Adjunct Placement for Acupuncture Points and Trigger Points for Lower Back Pain

The Primary Placement shown in the Lower Back Pain Treatment Protocol is the recommended starting point. The placements below are optional Adjunct Placements that may be considered when symptoms correspond with particular areas of tenderness, muscular involvement or movement restriction, or when the Primary Placement alone is not providing the desired response.

Adjunct Placements may be used alongside the Primary Placement, at different times, or when exploring other placement options. In some situations, an appropriately selected distal acupuncture point may also be useful on its own. Under the Field | Dose | Placement (FDP) principle, select from the approved points according to where symptoms are felt, tenderness, movement restriction and individual response rather than routinely applying every placement listed.

Recommended Additional Placements

Acupuncture Points

1. BL40 – Large Quadrapolar or Hexapolar – L
   Located at the back of the knee, near the centre of the crease. This distal point may be considered as an alternative or additional placement for lower back symptoms.
2. BL23 – Medium Quadrapolar or Hexapolar – M
   Located in the lower lumbar region on either side of the spine. Consider this placement where symptoms or tenderness correspond with this area.
3. BL25 – Large Quadrapolar or Hexapolar – L
   Located on either side of the lower lumbar spine. This local placement may be considered where pain, discomfort or tenderness corresponds with the lower lumbar region.
4. GB30 – Large Quadrapolar or Hexapolar – L
   Located in the buttock region. Consider this placement where lower back symptoms are accompanied by discomfort or tenderness extending into the gluteal area.

Myofascial Trigger Points

5. Multifidus Trigger Point – Large Quadrapolar/Hexapolar or Extra Large Octapolar/Concentric – L / XL
   The multifidus muscles lie close to the lumbar spine. Prioritise a focal tender or sensitive area when using a L Large magnet; broader coverage may be considered with the supported XL Extra Large option.
6. Quadratus Lumborum Trigger Point – Large Quadrapolar/Hexapolar or Extra Large Octapolar/Concentric – L / XL
   The quadratus lumborum lies to either side of the lumbar spine between the lower ribs and pelvis. Consider this placement where tenderness or muscular involvement corresponds with this region.
7. Gluteus Medius Trigger Point – Large Quadrapolar/Hexapolar or Extra Large Octapolar/Concentric – L / XL
   The gluteus medius lies over the outer-upper buttock and lateral pelvic region. Consider this placement where lower back symptoms are accompanied by local gluteal tenderness or muscular involvement.

Practical Placement Guidance

Begin with the Primary Placement shown in the Lower Back Pain Treatment Protocol. When considering Adjunct Placements, gently palpate the relevant areas where practical and prioritise those that most closely correspond with:

• local tenderness or sensitivity;
• where pain or discomfort is felt;
• muscular tenderness;
• movement restriction; and
• individual response.

For the multifidus, quadratus lumborum and gluteus medius, use L Large for a focal trigger point. Use the supported XL Extra Large option when broader lumbar, quadratus lumborum or gluteal coverage is intended. An Extra Large 50 mm device may also be used where broader coverage across adjacent spinal levels is required.

Maintain appropriate separation between magnets so their magnetic fields do not interfere with one another. The Lower Back Pain Treatment Protocol specifically notes the importance of spacing larger devices when applying them across the lower back.

This information is provided as educational guidance and does not replace diagnosis, medical assessment or treatment recommended or prescribed by an appropriately qualified healthcare professional.