Sacroiliac Joint Pain - Damp-Heat Bi Pattern

Dr. Li Wei, DACM

Sacroiliac Joint Pain · Damp-Heat Bi Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Lower Back

Pattern Overview

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

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Burning pain, swelling, redness in the sacroiliac region |

| Associated Symptoms | Local warmth, tenderness, limited hip movement, fever, dry mouth |

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

| Pathogenesis | Damp-Heat accumulating in the sacroiliac region |

| Etiology | Inflammatory sacroiliitis, infection, immune-mediated inflammation (e.g., ankylosing spondylitis) |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| BL23 Shenshu | Lower back, 1.5 cun lateral to L2 | Regulates Kidney Qi, clears Heat and drains Dampness |

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

| BL32 Ciliao | In the second sacral foramen | Treats lower back and sacral pain |

| Ashi points | Tender spots around the sacroiliac region | 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 burning pain | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

| Swelling | Add Ze Xie, Che Qian Zi to promote diuresis |

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

Western Mechanism Reference

Inflammatory sacroiliitis with elevated inflammatory cytokines, immune dysregulation, and sacroiliac joint edema. Damp-Heat Bi corresponds to inflammatory sacroiliitis, often seen in ankylosing spondylitis or reactive arthritis, where immune-mediated inflammation causes sacroiliac joint pain and stiffness.

References

  1. Textbook Standard.

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

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