BL33 Zhongliao (Middle Bone Hole)

Location

On the sacrum medial and inferior to the BL32 just at the 3rd posterior sacral foramen.

Indications

Conditions for which BL33 is listed as indicated. An indication list is a reference index, not a prescription – see the protocols below for sourced treatments.

TCM actions

What classical sources say BL33 does in the terms of Chinese medicine theory. These describe the point, not a condition.

Protocols using BL33

The 50 best-sourced of 116, ranked by strength of evidence. The count above is the full figure.

• Dysmenorrhea Primary – ST28, BL20, BL31, BL32, BL33, BL34, LV03 (doi:10.1016/s0254-6272(09)60035-2 ↗)
• Leg Pain, Prolapse Of The Lumbar Intervertebral Disc, Low Back Pain – BL23, BL25, BL31, BL32, BL33, BL34, BL40, BL54 (doi:10.1016/s0254-6272(09)60003-0 ↗)
• Low Back Pain, Pelvic Girdle Pain, Sacroiliac Pain, Symphysis Pain, Pregnancy Second Trimester, Pregnancy Third Trimester – LI04, ST36, SP12, BL26, BL32, BL33, BL54, BL60, KD11, GB30, GV20 (doi:10.1186/1472-6882-8-34 ↗)
• Bladder Dysfunction Neurogenic, Incontinence Urinary – BL33 (doi:10.1093/ecam/nep010 ↗)
• Back Pain, Sciatica Pain, Herniated Nucleus Pulposus – BL23, BL24, BL25, BL26, BL31, BL32, BL33, BL34, BL40, BL57, BL60, GB30 (doi:10.1093/ecam/nep085 ↗)
• Absent Periods, Infertility, Night Sweats, Hot Flashes, Vaginal Dryness, Mood Swings – ST25, ST29, BL33, CV04 (doi:10.1155/2013/657234 ↗)
• Nocturia, Urinary Frequency, Urinary Urgency, Urinary Hesitancy, Benign Prostatic Hyperplasia, Urinary Straining, Urinary Dribbling, Lower Urinary Tract Symptoms – BL33 (doi:10.1371/journal.pone.0059449 ↗)
• Incontinence Urinary Stress – BL33, BL35 (doi:10.1186/1745-6215-14-315 ↗)
• Constipation, Urinary Incontinence, Urinary Retention, Bladder Dysfunction Neurogenic, Bowel Dysfunction Neurogenic, Spinal Cord Injury Traumatic – BL32, BL33, BL35 (doi:10.1155/2013/543174 ↗)
• Constipation Chronic Severe, Constipation Straining, Constipation Incomplete-evacuation – ST25, ST37, SP14, BL33, GV20, GV24 (doi:10.1186/1472-6882-14-260 ↗)
• Nocturia, Urinary Frequency, Urinary Urgency, Urinary Incontinence Mixed, Urinary Incontinence Stress, Urinary Incontinence Urgency, Incontinence Urinary Mixed – BL33, BL35 (doi:10.1186/1472-6882-14-301 ↗)
• Urinary Incontinence Stress, Urinary Incontinence Exertional – BL33, BL35 (doi:10.1186/s13063-015-0560-1 ↗)
• Constipation Functional, Stool Hard, Constipation Chronic, Defecation Difficulty – ST25, ST36, ST37, BL25, BL33, BL34, TB06, CV04, CV06 (doi:10.1155/2015/396396 ↗)
• Incontinence Urinary Stress, Incontinence Urinary Mixed, Incontinence Urinary Urgency – SP03, SP06, BL14, BL18, BL20, BL23, BL28, BL31, BL32, BL33, BL34, KD03, KD07, PC06, LV03, CV03, CV04, CV06, GV04, GV20 (doi:10.1136/acupmed-2015-010828 ↗)
• Incontinence Urinary Stress, Urine Leakage Exertion, Urine Leakage Coughing, Urine Leakage Sneezing – BL33, BL35 (doi:10.1371/journal.pone.0150821 ↗)
• Urinary Retention Post-stroke, Bladder Dysfunction Incomplete Emptying – BL31, BL32, BL33, BL34 (doi:10.1186/s13063-016-1315-3 ↗)
