Yanglao

What is SI6?

SI6, or Yanglao, is an acupressure point in the small bony cleft just above the wrist bone on the little-finger side of the forearm.

It is the sixth point on the Small Intestine channel. The name Yanglao is usually translated as nourishing the old, and classical texts link it to dim or blurred vision in older people. Modern teaching knows it mainly as the channel's xi-cleft point, meaning the point traditionally reached for in sudden, sharp problems rather than slow ones.

In tradition it is used for a stiff neck that will not turn, shoulder and arm pain, and acute low back strain, usually pressed on the side opposite the pain while the sore part is gently moved.

Two things are worth saying once, clearly. Traditional standing is not evidence that a point does anything. It is also not evidence that a point is safe. Both questions have to be answered on their own, and this page answers them in separate sections.

On evidence, the honest verdict is thin. There is no good controlled trial of finger pressure at SI6 on its own for any condition. Where SI6 appears in research it is nearly always one needle among several in a multi-point protocol, so nothing can be credited to this point specifically. Most acupressure research in general is small, short and unblinded, which means expectation and attention can easily explain the results.

That is not the same as saying it does nothing. It means nobody has tested it properly. Gentle self-applied pressure on a healthy forearm is low-risk, so trying it for a few minutes and judging the result for yourself is reasonable. Treating it as a treatment for an eye condition, a disc problem or a fracture is not.

Everything described here is finger pressure that you apply to yourself. Needling, moxibustion and cupping are clinician procedures and are not taught on this page.

Where is SI6 and how do you find it?

SI6 sits in the bony cleft on the thumb side of the ulnar head, the knobbly lump on the back of the wrist on the little-finger side.

• Start palm down. Rest your forearm on a table with the back of the hand facing up and the wrist relaxed.
• Find the knob. Run a fingertip along the little-finger edge of the forearm towards the wrist. Just above the wrist crease you will meet a rounded bony lump. That is the head of the ulna.
• Press the top of the lump. Put the pad of your opposite index finger on the highest point of that knob and keep it there.
• Turn the palm towards your chest. Rotate the forearm slowly, as if bringing your palm up to your collarbone. As you turn, a small cleft opens under your fingertip and the finger drops into it.
• That hollow is SI6. It lies on the thumb side of the bony knob, roughly one thumb-width, about 2.5 cm, above the wrist crease.

In classical terms this is one cun proximal to the wrist, in the bony cleft on the radial side of the head of the ulna. The rotation trick is the reliable way to find it, because the cleft is hard to feel when the forearm is flat.

Two neighbours are easy to confuse with it. SI5 sits lower, right at the wrist crease in the dip between the ulnar styloid and the wrist bones. SI7 sits much higher, about halfway up the forearm. SI6 is the one that only reveals itself when you turn the palm inwards.

You will usually feel a firm, slightly tender spot rather than a sharp one. If you are getting pain or a buzzing feeling that shoots into the little and ring fingers, you have drifted onto a nerve. Move off and try again more lightly.

How do you apply pressure to SI6?

1. Settle the arm. Rest the forearm on a table or on your lap, palm turned towards your chest so the cleft stays open.
2. Use the opposite thumb or index finger. Place the finger pad, not the nail, into the hollow beside the bony knob.
3. Press in slowly. Lean in over about five seconds until you feel a firm, dull ache. Aim for roughly three or four out of ten on a discomfort scale. It should never be sharp.
4. Hold or circle. Hold steady for 30 to 60 seconds, or make small circles on the spot. Keep breathing normally rather than holding your breath.
5. Add gentle movement. For a stiff neck or a sore shoulder, slowly turn or lift the painful part while you keep the pressure on. Tradition uses the point this way, and the movement itself is useful regardless.
6. Release and repeat. Ease off over a few seconds, rest for half a minute, then repeat up to three times per side.
7. Keep sessions short. Two or three minutes per wrist, up to two or three times a day, is plenty.

Work the arm on the opposite side to the pain if you are using it for neck, shoulder or back complaints, which is the traditional pattern. For wrist or forearm soreness, press the sore side itself but go lighter.

Stop straight away if you get numbness, pins and needles, shooting pain into the hand, or skin that stays red and sore afterwards. The skin over the wrist is thin and bruises easily, so blunt, gentle pressure beats hard digging.

Clean hands and short nails help. Do not use a tool, a pen cap or a hard presser here, because the bone is close to the surface and the margin for error is small.

What is SI6 traditionally used for?

• Stiff neck that will not turn. Tradition presses SI6 on the opposite arm while the person slowly turns the head. Human evidence for SI6 specifically is absent, though gentle movement plus distraction is a reasonable way to coax a guarded neck.
• Shoulder and upper arm pain. The Small Intestine channel runs up the back of the arm to the shoulder blade, so SI6 is a standard distal choice for pain along that line. Trials that include SI6 bundle it with several other points, so no effect can be traced to this point alone.
• Acute low back sprain. Yanglao is a classical distal point for a back that has just seized up, again pressed while the person moves gently. The research that exists is small, mostly needling, and not designed to isolate SI6.
• Blurred or dim vision in older people. This is the claim behind the name Yanglao. There is no human evidence that pressing it changes eyesight, and age-related vision change needs an optometrist or eye doctor, not a wrist point.
• Wrist and forearm aching. As a local point, light pressure around the area may feel soothing for general ache or stiffness. That is a comfort effect, not a treatment for tendon or joint disease.
• Sharp, sudden complaints generally. Because it is the channel's xi-cleft point, tradition favours it for acute rather than long-standing problems. This is a classical rule of thumb, not a tested one.

