What is Pi Shu and what is it used for?

Pi Shu (脾俞, BL20) is the Back-Shu point of the Spleen, located on the back at the level of the 11th thoracic vertebra (T11). As a Back-Shu point, it is where Spleen Qi directly communicates with the body surface, making it one of the most powerful points for treating Spleen-related conditions. Pi Shu is primarily used to strengthen Spleen Qi, resolve dampness, improve digestion, treat bloating and poor appetite, relieve fatigue from Spleen deficiency, and support Blood production. It is essential for any condition involving digestive weakness, chronic tiredness, or fluid metabolism issues.

How can I stimulate Pi Shu at home?

Since Pi Shu is on the back, the most practical self-care method is using a tennis ball against a wall or lying on the floor. Place a tennis ball between your back and the wall at the level of T11 (roughly at the level of the lowest rib, 2 finger-widths from the spine). Lean into the ball and apply gentle to moderate pressure for 1–2 minutes on each side. You can also ask a partner to apply gentle thumb pressure or circular massage. Moxibustion (warming with a moxa stick) is particularly effective on Pi Shu for cold-type digestive weakness. Cupping along the Bladder meridian at the Pi Shu level is also deeply relaxing.

Pi Shu (BL20): The Spleen Back-Shu Point for Digestion, Fatigue, and Dampness

Introduction to Pi Shu

Pi Shu (脾俞, BL20) is the Back-Shu point (背俞穴) of the Spleen, located on the Bladder Meridian of Foot-Taiyang. As the Spleen’s Back-Shu point, it is the location where Spleen Qi rises to the body surface and can be directly accessed and regulated.

The Spleen in TCM is the foundation of postnatal life — it transforms food into Qi and Blood, transports fluids, holds organs in place, and governs the muscles. When Spleen function is compromised, the entire body’s energy supply is affected. Pi Shu is the point that directly restores Spleen function.

Detail	Description
Chinese name	脾俞 (Pí Shū)
English translation	Spleen Transport
Meridian	Bladder Meridian of Foot-Taiyang (足太阳膀胱经)
Point category	Back-Shu point of the Spleen (脾之背俞穴)
Location level	T11 (11th thoracic vertebra)

Location

Pi Shu is located on the back:

Anatomical level: At the inferior border of the 11th thoracic vertebra (T11)
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 rib — follow it to the spine to find T11–T12. Pi Shu is just above this level, 1.5 cun lateral

Key Functions

1. Strengthen the Spleen and Tonify Qi (健脾益气)

Pi Shu is the most direct point for tonifying Spleen Qi:

Poor appetite and lack of desire to eat
Fatigue and weakness, especially after meals
Shortness of breath and reluctance to speak
Pale complexion
General Qi deficiency

2. Resolve Dampness (化湿)

The Spleen is responsible for transforming and transporting fluids. When Spleen function is weak, fluids accumulate as dampness:

Bloating and abdominal fullness
Heavy, sluggish feeling in the body
Edema, especially in the lower body
Thick, greasy tongue coating
Nausea and feeling of fullness

3. Support Blood Production (生血)

The Spleen is the source of Qi and Blood production:

Pale complexion and lips
Dizziness from Blood deficiency
Poor memory
Weak nails
Menstrual irregularity with pale flow

4. Regulate Digestion (调理脾胃)

Bloating after eating
Gas and belching
Loose stools or diarrhea
Nausea and vomiting
Food stagnation

5. Lift Qi and Hold Organs (升提固摄)

The Spleen Qi has an upward-lifting function that holds organs in place:

Organ prolapse (stomach, uterus, rectum)
Chronic diarrhea
Bleeding from Qi deficiency (blood in stool, heavy menses)

Clinical Applications

Chronic Fatigue and Low Energy

Pi Shu is one of the most important points for chronic fatigue:

Tiredness that worsens with exertion or after meals
Needing to rest after eating
Heavy limbs and reluctance to move
Often combined with Zusanli (ST36) and Sanyinjiao (SP6)

Digestive Weakness

Poor appetite
Bloating and fullness after eating small amounts
Gas and belching
Loose stools
Feels cold in the abdomen

Typical combination: Pi Shu + Zusanli (ST36) + Zhongwan (CV12) — the classic “Spleen-Stomach trio.”

