ST25 Acupuncture Point (Tianshu)
ST25 Acupuncture Point
The Celestial Pivot Beside the Navel: Anatomy, Segmental Gut Reflexes, and Why This Abdominal Point Anchors Digestive Treatment
ST25 (Tianshu, often translated as Celestial Pivot or Heaven's Pivot) sits on the abdomen two cun to either side of the center of the navel, in the belly of the rectus abdominis muscle, directly over the loops of the large and small intestine. It is classified in the traditional literature as the front-mu (alarm) point of the Large Intestine, which is why it appears in almost every classical and modern prescription for bowel complaints (Deadman et al., 2007).
For a clinician, the appeal of the st25 acupuncture point is straightforward: it is one of the few points where the needle sits in the same segmental neighborhood as the organ being treated, which gives a plausible pathway for changes in gut sensitivity, motility, and abdominal wall tension. Patients usually meet it when the presenting complaint is constipation, loose or urgent stools, bloating, or a belly that feels tight and reactive after meals.
- Location and layers: stomach 25 is found two cun lateral to the umbilicus, a level that Deadman's manual places roughly halfway between the midline and the palpable lateral edge of the rectus abdominis, so the needle passes skin, fat, the anterior rectus sheath, and rectus muscle before reaching deeper fascia (Deadman et al., 2007).
- Traditional categories, translated: classical texts describe ST25 as regulating the intestines, harmonizing the Spleen and Stomach, draining dampness, and moving stagnant qi and blood in the lower abdomen (Deadman et al., 2007; Kim, 2007). In neurophysiological terms, those descriptions map onto autonomic modulation of motility, visceral sensitivity, and abdominal wall tone.
- Nerve story: the point lies in the T10 to T11 territory of the anterior cutaneous branches of the thoracoabdominal nerves, and neural tracing work in rats found that ST25 and the colon share overlapping innervation across roughly the T8 to L1 dorsal root ganglia (Zhang et al., 2022). That shared segmental input is the most credible explanation for a somatovisceral effect.
- Research picture: sham-controlled trials of multi-point acupuncture for IBS have been mixed, with one Cochrane review finding no clear advantage over credible sham (Manheimer et al., 2012), while a large electroacupuncture trial using deep needling at ST25 and SP14 reported more complete spontaneous bowel movements in chronic severe functional constipation (Liu et al., 2016).
- Clinical framing: ST25 is rarely used alone. It is typically combined with distal points such as ST36 and midline points such as CV6, and at Morningside it is often paired with dry needling of the abdominal wall when palpation reveals taut, tender rectus abdominis bands (Simons et al., 1999).
- De qi and dosing: patients usually report a dull, heavy, spreading fullness under the needle, sometimes with audible gurgling or a warm sinking sensation toward the pelvis. Depth is conservative in thin patients, since the peritoneal cavity lies close beneath the muscle (Deadman et al., 2007).
Struggling With Constipation, Loose Stools, or Daily Bloating?
Digestive symptoms rarely respond to a single point, so we build treatments around the pattern in front of us, and ST25 is usually part of that plan when the abdomen itself is tender or reactive. We combine gentle abdominal needling with distal points, breath work, and hands-on assessment of the abdominal wall. Many patients notice changes in stool regularity and post-meal comfort within a handful of sessions. Schedule an initial visit and we'll map out a realistic course of care.
Schedule NowAnatomy of ST25: Why the Level of the Navel Is Such an Important Location
ST25 sits two cun lateral to the center of the umbilicus, which in most adults places it within the substance of the rectus abdominis rather than at its lateral border. From the surface down, a needle passes skin, subcutaneous fat, the anterior layer of the rectus sheath, the rectus muscle itself, and then the posterior sheath, transversalis fascia, and peritoneum, with bowel immediately beyond (Deadman et al., 2007). That layered arrangement matters clinically because the tissue most often loaded in patients with chronic abdominal complaints is the muscle and fascia, not the viscera.
Prolonged sitting, repetitive flexion work, post-surgical scarring, chronic bracing, and breath-holding under stress all leave the rectus abdominis short and irritable, and the periumbilical portion of the muscle is a documented site for trigger points that can generate cramping, nausea, and a band of discomfort across the back at the same spinal level (Simons et al., 1999).