None of the above is a cure, and none of it should delay a diagnosis. Neck, back and shoulder pain have many causes, some of which need imaging or examination.

Across acupressure as a whole, the better studies are small, short and unblinded. PC6 for nausea is the one clear exception with decent human support. SI6 is nowhere near that level, and saying otherwise would be dressing tradition up as proof.

Are there tips for using SI6 effectively?

• Use the rotation trick every time. The cleft only opens when the palm turns towards the chest. Fish for it with a flat forearm and you will usually end up on bone.
• Aim for the hollow, not the knob. The point is in the soft gap on the thumb side of the bony lump. If your finger is sitting on something hard, slide a few millimetres towards the thumb.
• Press the opposite side. For neck, shoulder or back complaints, tradition works the arm opposite the pain. It also keeps the sore side free to move.
• Pair it with slow movement. Gently turning the head or easing the back through a comfortable range while you hold pressure is the classical method and the most practically useful part of it.
• Keep the pressure blunt. Use the flat pad of the finger. Nails, pen tips and hard massage tools concentrate force onto thin skin over bone and can bruise.
• Give it a fair but short trial. A couple of minutes, two or three times a day, for about a week. If nothing has shifted, it is probably not going to.
• Write down what happened. Note your pain or stiffness before and after. Self-care is easy to misjudge, and a simple note keeps you honest with yourself.
• Warm the forearm first. A minute under warm water or a warm cloth makes the area more comfortable and helps the muscles let go.
• Stop at numbness. Tingling or a zing into the little and ring fingers means you are on a nerve. Lift off, shake the hand out, and reposition.

Treat SI6 as one small comfort measure alongside the things with better support, such as staying gently active, sleeping well and getting persistent pain properly assessed.

What do people get wrong with SI6?

• Pressing the bone itself. Landing on the hard knob of the ulnar head instead of the cleft beside it. It hurts, it bruises, and it misses the point entirely.
• Hunting for it palm-down. The cleft at SI6 barely exists until the forearm rotates. Without turning the palm towards the chest, most people never find the hollow.
• Confusing it with SI5. SI5 sits right at the wrist crease in the dip on the little-finger side. SI6 is about a thumb-width higher, up on the forearm.
• Expecting a cure. No acupressure point cures a disc problem, a frozen shoulder or an eye condition. Expecting that from SI6 means a real diagnosis gets delayed.
• Taking the name literally. Yanglao means nourishing the old, and the classical link is to failing eyesight. That is a traditional claim with no human evidence behind it. Vision changes need an eye examination.
• Digging too hard. More force does not mean more effect. The skin here is thin and close to bone, so heavy pressure mostly produces tenderness and bruising.
• Ignoring nerve signals. Pushing on through pins and needles into the fingers. That feeling is a nerve complaining, and it is a reason to stop, not to persist.
• Pressing an injured wrist. People who have just fallen on an outstretched hand sometimes press the sore area. A wrist fracture can look like a simple sprain and needs an X-ray.
• Using it instead of movement. For a stiff neck or a strained back, gentle movement and staying active have far better support than any single pressure point.

What does the research on SI6 actually say?

There is no controlled human trial of finger pressure at SI6 on its own that supports any specific claim. That is the plain answer, and it applies to neck pain, back pain, shoulder pain and vision alike.

Where SI6 does turn up in the research literature, it is almost always as one needle within a multi-point acupuncture prescription, typically for neck pain, shoulder pain or acute low back strain. Those studies cannot tell you what SI6 contributed, because the point was never tested separately. Many of them are small, unblinded, and published in Chinese-language journals with limited methodological detail.

The wider picture for acupressure is worth knowing, because it sets expectations. Most trials recruit a few dozen people, run for days or weeks, and cannot blind participants to whether they are being pressed. Attention, touch and expectation all push results in a positive direction. For one use, PC6 for nausea and vomiting, the evidence is strong enough to state plainly. SI6 has nothing approaching that.

It is also worth separating the two questions people run together. Nobody has shown SI6 works. Nobody has shown it does not. Absence of evidence is not disproof, it is a gap, and the honest thing is to label it as a gap rather than fill it with tradition.

Practically, this means you can treat SI6 as a low-risk self-care experiment on a healthy forearm, with a short trial and a realistic eye on the result. It also means it should not be the reason you delay seeing someone about neck pain that is not settling, a back that is getting worse, arm weakness, or any change in your vision. Those need assessment, and a wrist point is not a substitute for one.