What is Gan Shu and what is it used for?

Gan Shu (肝俞, BL18) is the Back-Shu (背俞) point of the Liver, located on the Bladder meridian at the back. Back-Shu points are where each organ's Qi directly communicates with the body surface, making them powerful treatment points. Gan Shu is used to soothe Liver Qi stagnation, regulate Liver function, improve vision, relieve stress and anger, and treat conditions like rib-side pain, PMS, headaches, and eye problems. It is one of the most clinically important points in TCM for any Liver-related condition.

How do I find Gan Shu on my body?

Gan Shu is located on the back, approximately at the level of the 9th thoracic vertebra (T9). To find it: (1) Locate the lowest rib — follow it to the spine to find the T11-T12 level. (2) Count up two spinous processes to T9. (3) The point is 1.5 cun (about 2 finger-widths) lateral to the spine on each side. In practice, it's at the level slightly below the inferior angle of the scapula (shoulder blade). For self-care, use a tennis ball against a wall at this level to apply pressure. For exact location, consult a practitioner.

Gan Shu (BL18): The Liver Back-Shu Point for Anger, Stress, and Rib-Side Pain

Introduction to Gan Shu

Gan Shu (肝俞, BL18) is the Back-Shu point (背俞穴) of the Liver, located on the Bladder Meridian of Foot-Taiyang. The name translates directly: Gan (肝) = Liver, Shu (俞) = Transport/Conveyance point.

Back-Shu points are among the most clinically significant acupoints in TCM. Each organ has one Back-Shu point on the back, where the organ’s Qi rises to the surface and can be directly accessed. Gan Shu is the direct line to the Liver — stimulating it affects Liver function more powerfully than almost any other point.

Detail	Description
Chinese name	肝俞 (Gān Shū)
English translation	Liver Transport
Meridian	Bladder Meridian of Foot-Taiyang (足太阳膀胱经)
Point category	Back-Shu point of the Liver (肝之背俞穴)
Location level	T9 (9th thoracic vertebra)

Location

Gan Shu is located on the back:

Anatomical level: At the inferior border of the 9th thoracic vertebra (T9)
Lateral distance: 1.5 cun (approximately 2 finger-widths) lateral to the posterior midline
Bilateral: Present on both sides of the spine
Easy method: Find the lowest point of the scapula (shoulder blade) — this is approximately T7 level. Count down two vertebrae to T9, then move 1.5 cun lateral

Key Functions

1. Soothe the Liver and Regulate Qi (疏肝理气)

This is Gan Shu’s primary function. The Liver is responsible for the smooth flow of Qi throughout the body. When Liver Qi stagnates (from stress, anger, frustration), the entire body’s energy system becomes blocked.

Gan Shu directly communicates with the Liver to restore smooth Qi flow, making it essential for:

Stress and tension
Irritability and anger
Chest and rib-side fullness
Sighing frequently
Emotional instability

2. Nourish Liver Blood and Improve Vision (养肝明目)

The Liver opens into the eyes in TCM. Gan Shu supports Liver Blood, which nourishes the eyes:

Blurred vision
Dry eyes
Night blindness
Floaters
Eye fatigue from overwork

3. Resolve Rib-Side Pain (胁痛)

The Liver meridian passes through the rib area. Gan Shu treats:

Pain and tightness along the ribs
Intercostal neuralgia
Costochondritis
Discomfort when breathing deeply

4. Regulate Menstruation (调理月经)

Through the Liver’s relationship with Blood and the Chong Mai (Penetrating Vessel):

PMS with irritability and breast tenderness
Irregular periods
Menstrual pain with clots
Premenstrual mood changes

Clinical Applications

Stress and Emotional Imbalance

Gan Shu is one of the most important points for stress management in TCM:

Chronic stress with muscle tension
Anger that feels “stuck” in the body
Jaw clenching and teeth grinding
Tension headaches at the temples
Frustration and irritability

Typical combination: Gan Shu + Taichong (LV3) — this front-back combination (Back-Shu + Yuan-Source point) is the classic Liver treatment pair.

