A Guide to the Urinary Bladder Meridian

Welcome to this month’s edition of The Meridian Series where we explore the unique properties of each acupuncture channel in East Asian Medicine; plus the roles they play in our physical, emotional, and spiritual well-being. If you are new to this series, or have not heard about the meridians before, here is a little background before we dive into our next featured channel: The Urinary Bladder MeridianTrigger Warning: this article references SA, so read with caution.

What Are The Meridians?

In East Asian Medicine, there are twelve main Meridians (also known as Jing-Luo “channels”) that carry vital substances such as energy (aka Qi pronounced “chee”), Body Fluids (Jin-Ye), Essence (Jing) and Shen (Spirit), and Blood (Xue) to provide nourishment throughout the body.

In a healthy person, these vital substances freely move in a state of dynamic equilibrium. Yet when their flow becomes blocked in one or more of these channels from emotional stress, an injury, or illness — pain and other symptoms of disharmony manifest in the body.

Each meridian is associated with an organ system as well as a host of other natural phenomena since the foundations of East Asian Medicine were created on the basis of observing the human body as a microcosm of nature — from the elements (Metal, Air, Water, Fire, Earth), climate, seasonal shifts, and more. After all, we are just as dynamic as these cosmic changes: our internal systems have their own rhythms and are always seeking a return to harmony.Every meridian’s unique function also conveys the inseparable connection between the mind, body, and spirit. In East Asian Medicine, these facets of existence represent the spectrum of Qi’s manifestations from its most dense, material forms such as the organs while the psyche and spirit are more ethereal extensions of being. As you will find, every meridian is influenced by more than just the physiology of the organ it’s named after. Beyond the surface, they are reservoirs that are the sources of distinct emotions and expressions in someone’s disposition.Through reading the Meridian Series, my hope is for you to harness a deeper understanding of the capacity for comprehensive, holistic healing contained in each of these ancient vessels.

More Than An Organ

In East Asian Medicine, “Zang Fu” is the concept that describes how organ systems create, store, and regulate the body’s vital substances described above. Rather than WesternMedicine’s emphasis on the mechanisms of an organ's anatomy, each system is regarded for its effects on the entire body–how they communicate with other systems to ensure one’s health.Organs are categorized into pairs that are either relatively solid (Zang) or hollow (Fu).Zang Organs are Yin in nature: they govern the body’s interior (from its physical, mental, and emotional regulation). Since they are mostly solid structures, they are in charge of storage and transformation of pure substances–acting as reservoirs for the qi, blood, essence, and body’s fluids. The Lungs, Spleen, Kidney, Liver, and Heart comprise the five Zang Organs.Fu Organs Yang in nature: they influence the body’s exterior. As hollow structures, they are responsible for allowing the vital substances to move through them. Fu organs are entrusted with transporting and disposing of impure substances (food/waste) created by the Zang organs. The Stomach, Small & Large Intestines, Gallbladder, and Bladder makeup the six Fu organs.

Five Element Associations

“Nothing in the world is as soft and yielding as water, yet for dissolving the hard and inflexible, nothing can surpass it.” ~ Lao Tazu, The Tao Te ChingIn Chinese Medicine’s 5-Element Theory, Winter is associated with Water.On the 5-Element wheel, this is aligned with Water’s position on the lower left side indicating how nature’s cosmic Qi moves down & inwards before ascending with the Wood Element come Spring. Being the lowest point on the entropy cycle, it signifies a liminal space between death and rebirth.During what can seem like such a bleak time of year, we see the spirit of Water — this tenacity and willpower to live — in animal burroughs, caves, and oceanic abysses where primordial creatures still dwell.Water’s potency is evident even at its stillest while frozen as fertile sap stored within the roots and seeds underground, waiting for the right conditions to emerge.In the womb, life grows in the dark amniotic bath until ready to do the same.Within each of us, there are ancestral Qi (Essence aka “Jing”) stored within the marrow of our bones and expressed through Water Element’s ruled organs: The Kidneys, Bladder, and reproductive organs they encompass.However, while the Kidneys are Yin vessels which store our Essence, the Urinary Bladder is the Yang conduit for how it gets expressed.The Urinary Bladder governs how much and where our everyday and ancestral Qi is allocated. Its fundamental lesson, as with that of Winter, is to use them wisely.

