Society for Pediatric Pain Medicine
Better Care for Children in Pain

The Society for Pediatric Pain Medicine (SPPM) aims to advance the quality of anesthesia care and the alleviation of pain-related conditions in children.

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Question of the Month – December 2021




LI-4 is an acupuncture point that has been shown to decrease anxiety in children and adults. Which of the following statements is true regarding acupuncture at LI-4?

Correct! Wrong!

Question of the Month - December 2021

Picture from A Manual of ACUPUNCTURE by Peter Deadman and Mazin Al-Khafaji, with Kevin Baker. The Journal of Chinese Medicine, 2nd edition, 2007. Digital format


Correct Answer: E. All of the above statements are true.


LI-4 is a very commonly used acupuncture point used in the treatment of pain and anxiety. It is located on the dorsum of the hand, at the most prominent point of the thenar muscle, on the radial side of the midpoint of the second metacarpal. Because it is an easy point to locate, acupressure at this point can be easily performed and taught to patients, parents, or other medical providers. There are many studies demonstrating its effectiveness in the treatment of anxiety and headache when used in combination with other points2,3,4,5. In medical acupuncture, it is known to be particularly useful in the treatment of a variety of head and face disorders1 including toothache6,7, jaw pain/spasms8,9, rhinitis, nasal congestion, changes in taste10, and ear pain/tinnitus. It can also be used to relieve dysmenorrhea 1,11,12. ---------------------------------------------------------------------------------------------- References:


1 A Manual of ACUPUNCTURE by Peter Deadman and Mazin Al-Khafaji, with Kevin Baker. The Journal of Chinese Medicine, 2nd edition, 2007. Digital format


2 Amini Rarani S, Rajai N, Sharififar S. Effects of acupressure at the P6 and LI4 points on the anxiety level of soldiers in the Iranian military. BMJ Mil Health. 2021 Jun;167(3):177-181. doi: 10.1136/jramc-2019-001332. Epub 2020 Feb 2. PMID: 32015185.


3 Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40. doi: 10.1111/head.12857. Epub 2016 Jul 13. PMID: 27411557.


4 Doll E, Threlkeld B, Graff D, Clemons R, Mittel O, Sowell MK, McDonald M. Acupuncture in Adult and Pediatric Headache: A Narrative Review. Neuropediatrics. 2019 Dec;50(6):346-352. doi: 10.1055/s-0039-1695785. Epub 2019 Aug 29. PMID: 31466110.


5 Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016 Apr 19;4:CD007587. doi: 10.1002/14651858.CD007587.pub2. PMID: 27092807; PMCID: PMC4955729.


6 Grillo CM, Wada RS, da Luz Rosário de Sousa M. Acupuncture in the management of acute dental pain. J Acupunct Meridian Stud. 2014 Apr;7(2):65-70. doi: 10.1016/j.jams.2013.03.005. Epub 2013 Apr 11. PMID: 24745864.


7 Devanand Gupta, Deepak Ranjan Dalai, Swapnadeep, Parul Mehta, B Niranjanaprasad Indra, Saurabh Rastogi, Ankita Jain, Mudita Chaturvedi, Saumya Sharma, Sanjeev Singh, Shruti Gill, Nisha Singh, Rajendra Kumar Gupta. Acupuncture (針灸 Zhēn Jiǔ) – An Emerging Adjunct in Routine Oral Care. Journal of Traditional and Complementary Medicine. 2014;4(4). 218-223. ISSN 2225-4110. doi.org/10.4103/2225-4110.139113.


8 Shen YF, Younger J, Goddard G, Mackey S. Randomized clinical trial of acupuncture for myofascial pain of the jaw muscles. J Orofac Pain. 2009 Fall;23(4):353-9. PMID: 19888488; PMCID: PMC2894813.


9 Lu DP, Lu GP, Lu PM. Clinical effectiveness of acupuncture for mandibular subluxation and dislocation. Acupunct Electrother Res. 2010;35(3-4):187-92. doi: 10.3727/036012910803860896. PMID: 21319604.


10 Djaali W, Simadibrata CL, Nareswari I. Acupuncture Therapy in Post-Radiation Head-and-Neck Cancer with Dysgeusia. Med Acupunct. 2020 Jun 1;32(3):157-162. doi: 10.1089/acu.2020.1410. Epub 2020 Jun 16. PMID: 32595823; PMCID: PMC7310235


11 Huang T, Yang L, Jia S, Mu X, Wu M, Ye H, Liu W, Cheng X. Capillary blood flow in patients with dysmenorrhea treated with acupuncture. J Tradit Chin Med. 2013 Dec;33(6):757-60. doi: 10.1016/s0254-6272(14)60008-x. PMID: 24660607.


12 Bazarganipour F, Taghavi SA, Allan H, Beheshti F, Khalili A, Miri F, Rezaei M, Mojgori M, Imaninasab F, Irani F, Salari S. The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial. Complement Ther Med. 2017 Apr;31:65-70. doi: 10.1016/j.ctim.2017.02.003. Epub 2017 Feb 21. PMID: 28434473.

Upcoming Meeting Information

SPPM 13th Annual Meeting
March 12, 2026
Sheraton Denver Downtown
Denver, CO

 

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