Pressure point between thumb and index finger for headache: Brehan Crawford, L.Ac., pointing to the Hegu (LI4) point on the back of his hand

Pressure Point Between Thumb and Index Finger for Headache

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    When a headache starts, your hand goes to your forehead or your temples. There is a better place to put it. The pressure point between your thumb and index finger is called Hegu. Here is where it is, how to work it, and what the research says about why a point on the hand reaches the head.

    The short answer

    The pressure point between your thumb and index finger is Hegu, also written LI4 or Large Intestine 4. It sits in the muscle on the back of the hand, against the middle of the index-finger bone. Press in until you feel a dull ache, work it in small circles for a few minutes on each hand, breathe slowly and let your face go soft. Imaging studies show that stimulating this point changes blood flow in the face and activity in the brain’s pain-control centers.

    The short version, on video.

    What is the pressure point between the thumb and index finger?

    It is Hegu. The name means Joining Valley, for the valley where the thumb and index-finger bones meet. In the modern numbering it is LI4, the fourth point on the Large Intestine channel, which begins at the tip of the index finger, runs up the arm and over the shoulder, crosses the neck and jaw, and ends beside the nose.

    That pathway is why a point on the hand is used for the head. Acupuncture students memorize a classical verse of four command points, each governing a region of the body. The line for Hegu gives it the face and mouth. When the problem is above the neck, this is a point an acupuncturist reaches for.

    In the video I put it this way. Rubbing your forehead when you have a headache is like trying to turn off a light by pulling out the bulb. The switch is in your hand.

    Anatomy can tell you what is under your finger there. Hegu lies in the territory of the superficial branch of the radial nerve. When a Japanese team dissected 40 hands, they found the point an average of 4.3 millimeters from the place where small branches of that nerve reach the radial artery, far closer than the three other points they measured on the same channel. Those fibers are thought to control how tightly the artery is held.[1] In a second dissection study, of 25 forearms, the same nerve divided into a median of four branches on its way to the hand.[2]

    Finding the switch is how I approach pain in general. Chronic Pain: Start Here lays out that approach, and it is the work we do together inside Gut Brain Synchrony.

    Does rubbing your temples help a headache?

    A little, for a while. Your hand goes there for a reason. Increased tenderness in the muscles and connective tissue around the skull is the most apparent abnormality in people with tension-type headache.[3]

    But the sore muscle is not the whole problem. When Danish researchers tested people with chronic tension-type headache, their pressure pain thresholds were significantly lower in the finger, and tended to be lower at the temple. The pain system itself had become more sensitive, in the spinal cord, the brainstem and above.[3]

    A headache that keeps coming back is a nervous system with the volume turned up. Rubbing where it hurts does not change that.

    Chinese medicine made this distinction long ago. Where it hurts is the branch. What drives it is the root. Local points treat the branch. Distal points on the hands and feet move the whole channel, and Hegu is the best known of them.

    Does squeezing your hand help headaches?

    Pressing the right spot does.

    Start with what practitioners do. A 2021 review of 128 papers on acupuncture for tension-type headache, 137 prescriptions in all, counted every point used. Hegu was one of the five most used, alongside Fengchi at the base of the skull, Baihui at the crown, Taiyang at the temple and Taichong on the foot. About 60 percent of the points used were on the head, face and neck. Nearly a third were on the arms and legs.[4] The temple is on that list. So is the hand.

    Then the trials. In a randomized trial published in Neurology, 218 people with chronic tension-type headache received 20 acupuncture sessions over eight weeks. In the group needled until they felt the dull ache acupuncturists call deqi, 68.2 percent cut their headache days by at least half. In the group needled superficially, 48.1 percent did.[5] A Cochrane review of 12 trials and 2,349 participants concluded that the available results suggest acupuncture is effective for frequent episodic or chronic tension-type headaches.[6] Those trials used full prescriptions, not one point.

    Pressure without needles has been tested too. In a small trial of 33 dialysis patients, pressing Hegu and three points on the head and neck for one minute each lowered headache severity significantly compared with routine care.[7] In a trial of 28 people with chronic headache in Taiwan, a month of acupressure left pain scores lower than a month of a muscle relaxant did, and the gap was still there six months later.[8]

    And Hegu on its own: in a randomized trial of 131 dialysis patients, three minutes of pressure on Hegu before cannulation lowered the pain of the needle going in at every site tested.[9]

    Why do pressure points relieve headaches?