The nerve geography is the reason this point is interesting rather than merely convenient. The abdominal wall here is supplied by anterior cutaneous and muscular branches of the lower thoracoabdominal nerves, broadly the T10 and T11 segments at umbilical level. The colon sends its afferent traffic into an overlapping range of spinal segments, and neural tracing research in rats found that ST25 and the colon share dorsal root ganglion innervation across approximately T8 to L1, with some individual neurons labeled from both territories (Zhang et al., 2022).
Convergence like that provides a mechanism for segmental somatovisceral effects: needling the abdominal wall feeds into the same dorsal horn neurons that process signals from the gut, where inhibitory interneurons and descending pathways can dampen sensitized visceral input (Zhao, 2008). The same study reported retrogradely labeled sympathetic postganglionic neurons connected to ST25, which the authors suggest as a route for motility changes rather than pain relief alone (Zhang et al., 2022).
Deeper structures set the safety rules. Beneath the rectus and its sheath lies the peritoneal cavity with small bowel, transverse and descending colon, and, in the lateral part of the sheath, the inferior epigastric vessels. Standard needling is perpendicular to about 1 to 1.5 cun, and classical texts also describe an oblique inferior angle toward the lower abdomen when uterine complaints are the target (Deadman et al., 2007). In thin patients the working margin is small, so depth should be reduced, and Deadman's manual specifically cautions that deep insertion can enter the peritoneal cavity. We also avoid needling over hernias, surgical mesh, or unhealed scars, and ST25 is treated with caution in pregnancy.
Related Rectus Abdominis Trigger Points Related Stomach ChannelST25 at a Glance: Classification, Location, and Clinical Use
| Category | Detail |
|---|---|
| Traditional Name | Tianshu (Celestial Pivot, also translated Heaven's Pivot or Heaven's Axis) |
| Channel Classification | Stomach channel (Leg Yang Ming), abdominal region |
| Point Categories | Front-mu (alarm) point of the Large Intestine. No five-shu designation, no extraordinary vessel intersection, and no hui-meeting role are attributed to this point in the reference sources; it is classified primarily as a local abdominal alarm point used for intestinal and Stomach disorders. |
| Precise Location | On the abdomen, 2 cun lateral to the center of the umbilicus. The 2 cun line is commonly located about halfway between the midline and the palpable lateral border of the rectus abdominis. |
| Tissue Stimulated | Skin and subcutaneous fat, anterior rectus sheath, and rectus abdominis muscle, with the abdominal obliques and transverse abdominis lateral and deep to the point; bowel lies beneath the deep fascia and peritoneum. |
| Needle Depth / Direction | Perpendicular insertion 1 to 1.5 cun in average builds, reduced in thin patients; oblique inferior angling is described traditionally for lower abdominal and uterine complaints. Moxibustion is commonly applied in traditional practice. |
| De Qi Sensation | A dull, heavy, spreading fullness across the lower abdomen, sometimes with warmth, gurgling, or a sinking sensation toward the pelvis. Sharp or radiating pain means the needle should be adjusted or withdrawn. |
| Primary Clinical Uses | Constipation, diarrhea and loose stools, bloating and abdominal distention, periumbilical and lower abdominal discomfort, IBS-type symptom patterns, and traditionally menstrual irregularity and lower abdominal masses. |
| Common Point Combinations |
|
In Deadman's Manual of Acupuncture, ST25 is presented as the front-mu point of the Large Intestine, the place where that organ's influence was traditionally said to gather on the front of the body, and its position on the Stomach channel is treated as significant because classical theory links the Stomach closely to both intestines.
The attributed actions are regulating the intestines, harmonizing the Spleen and Stomach, resolving dampness and damp-heat, and moving stagnant qi and blood in the lower abdomen, and the indication lists cluster into four recognizable groups: bowel patterns (diarrhea of many kinds, dysenteric disorders, rumbling, constipation), upper digestive patterns reaching to the Stomach (vomiting, retching, poor appetite, simultaneous vomiting and diarrhea), fluid patterns (swelling, distention, difficult urination), and lower abdominal or gynecological patterns (periumbilical and cramping pain, hernia-type presentations, painful or irregular menstruation, masses).
Deadman notes that authorities considered its strongest suit to be diarrhea, with the more lateral SP15 sometimes preferred for constipation, and that older sources also credited it with a supplementing effect on deficiency and cold in the lower abdomen.
What is striking is how consistently the tradition placed a single point at the midpoint of the trunk and then asked it to work in both directions, upward toward the stomach and downward toward the pelvis (Deadman et al., 2007).
