Rib Pain - Blood Stasis Pattern

Dr. Li Wei, DACM

Rib Pain · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Chest

Pattern Overview

Blood Stasis is a common pattern in rib pain, characterized by fracture or traumatic pain, sharp fixed pain, and aggravation at night. The core pathogenesis is trauma causing stagnation of blood in the rib collaterals, leading to severe pain, swelling, and impaired healing.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain in the rib area, fixed location, worse at night |

| Associated Symptoms | History of trauma, swelling, tenderness on palpation, limited breathing |

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

| Pathogenesis | Blood stasis obstructing the rib collaterals from trauma |

| Etiology | Rib fracture, contusion, blunt trauma, surgery |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| BL17 Geshu | Lower back, 1.5 cun lateral to T7 | Back-Shu point of the Blood; invigorates Blood and resolves stasis |

| LR3 Taichong | Dorsum of the foot, between the 1st and 2nd metatarsals | Soothes Liver Qi and regulates Qi flow |

| Ashi points | Tender spots in the rib area | Local blood invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; cupping at Ashi points may be used to enhance blood stasis resolution. Avoid deep needling near the rib area.

Herbal Formula

Base Formula: Xue Fu Zhu Yu Tang (血府逐瘀汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di), Bupleurum (Chai Hu), Platycodon (Jie Geng), Licorice (Gan Cao)

Action: Invigorates blood, resolves stasis, regulates Qi, and relieves pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

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

| Swelling | Add Dan Shen, Chi Shao to improve microcirculation |

| Breathing difficulty | Add Zhi Ke, Jie Geng to regulate Qi and relieve chest tightness |

Western Mechanism Reference

Fracture or traumatic pain with local hematoma, tissue damage, and microcirculatory disturbance. Blood Stasis corresponds to rib pain following trauma, where soft tissue damage and localized bleeding cause inflammation and pain.

References

  1. Textbook Standard.

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

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