ST36 Acupuncture Point
ST36 Acupuncture Point
ST-36 (Zusanli) – Stomach 36 Acupuncture Point
ST-36 (Zusanli), also known as Stomach 36 acupuncture point, is one of the most powerful and widely used points in both acupuncture and acupressure. It is often called the “vitality point” because of its ability to boost energy, strengthen digestion, regulate the immune system, improve circulation, and relieve pain. Traditionally, ST36 is said to increase endurance and longevity, while in modern clinical practice it is a go-to point for fatigue, digestive disorders, and knee pain.
Key Points
Location: On the anterior aspect of the lower leg, 3 cun inferior to ST-35, one finger-breadth lateral to the anterior crest of the tibia.
Point Meaning: Zusanli translates to “Leg Three Miles,” indicating its function in increasing stamina and endurance.
Category: He-Sea and Earth point of the Stomach channel, Command point of the abdomen, Sea of Water and Grain point.
Actions: Tonifies Qi and Blood, harmonizes the Stomach, strengthens the immune system, alleviates pain.
Indications: Fatigue, digestive disorders, weak immunity, knee pain, poor circulation.
Point Combinations: ST-36 + SP-6 for Qi and Blood tonification, ST-36 + PC-6 for nausea.
ST 36 Acupuncture Point Location
Anatomical Position: On the anterior lower leg, 3 cun inferior to ST-35, one finger-breadth lateral to the anterior crest of the tibia.
Location Notes: Measure 3 cun (about 4 fingers) down from the bottom of the patella. ST-36 lies on the Stomach channel points pathway, making it one of the most important in the stomach acupuncture points chart.
Point Meaning
The name Zusanli means “Leg Three Miles.” Ancient tradition held that stimulating this point gave a person enough renewed strength to walk three more miles when exhausted. This reflects its role in increasing stamina, endurance, and vitality. Modern interpretations also see Zusanli as a point that enhances energy metabolism, circulation, and systemic resilience.
Needling Technique
Insertion Angle: Perpendicular or oblique.
Depth: 1 - 1.5 cun.
Caution: Avoid deep needling in thin patients to prevent discomfort.
ST36 Acupuncture Point Benefits
Tonifies Qi and Blood – boosts overall vitality and recovery.
Harmonizes digestion – relieves bloating, nausea, constipation, diarrhea, and stomach pain.
Strengthens the immune system – supports immune balance and may help those susceptible to colds.
Regulates circulation and relieves pain – improves blood flow, eases knee pain, and reduces fatigue.
Supports longevity and wellness – used for preventive care and resilience.
Indications – When to Use Stomach 36
Fatigue and Weakness: Low energy, general exhaustion, post-illness recovery.
Digestive Disorders: Bloating, nausea, diarrhea, constipation, acid reflux.
Pain Relief: Knee pain, muscle fatigue, poor circulation.
Immune Support: Frequent colds, weak immunity, autoimmune disorders.
Preventive Health: Longevity, resilience, general wellness.
Effective Point Combinations with ST36
ST-36 + SP-6 → Strengthens Qi and Blood, supports digestion and circulation.
ST-36 + PC-6 → Treats nausea, vomiting, and acid reflux.
ST-36 + LI-10 → Boosts general energy and immune function.
ST-36 + GB-34 → Benefits knee pain and lower limb mobility.
ST-36 + GB-34 → Relieves knee pain and stiffness.
ST-36 + CV-12 → Strong effect on stomach pain and bloating.
ST-36 + BL-20 + BL-21 → Strengthens Spleen and Stomach for chronic fatigue.
ST-36 + KI-3 → Balances Qi and Yin, helpful for weakness and poor circulation.
Anatomical and Muscular Relevance: ST-36 and the Tibialis Anterior Muscle
ST-36 lies directly over the tibialis anterior muscle, which is critical for ankle dorsiflexion and stable walking. Needling this region engages both the traditional channel system and modern neuromuscular mechanisms:
Muscle relaxation and circulation: Needling may release tension in tibialis anterior and improve blood flow.
Sports relevance: Often used for shin splints, anterior leg pain, and overuse injuries.
Integrated role: Combines systemic effects (digestion, energy, immunity) with local benefits for the lower leg.
ST36 Research Summary
Anti-Inflammatory Effects
A 2022 review reported that acupuncture at ST36 reduces inflammation in animal models by suppressing pro-inflammatory cytokines like TNF-α, IL-6, and IL-1β, mainly through modulation of the TLR4/NF-κB pathway and boosting CB2 receptor activity. These immune effects are observed alongside decreased Ca²⁺ influx and show possible neuroendocrine-immunological links.
Brain Functional Activation
A 2022 meta-analysis found that acupuncture at ST36 activates key brain regions involved in pain perception, mood regulation, and sensory integration, including the inferior frontal gyrus and cingulate cortex. Extended needle retention time enhanced activation in the olfactory cortex, mapping the effects to auditory and salience brain networks.
Autoimmune Disease Modulation
A 2023 study on experimental autoimmune encephalomyelitis showed that ST36 acupuncture increases splenic sympathetic nerve excitability, promoting anti-inflammatory differentiation in B and CD4⁺ T cells through the β2-AR-cAMP pathway. This anti-inflammatory response is mostly mediated by B cells and impacts T cell functions indirectly.