The Meridian

The Urinary Bladder channel is the longest in the body with 67 Acupuncture points that span from the head to the pinky toe. The meridian begins at the inner corner of the eye (UB-1) and traces up the forehead and down the back of the head to the base of the skull. From here it extends vertically down the neck and the length of the back in a line of “Back Shu” or Transport points that are parallel to the spine.Side Note: Back Shu points are where the Qi of the respective Zang-Fu organs collect deep within the body. The neat thing about Back Shu points is there is one for each of the organ system located over (or on the same vertebral level) as that organ. Therefore, Back Shu points are ideal to access when certain organs are in need of strengthening simultaneously. These points are also excellent local options for varieties of neck and back pain.The meridian continues lower to trace the outer border of the sacrum before making a quick turn upward that passes over the foramina (hollows of the sacrum) itself. At UB-35 the channel goes interior and emerges at the upper back just above the shoulder blade. It then runs down the back lateral to the Inner Shu points in what is known as the “Outer Shu” or “Spirit” Shu line. These points connect with each of the Five Spirits which rule over the psycho-emotional aspect of each of the Zang Organs.At my private practice, I love crafting individualized treatments for clients that incorporate both of these Shu lines which allows me to harmonize the physiology of the organ systems while simultaneously influencing these Spirits. Together they guide the release buried emotions, somatic memories, and trauma from the body.Rather than stopping at the low back, this outer Urinary Bladder channel travels all the way down the glutes and back of the hamstrings, behind the knee, and down the posterior lower leg, with a hedge towards the lateral portion of the calves (UB-58).From here it makes its final reach down the posterior-lateral aspect of the lower leg before pivoting at the lateral ankle (UB-60) to complete its path along the lateral aspect of the foot before terminating at the pinky toe.

The Urinary Bladder’s Functions

The Urinary Bladder in Chinese Medicine shares the role of storing and excreting urine like its roles in Western Medicine. However, it has a broader application in that it also participates in the transformation of fluids necessary for the production of urine in the first place. Simply stated, the Bladder removes water by transforming fluids, a unique type of Qi transformation.It is essential to know that the Bladder is the Yang organ counterpart to the Kidneys.Relationally, the Bladder performs its functions based on the heat and energy it derives from the Kidneys. If the Kidneys are weakened, the Bladder will become inhibited leading to urogenital disorders. The same is true vice versa.Besides the Kidneys, several organ systems are involved in urination: the Liver, Heart, Lungs, Triple Burner, and Small Intestine.In order for urine to be created and reach the Bladder, first, the Small Intestine separates the pure fluid (nutrient-rich) fluids from the impure fluid (waste). Next, the Triple Heater (San Jiao) ensures the water passages in the lower part of the body (the Lower Burner) are free to send the impure fluids to the Bladder. The Heart and Lung Qi’s descending dynamic helps the Bladder release urine. Lastly the Liver, whose channel approaches the end of the urethra, ensures that the flow of Qi (and urine) from the Bladder is smooth and complete.

Bladder Organ Patterns Explained

These symptoms and observations can indicate something is awry in this organ:

• Urination Issues: discomfort, pain, burning, difficulty starting or stopping, high or low frequency, poor or lost control (incontinence)
• Dampness in the Lower Burner: urine that is cloudy, dark, or foul in odor
• Having a “Sinking” Feeling: frequent urination, incontinence, prolapse
• Chronic Inflammation such as Interstitial Cystitis
• When thirst is lacking, insatiable, or a lack of desire to drink water persists
• Thick, sticky coating (white or yellow) at the root of the tongue

What Causes Bladder Disorders?