Why ST25 Is Used for Both Constipation and Diarrhea
The most counterintuitive thing about stomach 25 is that the same point appears in prescriptions for opposite problems. Traditional texts and modern Chinese teaching both describe this bidirectional or regulatory quality, and the physiology offers a reasonable account of it. Needling the abdominal wall at the umbilical level stimulates afferents that enter the spinal cord in segments that also receive input from the colon, and that shared territory has been mapped anatomically, with ST25 and colon innervation overlapping across roughly the T8 to L1 dorsal root ganglia in animal tracing work (Zhang et al., 2022).
Reflex output from those segments travels back through sympathetic and parasympathetic pathways, and reflex modulation tends to nudge a system toward its normal operating range rather than driving it in one fixed direction. In practical terms, that means the intent is regulation of motility and sensitivity, not stimulation or sedation of the bowel as such.
The second half of the mechanism concerns how the gut is felt rather than how it moves. Many patients with IBS-type symptoms have visceral hypersensitivity, meaning ordinary distention is registered as pain. Needling recruits spinal inhibitory circuits and descending pathways from the brainstem that use endogenous opioid and monoamine signaling to reduce the gain on incoming nociceptive traffic, which is the best-studied general mechanism of acupuncture analgesia (Zhao, 2008).
Applied to the abdomen, electroacupuncture at ST25 alone reduced markers of visceral hypersensitivity and normalized colonic slow-wave activity in an IBS rat model, with the dorsal root ganglia and spinal dorsal horn identified as likely targets and the sympathetic ganglia implicated in the motility changes (Zhang et al., 2022). Animal data cannot be transferred directly to patients, but it does explain why an abdominal point might change both comfort and transit.
There is also a purely mechanical layer that gets overlooked. The rectus abdominis is a common source of referred abdominal pain, nausea, and belt-like back discomfort, and periumbilical trigger points in this muscle can convincingly imitate visceral complaints (Simons et al., 1999). When we palpate a taut band exactly where ST25 sits and pressing it reproduces the patient's symptom, part of the response to needling is likely local: reduced muscle tone, improved local circulation, and a change in the nociceptive input arriving from the wall itself. Good clinical practice means testing both possibilities instead of assuming which one is operating.
What the Research Shows for ST25
A fair reading of the evidence starts with a caveat: almost no clinical trial tests ST25 by itself. Reviews and randomized trials evaluate whole protocols in which this point is one component, usually alongside ST36, ST37, CV6, CV12, SP6, or LR3, and results depend heavily on the comparison used. Sham-controlled trials for IBS have often shown modest or unclear separation from placebo needling, while trials in functional constipation using deep abdominal electroacupuncture have reported clearer differences.
The honest summary is that ST25 has a plausible mechanism, a strong classical and modern usage record, and clinical trial support that is promising for some bowel presentations and inconclusive for others.
| Study | Type | Focus | Key Finding |
|---|---|---|---|
| Manheimer et al., 2012 | Cochrane systematic review | Acupuncture for irritable bowel syndrome, sham-controlled and comparative trials | Compared with credible sham needling, acupuncture showed no clear benefit for IBS symptom severity or quality of life, though patients in Chinese comparative trials reported more improvement than with drug therapy. |
| Liu et al., 2016 | Multicenter randomized sham-controlled trial (n = 1075) | Electroacupuncture with deep abdominal needling at ST25 and SP14 for chronic severe functional constipation | Eight weeks of electroacupuncture increased mean weekly complete spontaneous bowel movements more than sham electroacupuncture, with benefits reported to persist during follow-up and a favorable safety profile. |
| Zhao et al., 2024 | Multicenter randomized sham-controlled trial (n = 170) | Acupuncture added to usual care for refractory IBS meeting Rome IV criteria | IBS symptom severity scores fell substantially more in the acupuncture group than in the sham group over four weeks, suggesting possible benefit for patients who have not responded to standard treatment. |
| Pei et al., 2020 | Randomized controlled trial | Multi-point acupuncture protocol including abdominal points for IBS | Acupuncture was associated with improvement in IBS symptoms compared with control conditions, though protocol-level design limits conclusions about any single point. |
| Zhang et al., 2022 | Animal mechanistic study with neural tracing | Electroacupuncture at ST25 alone in an IBS rat model, plus neuroanatomical mapping of ST25 and colon innervation | Stimulation reduced visceral hypersensitivity and normalized colonic slow-wave activity, and tracing showed overlapping T8 to L1 innervation between ST25 and the colon, supporting a segmental somatovisceral mechanism. |
Is Your Gut Sensitivity Tied to Stress and a Tight Abdominal Wall?
