SI-14 (Jian Wai Shu) Outer Shoulder Shu

What does SI-14 Jian Wai Shu do?

SI-14 activates the channel and alleviates pain, and it expels wind and cold and benefits the shoulder and scapula — a purely musculoskeletal record, with no organ action at all.

• Activates the channel and alleviates pain
• Expels wind and cold and benefits the shoulder and scapula

The contrast with its neighbour is clean, and it is the most useful thing to know about this point. SI-15 Jian Zhong Shu sits one level above at C7 and its recorded action leads with descending Lung qi; three of its four indications are respiratory. SI-14 has no respiratory action and no respiratory indication. Two points a level apart on the same channel, and the split between local and organ function is total. Where our data draws a distinction that sharply, this library reports it rather than blurring the two pages together.

Wind and cold, and why they belong here. The upper back and neck is where wind-cold is classically described as entering the body — the same reasoning behind BL-12 Feng Men (Wind Gate), GB-20 Feng Chi (Wind Pool) and DU-16 Feng Fu (Wind Palace), all in this region. Our BL-09 record notes the same cold emphasis at the occiput. A stiff, aching neck and shoulder after exposure is exactly the presentation this action describes.

On the name, and a caution. “Jian Wai Shu” — Outer Shoulder Shu. Wai, outer, marks it as the more lateral of a pair: SI-14 at 3 cun, SI-15 Jian Zhong Shu (Central) at 2 cun. The names describe their relationship to each other. Both end in -shu, and neither is a Back-Shu point — those all sit on the inner Bladder line at 1.5 cun. Our BL-26 and DU-02 records document the same trap on their own channels.

Source: Sacred Lotus sources & references (channel, action, location and translation records; the SI-15, BL-09, BL-12, BL-26, DU-02, DU-16 and GB-20 records queried and compared against our own data), cross-referenced against multiple online sources.

What is SI-14 Jian Wai Shu used for?

SI-14 is used for aching of the shoulder and back, and for pain and rigidity of the neck. Our own indication record is reproduced here in full — two entries, both local.

• Aching of the shoulder and back
• Pain and rigidity of the neck

Two entries, and the page will not stretch them. SI-14 is a local point in our source material and nothing more — no organ action, no systemic indication, no respiratory entry despite sitting one level from a point that is three-quarters respiratory. Where a record is this short this library states its limits plainly rather than filling the space, as on BL-06, BL-38, BL-45, BL-61 and DU-07.

An honest note. Sudden severe headache with neck rigidity requires urgent medical assessment, and neck stiffness with fever needs urgent assessment — that combination has causes that are emergencies. Neck pain with arm weakness, numbness or loss of coordination requires prompt medical assessment. This record documents classical use for ordinary aching and stiffness and should not delay care for any of the above.

How it is combined. With SI-15 Jian Zhong Shu above and medially, and SI-13 Qu Yuan below on the scapula. With DU-13 Tao Dao at the same T1 level on the midline, and BL-11 Da Zhu at 1.5 cun. With GB-21 Jian Jing on the top of the shoulder and BL-10 Tian Zhu on the neck. With SI-03 Hou Xi distally — the Confluent point of the Governing Vessel, and the classical distal point for the neck. All held here.

Source: Sacred Lotus sources & references (indication record; the BL-06, BL-10, BL-11, BL-38, BL-45, BL-61, DU-07, DU-13, GB-21, SI-03, SI-13 and SI-15 records queried from our own data), cross-referenced against multiple online sources.

Where is SI-14 Jian Wai Shu located?

SI-14 is on the upper back, three cun out from the midline, level with the lower edge of the first thoracic spinous process — the same level as DU-13 Tao Dao.

• 3 cun lateral to the midline, level with T1
• Level with DU-13 Tao Dao on the midline and BL-11 Da Zhu at 1.5 cun
• SI-15 Jian Zhong Shu lies one level above at C7, and closer in at 2 cun

Four points across one level, on three different channels. At T1 our records hold DU-13 on the midline, BL-11 at 1.5 cun, BL-41 Fu Fen at 3 cun on the outer Bladder line, and SI-14 also at 3 cun on the Small Intestine channel. That two different channels both place a point at 3 cun at the same level is worth knowing before reading a prescription: the lateral distance alone does not identify the point, and BL-41 and SI-14 are distinguished by which channel they belong to and by fine positional detail rather than by the measurement.

T1 is the first step of the chain that counts the whole back, taken from DU-14 below the prominent vertebra at the base of the neck. Our DU-13 and BL-11 records note the complication: C7 and T1 can both be prominent, and in some people T1 is the more so, which makes the starting point less obvious than it sounds.