Rib-Side Pain and Intercostal Neuralgia

Sharp or aching pain along the rib cage
Pain that worsens with deep breathing or twisting
Often accompanied by emotional stress or anger
Gan Shu addresses both the pain and the underlying Liver Qi stagnation

Eye Conditions

Chronic dry eyes
Eye fatigue from computer work
Blurred vision that worsens with stress
Red eyes from Liver fire (combined with clearing points)

Digestive Issues from Liver Overacting on Spleen

In Five Element theory, Wood (Liver) controls Earth (Spleen). When Liver Qi is stagnant, it can “overact” on the Spleen, causing:

Irritable bowel symptoms triggered by stress
Bloating that worsens with emotional upset
Alternating diarrhea and constipation
Poor appetite when stressed

Acupressure Self-Care

Tennis Ball Technique

Since Gan Shu is on the back, direct finger pressure is difficult. The most effective self-care method uses a tennis ball:

Stand with your back against a wall
Place a tennis ball between your back and the wall, at the Gan Shu level (around T9, slightly below the shoulder blade)
Gently lean into the ball, applying moderate pressure
Hold for 30–60 seconds, breathing deeply
Move slightly to find the tender spot — tenderness indicates the point needs attention
Repeat on the other side

Partner Massage

If you have a partner:

The receiver lies face down
The giver locates the point 1.5 cun lateral to the spine at T9
Apply gentle, circular pressure with the thumbs
Use moderate pressure — the area may be tender
Massage for 2–3 minutes on each side
Combine with gentle stroking along the Bladder meridian

Cupping and Gua Sha

Gan Shu is one of the most common points for cupping therapy:

Moving cupping along the Bladder meridian at the back is deeply relaxing
Static cups on Gan Shu help release deep muscle tension from stress
Gua sha (scraping) along the back at this level promotes Qi flow
These are best performed by a trained practitioner

Combination Points

Combination	Purpose
Gan Shu + Taichong (LV3)	Front-back Liver treatment — soothes Liver Qi, relieves stress
Gan Shu + Hegu (LI4)	Four-gate combination — powerful stress and pain relief
Gan Shu + Pi Shu (BL20)	Liver-Spleen harmony — treats stress-related digestive issues
Gan Shu + Shen Shu (BL23)	Liver-Kidney support — nourishes Blood and Yin
Gan Shu + Ge Shu (BL17)	Blood-related conditions — regulates Blood flow

Moxibustion on Gan Shu

Moxibustion is particularly beneficial on Gan Shu for:

Cold-type Liver patterns — pain that improves with warmth
Deficiency-type eye conditions — blurred vision from Blood deficiency
Chronic stress with cold hands — the warmth deeply relaxes
Menstrual cramps — especially when pain refers to the back

Method

Use a moxa stick held 2–3 cm above the point for 10–15 minutes per side. The warmth should feel pleasant and penetrating.

The Back-Shu Point System

Gan Shu is part of the complete Back-Shu system — a row of points on the Bladder meridian where each organ’s Qi can be accessed:

Level	Back-Shu Point	Organ
T3	Fei Shu (BL13)	Lung
T4	Jue Yin Shu (BL14)	Pericardium
T5	Xin Shu (BL15)	Heart
T6	Du Shu (BL16)	Governing Vessel
T7	Ge Shu (BL17)	Diaphragm
T9	Gan Shu (BL18)	Liver
T10	Dan Shu (BL19)	Gallbladder
T11	Pi Shu (BL20)	Spleen
T12	Wei Shu (BL21)	Stomach

This system allows practitioners to treat organ conditions by stimulating points on the back — a principle unique to TCM acupuncture.

Precautions

Pregnancy — use caution, especially in early pregnancy
Skin conditions — avoid if there are wounds, rashes, or infections on the back
Severe osteoporosis — use very gentle pressure only
Acute back injury — do not apply pressure to injured areas; wait until acute inflammation subsides

Key Takeaways

Gan Shu (BL18) is the Liver’s Back-Shu point — a direct communication point with Liver Qi
Located on the back at T9 level, 1.5 cun lateral to the spine
Primary functions: soothe Liver Qi, improve vision, relieve rib-side pain, regulate menstruation
One of the most important points for stress management and emotional regulation
Tennis ball against a wall is an effective self-care method
Often combined with Taichong (LV3) for a complete Liver treatment

Disclaimer: This article is for educational purposes only. Acupressure is a complementary practice. Consult a licensed TCM practitioner for personalized treatment.