When stress amplifies gut symptoms, we treat both ends of the loop: autonomic regulation through points like ST25 and ST36, and myofascial restriction in the rectus abdominis and obliques that can mimic or magnify visceral pain. Our licensed acupuncturists are also certified in trigger point therapy, so nothing gets treated in isolation. You'll leave with breathing and self-care strategies you can use between visits. Book a session and let's start with a full abdominal assessment.
Schedule NowST25 in the Context of Trigger Point Work
Because ST25 lands inside the rectus abdominis, it overlaps directly with a myofascial target. Travell and Simons documented that trigger points in the periumbilical and upper rectus regions can refer pain horizontally across the back, produce a cramping or colicky abdominal ache, and even generate nausea and a sense of fullness, all of which patients and clinicians reasonably interpret as digestive in origin (Simons et al., 1999).
At Morningside we palpate the abdominal wall before deciding what a needle is meant to do at this location. If firm pressure at the point reproduces the patient's familiar discomfort, we treat it as a wall problem first, with careful dry needling of the taut bands and often the adjacent external oblique and transverse abdominis, followed by breathing retraining so the muscle is not re-braced within hours.
When the picture is more visceral, with stool changes, urgency, or bloating dominating, ST25 is used at conventional depth as part of a regulating prescription rather than as a muscle release, usually with ST36 distally and CV6 on the midline, sometimes with gentle electrical stimulation. The two approaches are not mutually exclusive, and in chronic cases they frequently run together: reduce the abdominal wall's contribution to the pain signal, then keep working on the autonomic and segmental side of the problem.
Needling in this region is always shallow enough to respect the peritoneum, and we tell patients exactly where we are working and why before we begin.
ST25 Digestive Treatment at NYC's Highest-Rated Acupuncture Clinic
Morningside Acupuncture is the highest-rated acupuncture and dry needling clinic in New York City with over 500 five-star Google reviews, and digestive care is one of our most requested services. We use ST25 alongside evidence-informed point combinations, careful depth control, and myofascial work tailored to your abdomen. Every plan is explained in plain language before a needle goes in. Schedule your visit today and get started with a team that treats the whole picture.
Schedule NowFrequently Asked Questions
What does ST25 feel like when needled?
Most people describe a dull, heavy, slightly spreading fullness deep in the abdomen, sometimes with warmth or a sinking feeling toward the pelvis. It is common to hear or feel the gut gurgle within a minute or two, and some patients notice an urge to take a deeper breath as the abdominal wall lets go. If the needle passes through a taut band in the rectus abdominis, there may be a brief cramp or twitch that eases quickly. What should not happen is sharp, electric, or radiating pain, so tell your acupuncturist immediately if you feel that and the needle will be adjusted or removed.
Why needle the belly instead of a point on the arm or leg for gut symptoms?
Distal points such as ST36 and ST37 are genuinely useful and we use them constantly, but ST25 offers something they cannot: it sits in the same spinal segments that carry information to and from the colon. Neural tracing work found overlapping innervation between ST25 and the colon across roughly the T8 to L1 dorsal root ganglia, which gives a direct route for segmental reflex effects on gut sensitivity and motility (Zhang et al., 2022). Local needling also addresses the abdominal wall itself, which is a frequently missed contributor to abdominal pain (Simons et al., 1999). In practice, combining a local abdominal point with distal points is the norm rather than choosing between them.
Can I press ST25 myself between sessions?
Yes, acupressure here is simple and low risk for most people. Lie down with your knees supported, find your navel, then move about two finger widths to each side and press with the flat pads of two fingers, not the fingertips. Use steady, moderate pressure with a slow circular motion for 30 to 60 seconds per side, breathing out as you press in, then release and repeat two or three times. Twice daily is plenty, and many patients prefer doing it in the morning before getting up or an hour or more after eating rather than on a full stomach. Skip it if you are pregnant, if you have an abdominal hernia, recent abdominal surgery, or unexplained abdominal pain, and stop if the pressure produces sharp pain, nausea, or dizziness.
Is ST25 safe to needle?