• Spinal Cord Injury, Bladder Dysfunction Neurogenic, Urinary Retention Chronic – SP06, SP09, BL23, BL28, BL31, BL32, BL33, BL34, CV02, CV03, CV04, CV06 (doi:10.1155/2016/9245186 ↗)
• Sexual Dysfunction, Pelvic Pain, Chronic Prostatitis, Prostate Pain, Urinary Tract Symptoms Lower – SP06, BL23, BL33, BL35 (doi:10.1186/s12906-016-1428-y ↗)
• Pelvic Pain, Prostatitis Chronic, Urogenital Pain, Urinary Symptoms Lower Urinary Tract – SP06, BL23, BL33, BL35 (doi:10.1097/MD.0000000000012887 ↗)
• Constipation, Urinary Incontinence, Incontinence Post-surgical – BL32, BL33, BL34 (doi:10.1097/MD.0000000000015687 ↗)
• Infertility Female, Hypomenorrhea, Menstrual Irregularity, Fallopian Tube Obstruction Bilateral, Diminished Ovarian Reserve – ST25, BL32, BL33, CV04 (doi:10.1097/MD.0000000000017160 ↗)
• Dysuria, Nocturia, Urinary Frequency, Urinary Urgency, Benign Prostatic Hyperplasia, Urinary Obstruction – BL32, BL33 (doi:10.1155/2019/1439141 ↗)
• Incontinence Urinary Stress, Incontinence Urinary Mixed Stress-predominant – BL33, BL35 (doi:10.1136/bmjspcare-2019-002034 ↗)
• Nocturia, Urinary Frequency, Urinary Urgency, Incontinence Urinary Mixed, Incontinence Urgency, Incontinence Stress – SP06, BL33, BL35 (doi:10.1186/s12906-019-2784-1 ↗)
• Nocturia, Urinary Frequency, Urinary Urgency, Overactive Bladder, Urgency Incontinence – SP06, BL33, BL34, KD03, CV04, CV06, GV20 (doi:10.1155/2020/1705964 ↗)
• Nocturia, Urinary Urgency, Urinary Incontinence Urgency, Urinary Frequency Daytime – SP06, BL23, BL33, BL35 (doi:10.1186/s12906-020-03018-y ↗)
• Diarrhea, Abdominal Pain, Ulcerative Colitis, Blood In Stool – BL31, BL32, BL33, BL34 (doi:10.1186/s12906-020-03101-4 ↗)
• Frequency Urinary, Urgency Urinary, Discomfort Urinary Catheter-related, Suprapubic Pain, Agitation Postoperative – BL32, BL33, BL34, CV03, CV04, CV05, CV06, CV07 (doi:10.1155/2021/6691459 ↗)
• Insufficient Lactation, Urinary Retention Postpartum, Uterine Contraction Postpartum Pain, Depression Postpartum – BL31, BL32, BL33, BL34, KD01, CV08 (doi:10.1001/jamanetworkopen.2022.13261 ↗)
• Fatigue, Nausea, Diarrhea, Waist Pain, Dysmenorrhea Primary, Menstrual Pain, Lower-abdomen Pain – SP06, BL31, BL32, BL33, BL34, CV04 (doi:10.1155/2022/1281336 ↗)
• Nocturia, Urination Frequent, Benign Prostatic Hyperplasia, Urination Urgency, Urination Incomplete Emptying, Urinary Intermittent Stream – SP06, SP09, BL33, BL35, CV04 (doi:10.1097/MD.0000000000030429 ↗)
• Urinary Retention Postoperative, Postoperative Anal Pain, Anal Bloating, Hemorrhoids Mixed Postoperative – BL32, BL33 (doi:10.1007/s00384-023-04403-y ↗)
• Anxiety, Sweating, Palpitations, Hot Flashes, Cancer Prostate Androgen Deprivation Therapy Side Effects – SP06, SP09, BL15, BL23, BL33 (doi:10.1186/s12906-023-04218-y ↗)
• Fatigue, Constipation, Abdominal Distension, Voiding Dysfunction, Urinary Retention Acute, Herpes Zoster Sacral – SP06, BL32, BL33, CV02, CV03 (doi:10.1097/MD.0000000000036007 ↗)
