Sciatica - Qi Stagnation with Blood Stasis Pattern

Dr. Li Wei, DACM

Sciatica · Qi Stagnation with Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Leg

Pattern Overview

Qi Stagnation with Blood Stasis is the core pattern during the acute phase of sciatica, characterized by sharp radiating leg pain, nerve root compression, limited movement, and aggravation with coughing or straining. The core pathogenesis is herniated disc or piriformis muscle compression causing Qi stagnation and Blood stasis along the sciatic nerve pathway, leading to severe pain and impaired function.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Sharp, stabbing pain radiating from the lower back down the leg, worse with coughing or straining |

| Associated Symptoms | Worse at night, fixed location, limited movement, numbness |

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

| Pathogenesis | Nerve compression causing Qi stagnation and Blood stasis along the sciatic nerve pathway |

| Etiology | Lumbar disc herniation, piriformis syndrome, trauma |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

| BL25 Dachangshu | Lower back, 1.5 cun lateral to L4 | Unblocks the lower lumbar and sacral area, treats radiating leg pain |

| BL40 Weizhong | Midpoint of the popliteal crease (behind the knee) | The “back pain master point”; treats sciatica |

| GB30 Huantiao | Midpoint between sacral hiatus and greater trochanter of femur | Master point for sciatica; on the Gallbladder meridian |

Clinical Recommendation: Filiform needle, reducing method; during the acute phase, use light technique. May combine with cupping to enhance blood stasis resolution. Rest in bed is recommended.

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), Gentiana (Qin Jiao), Notopterygium (Qiang Huo), Licorice (Gan Cao)

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

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

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

| Numbness | Add Ji Xue Teng, Wu Shao She to unblock collaterals and invigorate blood |

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

| Piriformis muscle tightness | Add Bai Shao, Mu Gua to relax sinews and relieve tension |

Western Mechanism Reference

Nerve root compression from disc herniation or piriformis syndrome, with local inflammation and nerve root ischemia. Qi Stagnation with Blood Stasis corresponds to acute sciatica, where herniated disc material or piriformis muscle spasm causes nerve root compression, local inflammation, and severe radiating pain.

References

  1. Database + Textbook.

  2. Yuan, J., et al. (2016). TCM for sciatica: a meta-analysis. Medicine, 95(18), e3578.

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

Explore More

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

  • Deepen your knowledge at TcmCIO.com – Full research papers and clinical case studies on TCM nerve health.