Indications

Irregular menstruation, leukorrhea, spermatorrhea, impotence, difficult urination and defecation, lumbosacral pain, lumbar and knee soreness and weakness, abdominal pain, constipation, and diarrhea.

Precise Location

In the sacral region, directly in the 4th posterior sacral foramen.

Location Method

Lie prone. The point is approximately 0.5 cun lateral to the midline of the sacral region, level with the 4th posterior sacral foramen.

Massage Method

① Massage: Press and knead with the thumb. ② Moxibustion: Apply mild-warm moxa stick. Press and knead Xialiao with the thumb about 200 times, or for 3–5 minutes, to treat constipation and diarrhea. Therapeutic actions: Regulates the lower jiao, regulates menstruation and stops leukorrhea, tonifies the kidney and strengthens the lumbar region, unblocks urination and defecation.

Compatibility

Abdominal pain: Combine with Qihai (RN-6). Constipation and diarrhea: Combine with Tianshu (ST-25) and Zusanli (ST-36). Irregular menstruation and leukorrhea: Combine with Guanyuan (RN-4), Sanyinjiao (SP-6), and Shenshu (BL-23). Spermatorrhea and impotence: Combine with Shenshu (BL-23), Guanyuan (RN-4), and Sanyinjiao (SP-6). Difficult urination and defecation: Combine with Pangguangshu (BL-28), Zhongji (RN-3), and Sanyinjiao (SP-6). Lumbosacral pain and lumbar and knee soreness and weakness: Combine with Shenshu (BL-23), Dachangshu (BL-25), and Weizhong (BL-40).

Efficacy & Actions

This point belongs to the Foot Taiyang Bladder Meridian and is the meeting point of the Bladder Meridian and the Foot Shaoyang Gallbladder Meridian. It regulates the lower jiao, regulates menstruation and stops leukorrhea, tonifies the kidney and strengthens the lumbar region, and unblocks urination and defecation. It is a commonly used key point for treating gynecological, andrological, and lumbosacral disorders. First documented in Zhenjiu Jiayijing. “Xia” means lower; “Liao” means bone crevice or gap. Located in the 4th posterior sacral foramen, inferior to all the other eight-liao points – hence the name Xialiao (Lower Bone Crevice).

Contraindications

Located in the sacral region, needling should not be too deep – generally 0.8–1.2 cun vertically to avoid injury to internal tissues. Moxibustion is permissible.