Metatarsalgia - Damp-Heat Bi Pattern

Dr. Li Wei, DACM

Metatarsalgia · Damp-Heat Bi Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Foot

Pattern Overview

Damp-Heat Bi is an acute inflammatory pattern in metatarsalgia, characterized by acute bursitis, swelling, redness, and burning pain. The core pathogenesis is accumulation of Damp-Heat in the forefoot, causing acute inflammation, edema, and severe pain.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Swelling, redness, burning pain in the ball of the foot |

| Associated Symptoms | Local warmth, tenderness, limited toe movement |

| Tongue and Pulse | Red tongue with yellow greasy coating, slippery and rapid pulse |

| Pathogenesis | Damp-Heat accumulating in the forefoot |

| Etiology | Acute overuse, infection, or gout attack |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| SP9 Yinlingquan | Below the medial condyle of the tibia | Transforms Dampness and drains Heat |

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

| ST44 Neiting | Between the 2nd and 3rd metatarsal bones | Spring point of Stomach meridian; treats forefoot pain |

| Ashi points | Tender spots around the forefoot | Local clearing of Damp-Heat |

Clinical Recommendation: Filiform needle, reducing method; may combine with pricking and cupping at Ashi points to drain Damp-Heat.

Herbal Formula

Base Formula: Si Miao Wan (四妙丸)

Composition:

Atractylodes (Cang Zhu), Phellodendron (Huang Bai), Achyranthes (Niu Xi), Coix Seed (Yi Yi Ren)

Action: Clears Damp-Heat, reduces inflammation, promotes diuresis, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe redness and swelling | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

| Burning pain | Add Shi Gao, Zhi Mu to clear Heat and generate fluids |

| Fever | Add Huang Qin, Huang Lian to clear Heat |

Western Mechanism Reference

Acute bursitis with neutrophil infiltration, edema, and elevated inflammatory cytokines. Damp-Heat Bi corresponds to acute metatarsalgia with significant inflammatory response, often seen in bursitis or gouty inflammation.

References

  1. Textbook Standard.

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

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