External Causes

In Chinese Medicine, the climate of where we live (even places we travel to) play an important role in the external pathogens we are exposed to. If not weary of excessive exposure to Heat, Summer-Heat, Dryness, Cold, Wind, or Dampness, they can lead to disorders in the meridians and their related organ systems.The most common pathogen seen in Bladder conditions is the Accumulation of Dampness. Living in damp places, sitting on damp surfaces, and excessive exposure to Damp-Cold or Damp-Heat weather can all manifest in disorders along the Bladder meridian as well as in the organ itself.If that seems far-fetched, remember that an upper portion of the Bladder Channel travels down the base of the head and back of the neck. This region is called “The Wind Gate” where external pathogens easily invade and travel interior to “attack” the ZangFu. This is why covering your neck when you go out in windy or cold weather is not so much a superstition in Chinese Medicine — it's a preventative safeguard from the “pernicious evils” that can make us sick.When this portion of the Bladder Meridian remains exposed to these pathogens, it is common for frontal headaches, occipital headaches, neck pain and torticollis (a term used for neck stiffness in Western Medicine) to occur. I have even worked with clients who develop these from sleeping next to an open window or in air conditioned rooms in the summer.Given that the channel also traverses the back of the body to the pinky toe, if the feet are exposed to Dampness and Cold enough, these pathogens can travel lead to tightness, pain, spasm, swelling, and paresthesias in the lower half of the meridian (lateral feet & ankles, lower legs, low back, etc.) and Urinary Bladder too.

Lifestyle Causes

Sexual ActivityThe health of the Kidneys and Urinary Bladder are directly linked to one’s sexual health and that of their reproductive organs.As the Kidneys house our ancestral Qi or Jing (also known as Essence), the Bladder determines the ways (and how much of) one’s Jing is used.You can think of Jing as the unique blueprint of inherited traits that shape your constitution. To a certain degree, like genetics, it determines your growth and development, your susceptibility to disease, your fertility/virility, your inherited physical traits and even your interests or “gifts.”One of the ways Jing becomes depleted is through excess sexual activity.For men, Jing (and Kidney Yang) is lost through ejaculation, so this etiology is most common for them. Although Jing is not lost the same way during a female orgasm, it is depleted from their period and having babies. For both men and women, sexual activity that occurs before puberty can also weaken the Kidneys and Bladder.When excess sexual activity is an underlying factor, low back & sacral pain can be present with or without bladder dysfunction (depending on severity).To read more about Jing and the Kidneys, read A Guide to the Kidney Meridian.Excess Physical ExerciseA classic saying that I share with my athletic clients is “running consumes the Blood; lifting heavy taxes the Kidneys.” In general, excess physical exercise (even overwork from a physically demanding job) taxes the Kidney system and, by association, the Bladder by depleting the energy available for it to carry out its functions. Lifting heavy (especially from sports which emphasize this) can make the Bladder Deficient and Cold leading to incontinence, enuresis, or nocturia.As above, pain along the Bladder meridian can coincide with this cause.Metaphysical CausesIf you are new to the Meridian Series, you might be surprised to know a fundamental tenet of Chinese Medicine is: when emotions are suppressed, excessive, or felt with intensity for a short duration of time, they can be a root cause to disease. Each ZangFu is connected with a specific emotion that can lead to disorders in that meridian/organ (check out The Physical Effects of Emotions to learn more).

For our focus, the emotion that injures the Bladder the most is Fear.

Fear of change, the unknown, loss, aging, scarcity, pain, intimacy, traveling, expressing oneself, disappointing others... these are common ones I have seen impact the Bladder, but the fear can be of anything.To put this in perspective, let’s recall (again) how the Bladder Meridian supports our entire backside from our head to our feet.Its health metaphysically reflects the support one feels they have or lack in their life circumstances and relationships — but also the belief they have in themself. It’s both a mirror and conduit for our personal power. It enables one to stand tall and hold their heads high. When robust, it also empowers one with the capacity to adapt in the face of change & move forward with determination.As the Yang passageway for the Water Element, a healthy Bladder makes someone fluid in their emotional expression. They feel their feelings; they allow themselves to be swept into the depths of what is arising if necessary just so it can pass. That is Water’s Wisdom: just as the Bladder expands and empties, it invites us to emote to emit the pressure of their feelings without withholding.When someone does withhold their emotions, the Bladder will reflect this conflict. Besides fear, others that irritate the bladder from retention are anger, jealousy, and suspicion. In these cases, there is usually internal Damp Heat or Heart and/or Liver Fire that drains through the Bladder causing burning urination that can be dark, scanty, plus have hesitant flow.On a different end of the spectrum, repressed shame and guilt make Qi bind in the Lower Burner causing a weak or incomplete stream. When endured over a long period of time (as these emotions typically are) it can elicit a sinking sensation that reveals itself in incontinence and/or a urinary stream that always feels incomplete.At its most severe, there can be prolapse in any of the urogenital organs.When faced with a new unknown, a challenging relationship, or a situation that makes one feel powerless to quite literally stand up for themself (to know where they stand, to know how/if/where they can move forward etc.) the Bladder will reflect this too. These themes are more common in conditions where general inflammation (like interstitial cystitis) and incontinence are prevalent.Urgency can develop from feeling perpetually rushed — living out of sync with your desires. Perhaps overextending yourself or not allocating your resources - your everyday and Jing wisely. Where can you give yourself permission to slow down and reevaluate where you put your energy?

