Xiangu

What is ST43?

ST43 (Xiangu) is a Stomach-channel acupressure point on the top of the foot, in the groove between the second and third long foot bones. Its Chinese name is usually translated as "Sunken Valley", which describes the dip you feel between those two bones.

In classical Chinese medicine ST43 is the Shu-stream point of the Stomach channel and its Wood point. Old texts list it for puffiness of the face and feet, abdominal rumbling and pain, and for swelling or aching across the top of the foot itself. Modern textbooks still teach it in that role, mostly as a local foot point and as a secondary choice for digestive complaints.

Tradition tells you how a point has been used. It does not tell you that the point works, and it does not tell you that it is safe for you. Both of those are separate questions, and we answer them separately on this page. That caveat applies to everything below, so we say it once here rather than at the top of every section.

The honest verdict on the evidence: there is essentially no human research testing ST43 on its own for any condition. That is not the same as saying it does nothing. It means nobody has looked properly, so no one can tell you what it does. Acupressure research overall is dominated by small, short, unblinded studies, and a few points, such as PC6 for nausea, carry far better evidence than the rest. ST43 is not one of them.

What ST43 does offer is a safe, easy place to put your thumb. The top of the foot is accessible, the landmark is a real bone groove you can feel, and firm self-massage there is low-risk for most healthy adults. Treat it as comfort and self-care, not as treatment. If you have swollen feet, foot pain that is getting worse, or stomach symptoms that keep coming back, those need a doctor's opinion, not a pressure point.

Where is ST43 and how do you find it?

ST43 sits on the top of the foot, in the soft groove between the second and third metatarsals, about two thumb-widths back from the toe web.

• Start at the toe web. Find the skin web between your second toe (next to the big toe) and your third toe. This is your starting landmark.
• Slide back along the groove. Run your fingertip from that web backwards towards your ankle. You will feel a soft channel between two hard ridges. Those ridges are the long foot bones (metatarsals).
• Measure about two thumb-widths. Classical texts place ST43 roughly 2 cun back from the web margin. On most adults that is about 4 to 5 cm, or the width of two thumbs at the knuckle.
• Settle in the dip. ST43 lies in the depression just in front of where the second and third metatarsal bones meet and start to widen. Your finger should drop into a hollow, not sit on a ridge.
• Check by spreading the toes. Gently fan your second and third toes apart. The groove deepens slightly, which makes the spot easier to feel.

Two neighbours can confuse people. ST44 (Neiting) is much closer to the toes, only about half a thumb-width back from the same web. ST42 (Chongyang) is further back still, on the highest arch of the foot where you can feel a pulse. ST43 sits between those two, in the middle of the long bones.

Feet differ in size, so treat the measurement as a guide and the groove as the real landmark. Use your own thumb, not someone else's, for the two-thumb estimate. Many people find the spot feels slightly tender or dull when pressed, which is often how they confirm it. Tenderness is not proof you are in the right place, and a point that feels like nothing is not wrong. Pick the clearest hollow you can feel in that groove and work from there.

How do you apply pressure to ST43?

1. Sit down and get the foot up. Cross the ankle over the opposite knee, or rest the foot on a low stool. You need to see and reach the top of the foot comfortably.
2. Place your thumb in the groove. Use the pad of your thumb, not the nail. Settle it in the channel between the second and third foot bones, about two thumb-widths back from the toe web.
3. Press straight down, slowly. Increase pressure over two or three seconds. Aim for a firm, dull ache you would rate about 3 or 4 out of 10. Sharp pain means too hard, or too close to bone.
4. Hold or make small circles. Hold steady for 30 to 60 seconds, or rub small circles for the same time. Breathe normally and keep your shoulders relaxed.
5. Release and repeat. Ease off for 10 seconds, then repeat two or three times. One to three minutes per foot is plenty.
6. Do both feet. Most traditional routines treat the point on both sides. There is no evidence one side matters more.
7. Repeat once or twice a day. Daily use is reasonable for self-care. Give it a week or two before deciding whether it is doing anything for you.

This is finger pressure only. Nothing on this page involves needles, heat, suction or anything that breaks the skin. If you have read about ST43 being needled in a clinic, that is a clinician's procedure, not something to copy at home.

Stop immediately if you feel sharp or shooting pain, if the skin reddens and stays red, if the area swells, or if you feel dizzy or faint. Stop also if the spot is bruised the next day; that means you pressed far too hard. Pressure should never leave a mark. If a minute of gentle pressure is unbearable, something else is going on in that foot and it needs looking at.

What is ST43 traditionally used for?

• Swelling and puffiness. This is ST43's best-known classical use, covering a puffy face, swollen eyes and swollen feet. No human trial has tested ST43 for fluid retention. Persistent swelling can signal heart, kidney, liver or thyroid problems, so it is a doctor's question first.
• Pain and swelling on the top of the foot. As a local point, ST43 is used for aching across the forefoot. Gentle self-massage of a sore foot often feels good, but that is general massage comfort, not a point-specific effect.
• Abdominal rumbling and cramping pain. Classical texts list ST43 for borborygmus (gut rumbling) and abdominal pain, because it sits on the Stomach channel. There is no controlled human evidence for ST43 alone in digestive complaints.
• General stomach and digestive support. Modern practitioners sometimes add ST43 to a wider Stomach-channel combination for indigestion or poor appetite. Studies of such combinations cannot show what any single point contributed.
• Fever with no sweating. Older texts mention ST43 in febrile illness. There is no modern evidence behind this, and fever that worries you is a medical matter, not a pressure-point one.
• Toe and forefoot tension. Some people use ST43 simply as a release spot after long walks or tight shoes. This is a reasonable comfort use with no claims attached.

