Lower Back Pain - Blood Stasis Pattern

Dr. Li Wei, DACM

Lower Back Pain · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Lower Back

Pattern Overview

Blood Stasis is a common pattern in lower back pain, characterized by disc-related pain, sharp fixed pain, and aggravation at night. The core pathogenesis is stagnation of blood in the lumbar collaterals, leading to nerve root compression, local hematoma organization, and persistent pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain in the lower back, fixed location, worse at night |

| Associated Symptoms | Limited movement, tenderness on palpation, dull complexion |

| Tongue and Pulse | Purple-dark tongue with petechiae, thin white coating, hesitant pulse |

| Pathogenesis | Blood stasis obstructing the lumbar collaterals |

| Etiology | Lumbar trauma, disc herniation, prolonged illness entering collaterals |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| BL23 Shenshu | Lower back, 1.5 cun lateral to L2 | Regulates Kidney Qi, invigorates blood and relieves pain |

| BL40 Weizhong | Midpoint of the popliteal crease (behind the knee) | Relaxes sinews and activates collaterals, benefits the lower back and knees |

| DU3 Yaoyangguan | On the midline, between L4 and L5 spinous processes | Warms Yang and unblocks collaterals, invigorates blood and relieves pain |

| Ashi points | Tender spots around the lower back | Local blood invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; cupping or pricking at Ashi points may be used to enhance blood stasis resolution.

Herbal Formula

Base Formula: Shen Tong Zhu Yu Tang (身痛逐瘀汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Trogopterus Dung (Wu Ling Zhi), Myrrh (Mo Yao), Cyperus (Xiang Fu), Achyranthes (Niu Xi), Earthworm (Di Long)

Action: Invigorates blood, resolves stasis, unblocks collaterals, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Ru Xiang, Yan Hu Suo to invigorate blood and relieve pain |

| Radiating leg pain | Add Du Huo, Sang Ji Sheng to disperse Wind and unblock collaterals |

| Qi deficiency | Add Huang Qi, Dang Shen to supplement Qi and invigorate blood |

| Cold-Dampness | Add Fu Zi, Xi Xin to warm the meridians and disperse Cold |

Western Mechanism Reference

Disc-related pain with local hematoma organization, nerve root compression, and inflammatory response. Blood Stasis corresponds to lumbar disc herniation and lumbar spinal stenosis, where nerve root compression and local inflammation contribute to pain.

References

  1. Textbook Standard.

  2. WHO. (2023). Musculoskeletal pain. World Health Organization.

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