The uppermost of the four sacral points, Shangliao (BL-31) sits directly over the first sacral foramen and acts as a key regulator of the lower pelvis — relieving lower back and sacral pain, supporting gynecological health, and helping the body's urogenital functions find their balance.
Name & story
The name 上髎 Shangliao means "Upper Bone-Hole" — and it describes the point perfectly. 髎 (liáo) refers to a hollow or foramen in a bone, and 上 (shàng) simply means upper or first. Together they point to the uppermost of the four posterior sacral foramina, those small natural openings in the sacral bone where the needle finds its way in. BL-31 is the first of a family of four — Shangliao (BL-31), Ciliao (BL-32), Zhongliao (BL-33) and Xialiao (BL-34) — each named for its position: upper, second, middle and lower. There is something quietly elegant about a point whose name is simply a truthful description of its anatomy.
Point family & character
Shangliao (BL-31) belongs to the Bladder Meridian (BL). It is the first of the four Liao points (the Eight髎, Ba Liao), a group of eight points — four on each side — that sit over the posterior sacral foramina and together govern the pelvic region. These points are considered especially influential for the lower burner, covering gynecological, urological and lower back concerns.
Five-element dynamics
The Bladder Meridian (BL) is the great Yang channel of the Water element, running the full length of the back and sacrum. The sacral region, in Chinese medicine, sits at the crossroads of the lower burner — where the Kidneys govern reproduction, the Bladder governs urination, and the Uterus holds the menstrual cycle. Shangliao (BL-31), positioned right at the first sacral foramen, taps directly into this deep pelvic territory. When Qi and Blood (Xue) flow freely through the sacral foramina, the whole lower pelvis — uterus, bladder, intestines — can function smoothly. When they stagnate or when Cold settles in, pain, irregular cycles, and urinary difficulty follow. BL-31 helps restore that free movement.
Location
Shangliao (BL-31) is found in the sacral region, over the first posterior sacral foramen. To locate it, feel for the small depression of the first sacral foramen, which sits roughly level with the posterior superior iliac spine (the bony prominence at the back of the hip). It is the highest of the four Liao points that run down the sacrum.
Anatomy & fascia
The point lies directly over the first posterior sacral foramen, in the region of the sacral bone. The needle enters through this natural opening in the bone.
The golden tip
For those dealing with lower back or sacral pain, or menstrual discomfort, warming the sacral area at home can offer real relief. Place a warm pack or heat pad over the lower sacrum — the flat triangular bone at the base of the spine — for 15–20 minutes. Gentle circular massage over the sacral region can also help move stagnant Qi and Blood (Xue). As always, professional acupuncture treatment is recommended for ongoing conditions.
For education only — not medical advice. Consult a qualified practitioner.