Across all of these, the pattern is the same. ST43 has a long and consistent traditional record, especially for swelling and for local foot complaints. It has almost no modern human testing on its own.

That gap matters when you choose what to expect. Firm pressure on a sore foot may genuinely feel better for a while. Whether ST43 changes fluid balance, digestion or fever is simply unknown, and anyone telling you otherwise is going beyond what has been shown.

Are there tips for using ST43 effectively?

• Find the groove before you press. Trace the channel between the second and third foot bones with a light fingertip first. Landing in the hollow matters more than hitting an exact measurement.
• Use the thumb pad, not the tip. The broad pad spreads the load and is far less likely to jab a tendon or a bone edge. Keep nails short.
• Warm the foot first. A few minutes of general foot rubbing, or doing this after a shower, makes the tissue softer and the point easier to feel.
• Keep the toes relaxed. If you clench your toes the tendons on the top of the foot stand up and block the groove. Let the foot go floppy.
• Work both feet. Traditional routines use ST43 on both sides, and it takes only a couple of extra minutes.
• Stay in the dull-ache range. Firm and achy is the target. Sharp, hot or electric sensations mean move or stop, not push harder.
• Elevate swollen feet anyway. If puffy feet are the reason you are here, raising the legs above hip level for 15 minutes has far better support than any point. Use the pressure alongside it, not instead.
• Pick a regular slot. Evening, while sitting down, works for most people. Consistency helps you judge whether it does anything for you.
• Keep a simple note. Jot down what you felt before and after for a fortnight. Self-tracking stops you guessing and makes it easier to drop it if nothing changes.
• Check your shoes. Forefoot aching is often narrow toe boxes or worn soles. Fixing the cause beats massaging the symptom.

One broader tip: judge ST43 by comfort, not by claims. Short-term relaxation from self-massage is real and worth having. Treat anything beyond that as unproven, and keep your doctor in the loop for symptoms that persist.

What do people get wrong with ST43?

• Expecting a cure. No acupressure point cures swelling, indigestion or foot pain. ST43 may be a pleasant few minutes of self-care, and it should not replace a diagnosis.
• Pressing ST44 instead. ST44 (Neiting) sits only about half a thumb-width back from the toe web. ST43 is much further back, roughly two thumb-widths, in the middle of the long foot bones.
• Drifting back to ST42. If you feel a pulse under your finger you have gone too far towards the ankle and are near ST42 (Chongyang). Move forward, towards the toes.
• Pressing on the bone ridge. Many people land on top of a metatarsal instead of in the groove between two of them. Bone feels hard and sharply sore; the groove feels soft and dully achy.
• Digging with a fingernail or a tool. The skin on the top of the foot is thin and the tendons sit just beneath it. Use a thumb pad and nothing harder.
• Going far too hard. Bruising is a sign of damage, not of a good session. Pressure that leaves a mark should never be repeated.
• Ignoring one-sided swelling. A single swollen, warm or painful leg or foot needs urgent medical assessment, not massage. That pattern can mean a blood clot or infection.
• Massaging through numbness. If the foot is numb from nerve damage you cannot feel how hard you are pressing, so injury goes unnoticed.
• Treating it daily for months without review. If a symptom has not shifted in two or three weeks, the answer is a medical opinion, not more pressure.
• Copying needling videos. Clips showing ST43 being needled are clinical procedures. Nothing on this page involves needles, heat or broken skin.

What does the research on ST43 actually say?

There is no useful human research on ST43 on its own. We could not identify controlled trials testing finger pressure at ST43 for swelling, digestive symptoms, foot pain or anything else. That is the honest position, and it is the position for most individual acupuncture points.

Where ST43 does appear, it is usually one of several points in a larger needling protocol in a clinical study, often alongside other Stomach-channel points. Studies built that way cannot tell you what any single point contributed. Even if the overall protocol helped, you cannot attribute that result to ST43, and you certainly cannot attribute it to pressing ST43 with a thumb.

It is also worth knowing the general state of the field. Acupressure trials tend to be small, short and unblinded, meaning participants know they are being treated. That design inflates reported benefits, because expectation and attention both affect how people rate symptoms like pain, bloating or tiredness. Reviews of acupressure repeatedly flag these weaknesses.

A few points do better than that. PC6 on the inner forearm has been tested in many controlled trials for nausea and vomiting, including after surgery and in pregnancy, and the evidence there is genuinely reasonable. That contrast is useful. It shows what decent point-specific evidence looks like, and it shows that ST43 does not currently have it.

What should you take from this? Absence of evidence is not proof that a point does nothing. It means the question has not been answered, so claims about ST43 in articles and videos are tradition being restated with confidence, not findings. Pressing ST43 is low-risk for most healthy adults, costs nothing, and may feel good on a tired foot. Judge it on that basis.

If you have a specific symptom you want help with, speak to a clinician about treatments that have been tested for it. Use ST43 as self-care alongside that, never as a substitute.