    In the video I name three things: blood flow to the face and head, the part of the brain that registers pain there, and a lasting effect. Here is what has been measured.

    It changes blood flow in the face

    Researchers at the China Academy of Chinese Medical Sciences needled Hegu in 20 healthy volunteers and imaged the face with a laser technique that tracks blood moving through the skin. Blood flow rose over the forehead immediately and climbed gradually over the nose.[10] A second team warmed Hegu with moxa in 30 healthy volunteers and photographed the face with an infrared camera. Skin temperature rose around the nose, the cheeks and the lips, and the change peaked at ten minutes.[11] The anatomy fits: the point sits within a few millimeters of the nerve fibers thought to regulate the radial artery.[1]

    Your brain keeps the hand next to the face

    In the brain’s map of the body surface, the hand and the face are neighbors. In one patient studied after an arm amputation, touches on the lower face were felt as precisely located sensations in individual missing fingers.[12]

    That may be part of why a hand point talks to the face. In a brain imaging study, 36 people with facial palsy received electrical stimulation through the skin at Hegu, at a point on the jaw, or at a sham point. The real points activated the brain more than the sham did, and the regions activated from the hand and from the jaw were broadly overlapping and adjacent.[13]

    It switches on the brain’s own pain control

    At New Jersey Medical School, researchers applied rhythmic pressure to Hegu in seven healthy volunteers inside an MRI scanner. The sensory areas of the cortex responded more than 90 percent of the time. The periaqueductal gray, a cluster of cells in the brainstem that turns pain signals down, came on in episodes and showed up reliably after 20 to 25 minutes of stimulation. Pressure on a spot on the leg that is not an acupuncture point produced less of both.[14]

    The effect lasts

    In the Neurology trial, treatment stopped at eight weeks. At week 32, 68.2 percent of the true acupuncture group still had their headache days cut by at least half.[5] In the Cochrane review’s comparison with sham acupuncture, results six months after randomization were similar to those right after treatment.[6]

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    Hegu point benefits beyond headaches

    The channel is named for the large intestine, and in Chinese medicine that is not an accident. Hegu is the source point of the Large Intestine channel. Its job is to move what is stuck, in the bowels as much as in the head. The same point is used for shoulder pain, which sits on the channel’s path, for low back pain, and for constipated bowels. If you press it for a headache and one of those eases as well, that is the channel doing its work.

    The bowel effect has been tested. In a randomized trial of 90 patients recovering from heart bypass surgery, acupressure on Hegu and on a point beside the navel, twice a day for three days, produced more bowel movements and better stool consistency than sham pressure or usual care.[15] Digestive Health: Start Here covers the gut side of the picture.

    How to find the LI4 pressure point and use it

    01 Find it. Hold one hand out, palm down. Bring the thumb against the index finger and a mound of muscle rises between them. The point is at the top of that mound, in the meat of the hand, about halfway along the bone that runs from your wrist to your first finger.
    02 Dig in. Let the hand relax. Press in with a finger or the thumb of your other hand, angling toward the index-finger bone, until you feel a dull, spreading ache. When 42 volunteers had acupuncture points needled, aching, soreness and pressure were the most common sensations, and Hegu gave the most prominent response of the three points tested.[16]
    03 Work it around in circles for a few minutes. Small, slow circles, keeping the pressure on. The trials above used one to three minutes at a time.[7][9]
    04 Breathe, relax your whole face, and sigh. Take deep, slow breaths. Unclench your jaw and let your forehead go smooth. Sigh on the way out. In an experiment with 16 healthy volunteers, deep slow breathing raised pain thresholds and lowered sympathetic nervous activity when it was done in a relaxed way. The same breathing done as a concentration task changed neither.[17]
    05 Switch hands. The point is on both hands. Give each one its few minutes.

    Hand pressure point questions, answered

    How long should you hold pressure points for headaches?

    A few minutes on each hand. The acupressure trials used one to three minutes per point. Staying with it may pay: in the imaging study, the brainstem’s pain-control center showed up reliably only after 20 to 25 minutes of on-and-off pressure.[14] Work the point, rest, and return to it.

    Why does the pressure point between my thumb and index finger hurt?

    A dull ache under pressure is the expected response at this point, and it is the sensation acupuncturists aim for.[16] In Chinese medicine, a point that is more tender than usual is read as a channel that is not moving freely. If the pain is sharp, ease off until it becomes a dull ache again.

    Which hand do you press for a headache?

