If you’ve been around an acupuncture classroom for more than five minutes, you’ve probably heard someone mention the legendary “Four Gates.”

If not… you will. Trust me.

This dynamic duo pairs two superstar points: Large Intestine 4 (LI4) and Liver 3 (LV3).
Together, they’re the ultimate Qi-moving team — like the acupuncture world’s version of Batman and Robin.

Why Clinicians Love This Combo

You’ll see this pairing everywhere in clinic because it’s that effective. The Four Gates are famous for their ability to move Qi and Blood throughout the body, making them a go-to for pain, stress, and stagnation of all kinds.

Think:

• Tense shoulders from stress

• Frustration that bubbles over into headaches

• Menstrual cramps from Liver Qi stagnation

• Pretty much any case that screams “things aren’t moving!”

When your patient’s Qi flow feels stuck — emotionally, physically, or both — the Four Gates are a fantastic choice.

Same Structure, Different Limbs

Here’s something fun: anatomically, LI4 and LV3 are practically twins — just on opposite ends of the body.

LI4 is located between the 1st and 2nd metacarpal bones of the hand.
LV3 is between the 1st and 2nd metatarsal bones of the foot.

It’s a lovely bit of TCM symmetry — a hand-foot balance that echoes the harmonizing effect this combo has on the whole system.

What Modern Research Is Saying

From a Western perspective, LI4 has been shown to trigger the release of endogenous opioids, explaining why it’s famous for pain relief (and nicknamed “the headache point”).

Meanwhile, LV3 interacts with the deep peroneal nerve and dorsalis pedis artery, influencing peripheral circulation and helping move blood through the system.

So, when you put these two points together, you get a combo that relieves pain, promotes circulation, and does exactly what the classics say: moves Qi and Blood, stops pain.

New Research Directions

Recent studies are shining more light on LV3, especially in the treatment of hypertension — a common issue you’ll see in clinic.

And here’s something fascinating: researchers are also exploring LV3 in relation to Parkinson’s disease.

If that sounds random, think in TCM terms — Parkinson’s involves tremors, and tremors often fall under “Internal Wind.” Where does Wind come from in TCM? You guessed it — the Liver.

So LV3’s connection makes perfect sense once you view it through the TCM lens.

Bringing It All Together

You’ll use the Four Gates combo a lot in practice. Not every patient needs it, of course, but when you’re aiming to “get things moving,” this pair rarely disappoints.

And before you start needling, make sure your point location is on point — both LI4 and LV3 have common pitfalls. (Check out my videos on my YouTube channel – LI4 and LV3