GB 14 and Its Many Clinical Applications

Figure 1. GB 14 acupuncture point shares the same location as the frontalis muscle primary motorpoint. Image: Nancy-Ryan Illustrations.

GB 14 (Yangbai) translated as Yang White is an acupuncture point that many acupuncturists infrequently use in their treatment protocols. The intent of this article is to discuss its traditional functions, its neuroanatomical influence on the frontalis muscle and overall systemic effect.

Location: On the forehead, directly above the pupil of the eye, 1.0 cun superior to the eyebrow.

Traditional Functions: Dispels Wind, benefits the eyes and head, calms the spirit and relieves pain. 

Classification: Primary motor point for the frontalis muscle (facial nerve—temporal branch) (Figure 1). Useful in facial nerve paralysis.

Intersection Point of the GB, ST, SJ, LI channels & Yang Wei vessel. Because of the connection to the shaoyang and yangming channels, this point can be used for frontal headache pain due to tension, sinusitis and digestive disturbances.

Indications: 

• Facial paralysis, drooping of the eyebrow. Facial nerve paralysis such as Bell’s palsy causing a drooping of the eyebrow. Refer to the video below for the Rotate and Lift needle technique the author uses for frontalis muscle paralysis and is best applied in combination with exercises for the frontalis muscle.
• Blurring of vision, eye pain, asthenopia (redness, swelling, itching). Combine with GB 20, GB 37 and LI 4.
• Forehead pain, muscle tension headaches (MTH). In an interesting study comparing subjects susceptible to MTH (group A) and subjects that do not generally suffer from headaches (group B), EMG activity of the frontalis muscle was significantly greater at rest in group A compared to the non-headache group B.  (Vaughn, R.1977). In another study, researchers found that tension reduction exercises focused on relaxing the frontalis muscle mediated an increase in parasympathetic activity, which is one reason why this acupuncture point is great to use in stress conditions especially when due to emotional constraint. (Sime, W. E., 1997). Combine with LIV 3, GB 40 and P6.

Needle Technique and Depth: Subcutaneous oblique-transverse insertion 0.5 – 0.8 cun. Refer to the video below for more information. 

Frontalis Muscle

The frontalis muscle raises the eyebrows and causes horizontal wrinkles in the cutaneous layers tissue of the forehead. These actions play a role in various facial expressions and is essential for conveying emotions and non-verbal communication. Repeated contractions of the frontalis muscle overtime (stress, excessive lifting of the eyebrows) can cause deep horizontal wrinkles to form in the skin and subcutaneous fascia. These wrinkle lines can be lessened with acupuncture and guasha techniques.

Rather than having bony attachments, the frontalis muscle attaches to the soft tissue surrounding it e.g. it attaches to the galea aponeurotica superiorly, is continuous with the corrugator supercilli and orbicularis oculi muscles inferiorly, and with the orbicularis oculi and temporalis muscles laterally.

Figure 2. Galvanic stimulator identifying the motor point location for the frontalis muscle at GB 14

The primary motor nerve innervation is at GB 14 via the temporal branch of the facial nerve. Figure 2, the author is using a galvanic stimulator to locate the motor nerve entrance into the frontalis muscle. Notice the eyebrow raising upward.

Resources

• Vaughn, R., Pall, M. L., & Haynes, S. N. (1977). Frontalis EMG response to stress in subjects with frequent muscle‐contraction headaches. Headache: The Journal of Head and Face Pain, 16(6), 313-317.
• Sime, W. E., & DeGood, D. E. (1997). Effect of EMG biofeedback and progressive muscle relaxation training on awareness of frontalis muscle tension. Psychophysiology, 14(6), 522-530).