A note on Incontinence:

Given how the Kidneys govern growth, aging, and longevity, it is no surprise that incontinence is associated with getting older. However, this is not necessarily a given for every elderly person or a physical issue alone. With age, unique fears related to embracing (or resisting) what the next stages of life bring deplete the Bladder.Since incontinence is so common in women postpartum, I have come to view an energetic layer of this condition relating to the process of matrescence - the identity shift a woman undergoes when becoming a mother. While everything from her organs to her bones try to align again, she tries to find herself in what feels like a new skin - a new embodiment in every sense. There is an inherent loss of self yet urgency to adopt or settle into a new way of being and relating to everything you once knew & prioritized. This transformation can elicit existential fear and is, in its own right, an initiation for a mother to reclaim her personal power too.

A note on Urinary Tract Infections (UTIS):

Vulnerability, change, losing control, and boundaries are key themes that usually come up in conversations with clients around UTIS.There can be fear of change or difficulty adapting to new circumstances. Even welcomed and exciting change can trigger uncertainty that the Bladder will reflect almost like an act of preventative armoring. If the psyche and spirit has trouble releasing the past to fully commit to the course ahead, the debate of “should I stay or should I go” mimics the interrupted stream that can be seen in UTIS.It is important noting that because of the Bladder’s inherent connection to the genitals, UTIS can metaphysically show up when engaged in a new intimate relationship, when there is withheld resentment or fear of vulnerability in an existing relationship or in situations when a personal boundary has been violated such as sexual abuse or infidelity. In these cases, a UTI is metaphysically how the Bladder responds to the presence of a threat.

Note: this is not an exhaustive or precise interpretation for every person. These are insights based on my knowledge of Chinese Medicine and own clinical experience.

