TB9 Four Rivers

Reviewed by · Licensed Acupuncturist & TCM Physician · Last reviewed June 2026

TB9 (Sìdú, “Four Rivers”) is an acupuncture point on the Triple Burner Meridian. It is located on the dorsal forearm, 7 cun proximal to the dorsal wrist crease, between the ulna and radius. It clears heat, alleviates pain, benefits the ear.

Location

On the dorsal forearm, 7 cun proximal to the dorsal wrist crease, between the ulna and radius.

Needling

Perpendicular insertion 0.5-1 cun.

TCM functions

Clears heat, alleviates pain, benefits the ear.

Indications

Deafness, toothache, headache, forearm pain.

Clinical notes

TB9 is primarily used for local pain and swelling in the forearm and elbow, often associated with conditions like tennis elbow or repetitive strain injuries. It also has a significant role in treating ear disorders, particularly sudden deafness or tinnitus, by clearing heat and promoting qi circulation in the region. Its name 'Four Rivers' alludes to its ability to regulate fluids and clear obstructions in the upper limb.

On the Triple Burner channel

TB9 is one of 23 points on the Triple Burner Meridian. Nearby points:

Frequently asked questions

Where is TB9 located?

TB9 (Sìdú) is located on the dorsal forearm, 7 cun proximal to the dorsal wrist crease, between the ulna and radius.

What is TB9 used for?

TB9 clears heat, alleviates pain, benefits the ear. Common clinical indications include deafness, toothache, headache, forearm pain.

How is TB9 needled?

Perpendicular insertion 0.5-1 cun.

Which meridian is TB9 on?

TB9 is a point on the Triple Burner Meridian (Sān Jiāo).

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⚠️ This page is for general education and is not medical advice. Acupuncture is a traditional practice; evidence varies by condition and study quality, and individual results differ. It does not replace diagnosis or treatment by a licensed professional. Always consult a qualified acupuncturist or physician.