On the name. “Jian Wai Shu” — Outer Shoulder Shu. Positional, and describing its relation to SI-15 rather than to an organ.

Source: Sacred Lotus sources & references (location and translation records, retained unchanged; the BL-11, BL-41, DU-13, DU-14 and SI-15 positions queried and compared against our own data).

• A Manual of Acupuncture (p. 243): 3 cun lateral to the lower border of the spinous process of T1 (Taodao DU-13).
• Chinese Acupuncture and Moxibustion (p. 171): 3 cun lateral to the lower border of the spinous process of the 1st thoracic vertebra where Taodao (DU-13) is located.

How is SI-14 Jian Wai Shu needled, and what is the pneumothorax risk?

Stated plainly: SI-14 lies over the top of the thorax with lung beneath it, pneumothorax is the documented hazard of this band — and it holds the SECOND thickest measured margin of the 23 points in the study covering this region. What follows is a neutral record of what the reference literature and the published measurements document. It is not instruction, and this page does not teach technique.

• Angle and depth as recorded: oblique, 0.3–0.7 inch. The obliquity is the safety feature, not a stylistic detail — angling toward the spine keeps the needle in muscle; angling outward points it at the pleura.
• Moxibustion: recorded as applicable. It carries no pneumothorax hazard.
• Regional anatomy: the upper fibres of trapezius overlie levator scapulae and the rhomboids, with the superior angle of the scapula nearby; the first and second ribs and the apex of the lung lie deep, with the pleural dome rising above the first rib.

The measurement, attributed precisely. The paediatric chest-CT study gives SI-14 as 36.82 mm in boys and 32.51 mm in girls on average, measured skin to the pleura as for every off-midline point in it. These are paediatric figures, not adult values (Wang J et al., PMID 26922245, PMC4769822).

Read the T1 level across and the study’s own definitions come into focus. At this one vertebral level the same paper measures:

• DU-13, midline — 33.61 mm (boys), skin to the EPIDURAL layer
• BL-11, 1.5 cun — 33.39 mm, skin to the PLEURA
• BL-41, 3 cun — 30.86 mm, skin to the PLEURA
• SI-14, 3 cun — 36.82 mm, skin to the PLEURA

Four figures within six millimetres of one another, and one of them measures a completely different structure from the other three. Our DU-13 record is built around that trap. Note also that BL-41 and SI-14 are both at 3 cun and differ by nearly six millimetres — measured depth is not a function of lateral distance alone.

What a thicker margin does not license. Our record’s bound is 0.3–0.7 inch regardless; the figure explains why that bound is comfortable rather than tight. The pleural dome is still beneath, and our BL-11 record cites adult cadaveric work finding it extended beyond the medial third of the clavicle in almost 60 per cent of 46 bodies. No adult figure for SI-14 could be located.

Source: Sacred Lotus sources & references (needling record, retained unchanged); PMID 26922245 / PMC4769822 (paediatric chest CT; SI-14 among the 23 measured points, skin-to-pleura, with the DU-13, BL-11 and BL-41 same-level figures and their differing layer definitions compared directly); PMID 16739850 via our BL-11 record; regional anatomy from standard anatomical description.

Is there research on SI-14, and what should a reader know?

No trial isolates SI-14. Where the point appears it is one component of a neck-and-shoulder protocol, and a study that includes a point in a protocol is not evidence about that point.

The research that names SI-14 is anatomical, and its value is comparative. Read alongside DU-13, BL-11 and BL-41 at the same T1 level, it shows two things at once: that measured depth varies by several millimetres between points at the same level and the same lateral distance, and that one of the four figures is measured to a different layer entirely.

What this page can state with confidence. SI-14 sits at 3 cun lateral to T1, level with DU-13 — sharing that lateral distance with BL-41 on a different channel, so the measurement alone does not identify it. Its recorded indications are two entries, both local, with no organ action at all, in sharp contrast to SI-15 one level above whose record is three-quarters respiratory. And its measured margin of 36.82 mm in boys is the second thickest of the 23 points, after SI-15.

A note on searching for it. “SI 14” and “Jianwaishu” searches return protocol trials and unrelated material — “SI” also abbreviates the International System of Units, making the code alone a poor search term, and Jian Wai Shu differs from Jian Zhong Shu by one syllable. Any claim attached to this point should be checked against what a study actually used, and to which layer it measured.

Source: Sacred Lotus sources & references (action, indication and location records; the SI-15, BL-11, BL-41 and DU-13 records compared against our own data); PMID 26922245 for the measured depths and the same-level comparison.