Tips To Support Your Bladder

Support the Bladder with Water & Essence-Rich FoodsAlthough staying hydrated is important for supporting the Urinary Bladder, drinking water alone is not the only (or most effective) way to achieve this. In fact, drinking too much water can weaken the Bladder’s ability to lift and uphold the Qi, leading to frequent, urgent urination. In Eastern Nutrition, the Bladder benefits from consuming more water-dense foods such as fruits and vegetables which make it easier for the body to retain the water for hydration purposes rather than just passing through the Bladder. As for drinks, opting for water that already has minerals and electrolytes in it can help you hydrate more effectively: coconut water, herbal teas, water with a pinch of salt, or (if choosing store-bought) a bottled brand that has not been demineralized are all options worth exploring.Additionally, choosing foods that are black in color, come from deep within the earth or animal will dually support the Bladder and Kidneys, its paired Yin organ such as: Bone broth, bone marrow, organ meat, sea greens, seafood, pasta infused with cuttlefish ink (a favorite of mine), and roasted root vegetables.Channel Water Element’s Wisdom:During the Winter months (as well as those figurative chapters of your life where circumstances feel just as fallow) can you trust in the turning of the life’s wheel and lean into the entropy of all things? Can you embody Water’s ways of being: of flowing, of percolating, of going down and in which is to live in sync with its nature.Your inclinations to rest, reflect, plan, and dream for how you want to pursue your potential are not just natural during these seasons, they are medicinal.Although the New Year heralds a time of new beginnings where we are culturally inundated with the expectation to participate in reflexive change, this ethos is not incorrect, per say, but poorly timed when considering the rhythms of nature which we are innately linked to — and the cultures of our ancestors globally who experienced Winters. Think of it this way: setting resolutions and kick-starting a new routine in January is like planting seeds in the snow and expecting them to sprout right away. It is empirically unrealistic.For women still menstruating, this Winter practice is an ideal complement during your period which is considered the “Winter” phase of your cycle. Giving yourself permission to slow down and retreat will set you up for a more vibrant, healthy month ahead. Nearly all of my menstruating clients notice an increase in energy and reduction in deficiency symptoms when they do not bypass this critical phase without making small but impactful adjustments in their lifestyle.For overall attunement, rather than wasting precious Qi and life essences fighting what is, can you direct your Zhi to accept the ever-changing pace of life and let yourself be carried by time to the other side... Like Water, can you trust when it is time to surrender your ambitions and desires with the circumstances revealed by your current situation, relationships, and health? I see this resistance often in clients whose identities are being called to change: following a breakup, becoming a parent, realizing the gravity of aging, changing careers, approaching retirement, etc.If this is something you can relate to, I suggest reading the book Wintering: The Power of Rest & Retreat in Difficult Times by Katherine May.Opt for a salty but nutrient rich snack as a midday pick-me-up. According to the Chinese Medicine Body Clock, the Bladder is exalted between 3-5pm meaning, it has the most vital substances traveling through it during this window to restore itself. Considering the Bladder’s yang role of allocating our ancestral and everyday (postnatal) energy — our precious resources — it is no coincidence how, 3-5pm is when those with dwindling reserves of Qi from burnout and overwork is when the midday slump turns into a crash that is hard to recover from without an extra dose of caffeine or sugar.

To make this afternoon to evening transition less taxing on your kidneys, adrenals, and bladder, rather than pushing your system further into a sympathetic overdrive with coffee (or a blood sugar rollercoaster with a sweet high in processed sugars), source a snack that is salty but nutrient-dense.

This might look like: a hummus spread with olives and pita, slices of your favorite cheese with fruit and crackers, a broth-based soup with an extra pinch of salt (Himalayan for the extra minerals if you can), sea greens like nori, a satiating serving of easy-to-eat seafood (a bit of tuna salad, sardines, smoked salmon, or salad with anchovies). You might be surprised with how that shift that works synergistically with the Bladder’s needs can empower you to flow through your midday without a drastic dip in Qi.

Coffee & UTIS: An Unsuspecting Connection To Consider

Did you know that too much coffee can increase your odds of developing a UTI?

In Chinese Medicine, this is a more common phenomenon than you might think. Here’s why...In addition to the primary Urinary Bladder meridian, it has an internal branch (called a divergent channel) that flows through the Heart. Keep in mind that in order for urine to be created the Heart Qi needs to descend to the Small Intestine which separates the pure (nutrient-containing) fluids from the impure (waste-containing) fluids — the latter of which is eliminated by the Bladder. Too much coffee (which is bitter in flavor) does not just stimulate the heart to spur the body into a state of alertness, it agitates it, creating what is called “Heart Fire” in Chinese Medicine. This Fire then drains to the Small Intestine and inevitably the Bladder which is what creates burning and pain with urination.If you are someone who lives on coffee or energy drinks (and do not hydrate enough with water) you are especially prone to this manifestation. Consider this causative relationship something to keep in mind (and adjust for) if you get UTIS frequently.Dr. Lauren Favreau is the Founder of Rune Acupuncture in New Gloucester, Maine where her approach to care can best be described as a merging of medicine and mysticism. Dr. Favreau addresses her client’s needs with a holistic and integrative approach. Her specialty lies in offering Acupuncture for emotional health and pain management, guiding patients towards a state where the body and mind are re-integrated, allowing one to reclaim the essence of who they are, as well as a more harmonized state of health. Book a session with Dr. Lauren through Rune Acupuncture or follow her on the ’gram for daily inspiration and wisdom.