Motor Cortex Stimulation
A 2019 study found that acupuncture at ST36 enhances motor cortical excitation and reduces inhibition, as measured by transcranial magnetic stimulation. The effect was correlated with the “Deqi” sensation, suggesting a neurophysiological substrate for some clinical benefits in motor recovery.
Gastrointestinal Motility and ICC Plasticity
A 2014 animal study found that electroacupuncture at ST36 improved slow wave intestinal myoelectric activity, promoted the recovery of interstitial cells of Cajal (ICCs), and lowered pro-inflammatory mediators in models of partial bowel obstruction. The action appears linked to restoration of c-Kit signaling and modulation of the intestinal microenvironment.
Acupressure Point ST36
In addition to acupuncture, acupressure point Stomach 36 can be massaged daily for similar benefits:
Digestive health: Gentle pressure can ease nausea, bloating, and stomach discomfort.
Energy and fatigue: Pressing Zusanli helps restore vitality.
Immune function: Regular acupressure may help with prevention of colds.
Stomach pain relief: Often used in self-care routines for gastric discomfort.
ST 36 Acupressure Point Benefits
Boosts energy and stamina (traditional “three miles” effect).
Supports digestion and relieves stomach pain.
Enhances immune system function.
Improves circulation and eases lower limb pain.
Provides pain relief for knee pain, shin splints, and anterior leg discomfort.
Used in preventive health and longevity routines.
For patients uncomfortable with needles, acupressure point ST-36 offers a simple, accessible way to experience its benefits.
Commentary on Zusanli (ST36)
ST-36 is one of the most frequently cited “vital points” in acupuncture literature. Classical texts note its role in harmonizing the Stomach, supporting digestion, and building strength.
Modern research suggests ST-36 can modulate autonomic function, reduce inflammation, and improve microcirculation. It is equally valuable for local musculoskeletal pain (tibialis anterior, knee) and systemic regulation (digestion, fatigue, immunity).
In addition, among acupressure points, it is considered indispensable.
Conclusion
The ST-36 acupuncture point is among the most clinically powerful points for energy, digestion, circulation, immunity, and pain relief. Its location over the tibialis anterior gives it dual benefits: treating local muscle tension and systemic health issues. Whether needled in clinic or used as acupressure point ST36 for home care, it remains one of the most important acupuncture points for both treatment and prevention.
Learn About More Styles of Acupuncture
To discover more about the diverse world of acupuncture and its various methodologies, visit our comprehensive guide on different acupuncture styles: The Ultimate List of Acupuncture Styles. This resource offers a broader understanding of the range and depth of acupuncture practices available, placing Five Element Acupuncture within the context of a rich and varied healing tradition.
ST36 Frequently Asked Questions
What is ST36 (Zusanli) acupuncture point used for?
It is used for boosting energy, strengthening digestion, improving circulation, and relieving pain.
Where is the ST 36 acupuncture point location?
On the anterior lower leg, 3 cun below ST-35, one finger-breadth lateral to the tibial crest.
What does Stomach 36 (Zusanli Point) mean?
It means “Leg Three Miles,” symbolizing stamina and vitality.
What are the best acupressure point combinations for ST-36?
SP-6 for energy and Blood, PC-6 for nausea, LI-10 for immunity, CV-12 for stomach pain.
Is ST-36 (Stomach 36 acupuncture point) safe to needle?
Yes, when performed by a licensed practitioner. In thin patients, shallow insertion is advised.
Over to you
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Sources:
Deadman P. Al-Khafaji M. & Baker K. (2009). A manual of acupuncture. Journal of Chinese Medicine Publications.
Maciocia, G. (2015). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists. Churchill Livingstone.
Kim, J. Y., Park, J. H., Lee, J. S., et al. (2022). Anti-Inflammatory Effects of Acupuncture at ST36 Point: A Literature Review. Frontiers in Immunology, 13, Article 8790576. https://pmc.ncbi.nlm.nih.gov/articles/PMC8790576/
Li, H., Chung, H., & Lin, Y. (2022). Brain Activities Responding to Acupuncture at ST36 (zusanli) in Humans: A Meta-Analysis. Frontiers in Neuroscience, 16, Article 9373901. https://pmc.ncbi.nlm.nih.gov/articles/PMC9373901/
Zhao, J., Wang, C., Wang, H., et al. (2023). Acupuncture at ST36 ameliorates experimental autoimmune encephalomyelitis by targeting splenic sympathetic nerves and B cells. Neuroimmunomodulation, 30(5), Article 37531831. https://pubmed.ncbi.nlm.nih.gov/37531831/
Hu, X., Liu, T., & Bai, J. (2019). Effect of acupuncture at ST36 on motor cortical excitation and inhibition: Evidence from TMS. Neural Plasticity, 2019, Article 6749473. https://pmc.ncbi.nlm.nih.gov/articles/PMC6749473/
Lai, S., Peng, S., Wang, X., et al. (2014). Therapeutic effect and mechanism of electroacupuncture at Zusanli (ST36) on intestinal motility and plasticity of ICCs in bowel obstruction. World Journal of Gastroenterology, 20(22), Article 4096531. https://pmc.ncbi.nlm.nih.gov/articles/PMC4096531/
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