Metatarsalgia - Blood Stasis Pattern

Dr. Li Wei, DACM

Metatarsalgia · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Foot

Pattern Overview

Blood Stasis is a chronic pattern in metatarsalgia, characterized by neuroma or stress fracture, sharp fixed pain, and aggravation at night. The core pathogenesis is stagnation of blood in the forefoot collaterals, leading to chronic inflammation, fibrosis, and persistent pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain in the ball of the foot, fixed location, worse at night |

| Associated Symptoms | Swelling, tenderness, limited toe movement, possible neuroma on examination |

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

| Pathogenesis | Blood stasis obstructing the forefoot collaterals |

| Etiology | Chronic overuse, repetitive microtrauma, improper footwear |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| SP4 Gongsun | Medial foot, below the base of the 1st metatarsal | Luo-connecting point of Spleen meridian; treats foot pain |

| BL60 Kunlun | Depression between lateral malleolus and Achilles tendon | Unblocks the Bladder meridian; treats foot pain |

| SP10 Xuehai | On the medial thigh, 2 cun above the patella | Invigorates blood and resolves stasis |

| Ashi points | Tender spots around the forefoot | 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: Tao Hong Si Wu Tang (桃红四物汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di)

Action: Invigorates blood, resolves stasis, nourishes blood, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Ru Xiang, Mo Yao to relieve pain |

| Neuroma | Add Dan Shen, San Leng to break up stasis |

| Swelling | Add Ji Xue Teng to improve microcirculation |

Western Mechanism Reference

Neuroma or stress fracture with local microcirculatory disturbance, tissue fibrosis, and impaired healing. Blood Stasis corresponds to metatarsalgia from Morton’s neuroma or stress fracture, where chronic inflammation and impaired microcirculation contribute to persistent pain.

References

  1. Textbook Standard.

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

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  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for foot pain relief.

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