    Both. Each hand has its own Large Intestine channel, and classically each one crosses the midline at the upper lip to end beside the opposite nostril. So each hand reaches both sides of the face.

    The next time your hand goes to your forehead, send it to your other hand instead. Try it and see how it feels for you.

    — Brehan Crawford, L.Ac.

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    References

    1. Umemoto K, Naito M, Tano K, et al. Acupuncture Point “Hegu” (LI4) Is Close to the Vascular Branch from the Superficial Branch of the Radial Nerve. Evid Based Complement Alternat Med. 2019;2019:6879076. doi:10.1155/2019/6879076
    2. Robson AJ, See MS, Ellis H. Applied anatomy of the superficial branch of the radial nerve. Clin Anat. 2008;21(1):38-45. doi:10.1002/ca.20576
    3. Bendtsen L. Central sensitization in tension-type headache—possible pathophysiological mechanisms. Cephalalgia. 2000;20(5):486-508. doi:10.1046/j.1468-2982.2000.00070.x
    4. Lu L, Wen Q, Hao X, Zheng Q, Li Y, Li N. Acupoints for Tension-Type Headache: A Literature Study Based on Data Mining Technology. Evid Based Complement Alternat Med. 2021;2021:5567697. doi:10.1155/2021/5567697
    5. Zheng H, Gao T, Zheng QH, et al. Acupuncture for Patients With Chronic Tension-Type Headache: A Randomized Controlled Trial. Neurology. 2022;99(14):e1560-e1569. doi:10.1212/WNL.0000000000200670
    6. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4(4):CD007587. doi:10.1002/14651858.CD007587.pub2
    7. Narimani MM, Motamed-Jahromi M, Radmehr M. Comparative Effectiveness of Acupressure and Eucalyptus Aromatherapy on Headache Severity in Hemodialysis Patients: A Randomized Controlled Clinical Trial With a Pretest-Posttest Design. Health Sci Rep. 2026;9(5):e72494. doi:10.1002/hsr2.72494
    8. Hsieh LL, Liou HH, Lee LH, Chen TH, Yen AM. Effect of acupressure and trigger points in treating headache: a randomized controlled trial. Am J Chin Med. 2010;38(1):1-14. doi:10.1142/S0192415X10007634
    9. Turgay G, Çevik B, Eskigülek Y, Inanoğlu I, Kaya S. Hegu point acupressure for cannulation pain across fistula sites: Randomized controlled trial. Explore (NY). 2026;22(2):103324. doi:10.1016/j.explore.2026.103324
    10. Tian Y, Huang T, Litscher G, et al. Comparison of acupuncturing Hegu (LI4) by metal or laser needle on facial blood perfusion using laser speckle technique. J Acupunct Meridian Stud. 2011;4(3):187-192. doi:10.1016/j.jams.2011.09.007
    11. Yang Y, Ji L, Li G, Deng X, Cai P, Guan L. Differences in thermal effects of moxibustion at zusanli (ST 36) and hegu (LI 4) on various facial areas in healthy people. J Tradit Chin Med. 2012;32(3):397-403. doi:10.1016/s0254-6272(13)60045-x
    12. Ramachandran VS, Stewart M, Rogers-Ramachandran DC. Perceptual correlates of massive cortical reorganization. Neuroreport. 1992;3(7):583-586. doi:10.1097/00001756-199207000-00009
    13. Kong SP, Tan QW, Liu Y, et al. Specific Correlation between the Hegu Point (LI4) and the Orofacial Part: Evidence from an fMRI Study. Evid Based Complement Alternat Med. 2015;2015:585493. doi:10.1155/2015/585493
    14. Liu WC, Feldman SC, Cook DB, et al. fMRI study of acupuncture-induced periaqueductal gray activity in humans. Neuroreport. 2004;15(12):1937-1940. doi:10.1097/00001756-200408260-00021
    15. Khan-Mohammadi F, Jafari H, Bagheri-Nesami M, et al. Effects of acupressure on intestinal function in patients with coronary artery bypass graft surgery: a randomized clinical trial. Gastroenterol Hepatol Bed Bench. 2023;16(3):282-291. doi:10.22037/ghfbb.v16i2.2720
    16. Hui KK, Nixon EE, Vangel MG, et al. Characterization of the “deqi” response in acupuncture. BMC Complement Altern Med. 2007;7:33. doi:10.1186/1472-6882-7-33
    17. Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Med. 2012;13(2):215-228. doi:10.1111/j.1526-4637.2011.01243.x