In trained hands it is a routinely used point, and abdominal electroacupuncture protocols including ST25 have reported good safety in large trials (Liu et al., 2016). The relevant caution is depth: the peritoneal cavity and bowel lie beneath the rectus abdominis, and Deadman's manual warns that deep insertion in thin patients can penetrate the peritoneum (Deadman et al., 2007). We reduce depth based on body habitus, avoid needling over hernias, surgical mesh, unhealed scars, or areas of unexplained tenderness, and we use caution in pregnancy. Patients on anticoagulants, with abdominal aortic pathology, or with recent abdominal surgery should mention it during intake so the treatment plan can be adjusted.
Where exactly is ST25 located?
The st 25 location is on the abdomen, two cun lateral to the center of the umbilicus, one point on each side. Cun measurements are proportional to the individual, and a practical guide used in the texts is that the distance from the midline to the nipple line is four cun, so two cun is half of that; another common check is that the two cun line falls approximately halfway between the midline and the palpable lateral border of the rectus abdominis (Deadman et al., 2007; Kim, 2007). For self-orientation, two finger widths lateral to the navel is close enough for acupressure, though for needling your acupuncturist will locate it by palpating the muscle border and the surrounding tissue texture.
References
- Deadman, P., Al-Khafaji, M., & Baker, K. (2009). A manual of acupuncture. Journal of Chinese Medicine Publications.
- Kim, H. (2008). Handbook of Oriental medicine (3rd ed.). Harmony & Balance Press.
- Simons, D. G., Travell, J. G., & Simons, L. S. (1999). Travell & Simons' myofascial pain and dysfunction: The trigger point manual, Vol. 1: Upper half of body (2nd ed.). Williams & Wilkins.
- Zhang, L., Yu, C., Chen, B., Chao, Y., Zhang, H., Zhao, Q., Yang, K., Zhang, Y., & Chen, S. (2022). Modulation of colonic function in irritable bowel syndrome rats by electroacupuncture at ST25 and the neurobiological links between ST25 and the colon. Frontiers in Neuroscience, 16, 930489. https://doi.org/10.3389/fnins.2022.930489
- Manheimer, E., Cheng, K., Wieland, L. S., Min, L. S., Shen, X., Berman, B. M., & Lao, L. (2012). Acupuncture for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews, 2012(5), CD005111. https://doi.org/10.1002/14651858.CD005111.pub3
- Liu, Z., Yan, S., Wu, J., He, L., Li, N., Dong, G., Fang, J., Fu, W., Fu, L., Sun, J., Wang, L., Wang, S., Yang, J., Zhang, H., Zhang, J., Zhao, J., Zhou, W., Zhou, Z., Ai, Y., Zhou, K., Liu, J., Xu, H., Cai, Y., & Liu, B. (2016). Acupuncture for chronic severe functional constipation: A randomized trial. Annals of Internal Medicine, 165(11), 761-769. https://doi.org/10.7326/M15-3118
- Zhao, J., Zheng, H., Wang, X., Wang, X., Shi, Y., Xie, C., Tao, Q., Li, D., Sun, J., Tian, J., Gao, J., Liu, H., Shi, S., Ni, J., Xue, R., Hu, H., Chen, M., Yu, S., & Li, Z. (2024). Efficacy of acupuncture in refractory irritable bowel syndrome patients: A randomized controlled trial. Frontiers of Medicine, 18(4), 678-689. https://doi.org/10.1007/s11684-024-1073-7
- Pei, L., Geng, H., Guo, J., Yang, G., Wang, L., Shen, R., Xia, S., Ding, M., Feng, H., Lu, J., Li, J., Liu, L., Shu, Y., Fang, X., Wu, X., Wang, X., Weng, S., Ju, L., Chen, X., Shu, Q., & Sun, J. (2020). Effect of acupuncture in patients with irritable bowel syndrome: A randomized controlled trial. Mayo Clinic Proceedings, 95(8), 1671-1683. https://doi.org/10.1016/j.mayocp.2020.01.042
- Zhao, Z. Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355-375. https://doi.org/10.1016/j.pneurobio.2008.05.004
Disclaimer: This web site is intended for educational and informational purposes only. Reading this website does not constitute providing medical advice or any professional services. This information should not be used for diagnosing or treating any health issue or disease. Those seeking medical advice should consult with a licensed physician. Seek the advice of a medical doctor or other qualified health professional for any medical condition. If you think you have a medical emergency, call 911 or go to the emergency room. No acupuncturist-patient relationship is created by reading this website or using the information. Morningside Acupuncture PLLC and its employees and contributors do not make any express or implied representations with respect to the information on this site or its use. For any legal interpretation of scope of practice in your state, consult a licensed attorney or regulatory authority.
Read more from our blog