• Chronic Pain, Low Back Pain, Disability Low Back, Low Back Chronic Pain – SP06, BL23, BL31, BL32, BL33, BL60 (doi:10.1016/j.jams.2018.02.002 ↗)
• Pelvic Pain, Anorectal Pain, Defecation Disorder, Pelvic Floor Dysfunction – BL18, BL23, BL25, BL33, BL34 (doi:10.5152/tjg.2024.22516 ↗)
• Depression Postpartum, Mood Disorder Postpartum, Anxiety Postpartum, Insomnia Postpartum, Postpartum Mood Changes – BL31, BL32, BL33, BL34, KD01, CV08 (doi:10.1159/000543477 ↗)
• Pelvic Chronic Pain, Lumbosacral Pain, Lower-abdomen Pain, Pelvic-inflammatory-disease – LI04, SP06, SP09, BL33, BL35, LV03 (doi:10.3390/medicina61020354 ↗)
• Fecal Incontinence, Sleep Disturbance, Defecation Frequent, Evacuation Incomplete, Bowel Urgency – BL31, BL32, BL33, BL34, GV01 (doi:10.3389/fmed.2025.1517325 ↗)
• Fracture Coccyx, Coccyx Pain, Subluxation Coccyx, Difficulty Sitting – BL31, BL32, BL33, BL34 (doi:10.1097/MD.0000000000044068 ↗)
• Incontinence Urinary, Incontinence Stress, Prostatectomy Post-radical, Postoperative Radical Prostatectomy – BL32, BL33, BL34 (doi:10.1001/jamanetworkopen.2025.34491 ↗)
• Fatigue, Anxiety, Depression, Lumbar Pain, Abdomen Lower Pain, Pelvic Chronic Pain, Bowel Dysfunction Constipation – ST25, SP06, BL23, BL32, BL33, BL35, CV03, CV04, CV12 (doi:10.2147/IJWH.S541559 ↗)
• Urinary Incontinence Stress, Pelvic Floor Dysfunction – ST36, SP06, BL23, BL24, BL31, BL32, BL33, BL34, BL35, CV03, CV04 (doi:10.11817/j.issn.1672-7347.2025.240242 ↗)
• Infertility, Poor Ovarian Response, Diminished Ovarian Reserve – ST25, ST36, SP06, BL23, BL33, KD03, KD12, GB13, LV03, CV04, CV12, GV20, GV24 (doi:10.3389/fendo.2026.1765527 ↗)
• Urinary Retention, Spinal Cord Injury, Urinary Retention Spinal Cord Injury – BL32, BL33 (doi:10.13702/j.1000-0607.20250263 ↗)
• Urinary Dysfunction, Pelvic Pain, Prostatitis Chronic – BL33 (doi:10.1186/1749-8546-2-1 ↗)
• Premature Ejaculation, Sexual Dysfunction – ST36, SP12, SP13, BL23, BL27, BL28, BL29, BL30, BL31, BL32, BL33, BL34, BL47, KD01, KD03, CV04, CV06 (doi:10.4103/0973-6131.113408 ↗)
• Childbirth Pain, Labor Pain – LI04, BL31, BL32, BL33, BL34, GB30, LV03 (doi:10.2147/JPR.S46693 ↗)
• Leg Pain, Leg Numbness, Leg Weakness, Radiculopathy Lumbar, Lower-back Pain – BL22, BL23, BL24, BL25, BL26, BL27, BL31, BL32, BL33, BL34, BL54, GB30, GV03, GV04 (doi:10.3831/KPI.2025.28.4.269 ↗)
• Anorectal Pain, Levator Ani Syndrome – LI04, ST36, SP06, HT07, BL33, KD01, LV03, CV04, GV01 (doi:10.22246/jikm.2024.45.1.111 ↗)

Most often selected alongside BL33

How many sourced protocols in the index pair each point with BL33. Corpus frequency, not a combination to use.

• BL32Second Bone Hole73 protocols
• BL34Lower Bone Hole47 protocols
• SP06Three Yin Intersection43 protocols
• BL23Kidney Shu Point39 protocols
• BL31Upper Bone Hole38 protocols
• BL35Meeting Of Yang35 protocols
• CV04Original Qi Gate34 protocols
• CV03Central Pivot19 protocols
• ST36Leg Three Miles16 protocols
• ST25Celestial Pivot15 protocols
• CV06Sea Of Qi14 protocols
• GV20100 Convergences14 protocols

Other points on the Bladder Meridian