Dampness and Edema

Heavy, sluggish body feeling
Edema in legs and ankles
Vaginal discharge (leukorrhea)
Thick tongue coating
Water retention that worsens with damp weather

Post-Illness Recovery

After prolonged illness has depleted Spleen Qi
Weak appetite during convalescence
Weight loss and muscle wasting
Difficulty regaining strength

Blood Deficiency

Pale complexion and lips
Dizziness and lightheadedness
Blurred vision
Numbness in hands and feet
Scanty menstrual periods

Acupressure Self-Care

Tennis Ball Method

Stand with your back to a wall
Place a tennis ball at the Pi Shu level (T11, near the lowest rib, 2 finger-widths from spine)
Lean into the ball with gentle to moderate pressure
Hold for 30–60 seconds on each side
Breathe deeply into the abdomen

Partner Massage

Receiver lies face down
Giver locates the point at T11 level, 1.5 cun from the spine
Apply gentle, circular thumb pressure
Use a warm palm to rub the area in circles
2–3 minutes per side

Warm Compress

A warm towel or heating pad over the Pi Shu area
Especially beneficial for cold-type digestive weakness
15–20 minutes, 1–2 times daily

Combination Points

Combination	Purpose
Pi Shu + Zusanli (ST36)	The classic Spleen tonifying pair — digestive strength and energy
Pi Shu + Sanyinjiao (SP6)	Spleen tonification + Blood nourishment
Pi Shu + Zhongwan (CV12)	Back-front combination for the Stomach and Spleen
Pi Shu + Gan Shu (BL18)	Spleen-Liver harmony — treats stress affecting digestion
Pi Shu + Shen Shu (BL23)	Spleen-Kidney support — postnatal + prenatal Qi
Pi Shu + Wei Shu (BL21)	Spleen-Stomach Back-Shu pair — complete digestive regulation

Moxibustion on Pi Shu

Moxibustion is exceptionally effective on Pi Shu, especially for:

Cold-type Spleen deficiency — cold abdomen, loose stools, prefers warm food
Dampness — heavy feeling, thick tongue coating
Post-illness recovery — to rebuild Spleen Qi
Chronic fatigue — warming the Spleen’s source of energy

Method

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

Dietary Support for Pi Shu

To reinforce the effects of stimulating Pi Shu, consume these Spleen-supporting foods:

Food	TCM Action
Millet	Tonifies Spleen and Stomach
Chinese yam (Shan Yao)	Tonifies Spleen, Lung, Kidney
Sweet potato	Tonifies Spleen Qi
Jujube dates	Tonifies Spleen, nourishes Blood
Rice porridge (congee)	Easy to digest, strengthens Spleen
Pumpkin	Tonifies Spleen, resolves dampness

Avoid: raw cold foods, excessive dairy, greasy foods, and ice-cold drinks — these directly weaken Spleen function.

Precautions

Pregnancy — use caution, especially with strong pressure or moxibustion
Skin conditions — avoid if wounds, rashes, or infections are present
Acute back injury — wait until inflammation subsides
After a large meal — wait 1 hour before applying pressure

Key Takeaways

Pi Shu (BL20) is the Spleen’s Back-Shu point at T11 level — direct access to Spleen Qi
Primary functions: tonify Spleen Qi, resolve dampness, support digestion, nourish Blood
Essential for chronic fatigue, digestive weakness, bloating, and edema
Tennis ball or partner massage is practical for self-care
Moxibustion on Pi Shu is particularly effective for cold-type digestive patterns
Often combined with Zusanli (ST36) for the strongest Spleen tonification effect

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