treatments, with roughly half of all recorded events being bleeding, pain or flare at the needle site (BMJ Open 2021;11:e045961, PMID 34489268). Bruising is the commonest minor event at any forearm point.

Standard clean-needle practice applies. Acupuncture is carried out only by a qualified, licensed practitioner; this record documents the reference literature and is not a technique guide.

Source: Sacred Lotus sources & references (existing needling record); Chinese Acupuncture & Moxibustion, p. 142; Deadman & Al-Khafaji, A Manual of Acupuncture, p. 111 (surface and deep anatomy of the radial forearm); PubMed PMID 33204248, 34489268.

What does the name Shou San Li mean?

Shou San Li translates as "Arm Three Li" — shou meaning hand or arm, and san li meaning three li. As with its counterpart on the leg, two readings of li are recorded and both are old. In the first, li is a unit of measure and the name records the point's position: it lies a short measured distance below the elbow, given in the classical texts as three li and in our own location records as two cun below the elbow crease. In the second, li carries its sense of a village or a settlement, and the name is read as a place along the road of the channel. The point is also met simply as San Li in older texts, which is one source of the confusion with the leg point described below. Other translations render it "Hand Three Li" or "Arm Three Measures".

Is LI-10 Shou San Li the arm version of ST-36 Zu San Li?

No — and this is the single most useful thing to understand about this point. The two names are built identically. Zu San Li is "Leg Three Li"; Shou San Li is "Arm Three Li"; the only difference is the body part. Both points sit a short measured distance below a major joint on a Yang Ming channel — ST-36 three cun below the knee on the Stomach channel of Foot Yang Ming, LI-10 two cun below the elbow crease on the Large Intestine channel of Hand Yang Ming. Both are on the same six-channel division. The parallel is real, it is deliberate, and it stops there. The two points are not functional analogues, and treating them as such is a mistake made constantly by students and, in a diluted form, by a good deal of writing about acupuncture.

• Their classifications are not comparable. Sacred Lotus sources & references record ST-36 as the He-Sea and Earth point of the Stomach channel, the Lower He-Sea point of the Stomach, a Gao Wu Command Point governing the abdomen, a Ma Dan-yang Heavenly Star point and a Point of the Sea of Water and Grain — five classifications, more than almost any point in the system. For LI-10 they record no point-category classification at all. It is a plain channel point. That difference is not a gap in our data; it is the actual position in the standard references.
• Their scope is not comparable. ST-36 is the principal tonification point of the whole system — the point used to build qi and blood, support a depleted patient, and treat almost anything arising from weakness of the digestive centre. LI-10 has no such role. Nothing in its recorded action list corresponds to ST-36's capacity to strengthen the body as a whole.
• What they genuinely share. Both are Yang Ming points, and both carry some intestinal and abdominal indications — LI-10's "harmonises the intestines and Stomach" is a real recorded action, and abdominal pain and diarrhoea are in its classical indication list. So the family resemblance is not imaginary. But for LI-10 those are secondary indications reached along the channel, while for ST-36 they are the centre of the point.
• The reverse comparison is fairer. If LI-10 is to be paired with a leg point by function rather than by name, the honest counterpart is a local channel point of the lower limb used for pain and movement — not the great tonifying point of the system. LI-10's true peer on its own channel is LI-11 Qu Chi, two cun above it, which does carry the He-Sea classification that ST-36 carries on its channel.

A reader who takes only one thing from this page should take this: the names are parallel; the points are not.

Is there research on LI-10 Shou San Li?

LI-10 is one of the relatively few points that has actually been studied on its own, and one of the findings is a direct test of the ST-36 comparison — with a negative result for both points. The literature is small and none of it establishes clinical effectiveness.

• The head-to-head with ST-36, and it is worth reading carefully. Fifteen healthy volunteers received electroacupuncture at 2 Hz and at 100 Hz at Zusanli ST-36 and at Shousanli LI-10, with heart rate variability measured before, during and after as an index of vagal activity. Neither low- nor high-frequency stimulation at either point produced a significant change in cardiovagal activity; the LF/HF ratio rose after 2 Hz stimulation at ST-36 but not significantly (Am J Chin Med 2010;38(2):231–239, PMID 20387221). A small healthy-volunteer study with a physiological rather than a clinical outcome — but it is the only study we located that put the two same-named points side by side, and it found nothing to distinguish either of them on that measure.
• LI-10 as the test point for needle sensation and pain threshold. A randomised crossover study in 22 healthy volunteers inserted a needle at LI-10 in two sessions, with bidirectional rotation in one and mock rotation in the other, measuring heat pain thresholds and rating needle sensations on the Massachusetts Acupuncture Sensation Scale. Real rotation produced significantly higher sensation scores and significantly raised heat pain thresholds both during needling and 15 minutes after removal, which mock rotation did not (Acupunct Med 2014;32(3):267–272, PMID 24509551). The study is about needle technique, with LI-10 chosen as a convenient and reliably locatable site — it is not a study of what LI-10 treats — but it is a controlled experiment conducted at this point.
• The elbow-pain literature, measured. The data-mining analysis of 42 clinical studies of acupuncture for lateral epicondylitis published between 2015 and 2025 found that the most frequently used points were Ashi points, Quchi LI-11, Shousanli LI-10, Hegu LI-04 and Waiguan SJ-05; that the Large Intestine channel was the most frequently used channel; and that the strongest association rule in the entire dataset was the pair LI-11 with LI-10 (J Pain Res 2026;19:583466, PMID 41938221, PMC13050256). This measures what practitioners have chosen, not whether it worked — but it establishes LI-10 as a core point for this condition in the published record rather than by assertion.
• A single-point clinical note. A short Chinese report describes acupuncture at Shousanli LI-10 combined with cupping for a strained neck (PMID 21739713); it is indexed without an abstract or a control group and is recorded here as a bibliographic reference only.

What is missing should be said plainly: there is no sham-controlled randomised trial isolating LI-10 for arm pain, tennis elbow or hemiplegia — its three principal traditional uses. What exists is a documented place in the prescribing record for elbow pain, two small controlled experiments in healthy volunteers, and no clinical trial of the point alone. Its standing rests on the classical record and on continuous clinical use.

Source: Sacred Lotus sources & references (LI-10 and ST-36 records, including the point-category classifications of both, queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, p. 111; Chinese Acupuncture & Moxibustion, p. 142; PubMed PMID 20387221, 24509551, 41938221, 21739713 (each verified resolvable and checked for retraction status before citation); cross-referenced against multiple online sources.