Tension Headache - Blood Stasis Pattern

Dr. Li Wei, DACM

Tension Headache · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Blood Stasis is a chronic pattern in tension headache, characterized by chronic pain-induced central sensitization, fixed headache, worsened at night, and dull complexion. The core pathogenesis is Blood stasis in the head collaterals, leading to cerebral blood flow abnormalities, central sensitization, and persistent headache.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Fixed headache (stabbing or boring), worsened at night |

| Associated Symptoms | Dull complexion, purple-dark lips, dry skin, poor memory |

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

| Pathogenesis | Blood stasis in the head collaterals |

| Etiology | Chronic tension headache, prolonged illness, trauma, poor circulation |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Fengchi (GB20) | Depression below the occipital bone, between the sternocleidomastoid and trapezius | Unblocks the head collaterals and relieves pain |

| Taiyang (EX-HN5) | In the depression at the temple | Invigorates blood in the head and relieves pain |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Regulates Qi and invigorates blood |

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

| Ashi points | Tender spots around the head | Local blood invigoration and pain relief |

Clinical Recommendation: Filament needle, reducing method; may combine with cupping on the neck to enhance blood stasis resolution.

Herbal Formula

Base Formula: Tong Qiao Huo Xue Tang (通窍活血汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Musk (She Xiang), Scallion (Lao Cong), Ginger (Sheng Jiang), Jujube (Hong Zao), Licorice (Gan Cao)

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

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

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

| Dizziness | Add Tian Ma, Gou Teng to calm Liver Wind |

| Dull complexion | Add Dan Shen, San Qi to enhance blood invigoration |

| Poor memory | Add Yuan Zhi, Shi Chang Pu to open the orifices and improve cognition |

Western Mechanism Reference

Chronic pain-induced central sensitization with cerebral blood flow abnormalities, elevated substance P, and CGRP. Blood Stasis corresponds to chronic tension headache with central sensitization, where cerebral blood flow abnormalities and elevated nociceptive mediators contribute to persistent pain.

References

  1. Internal Medicine of TCM - Headache with Blood Stasis.

  2. Xiong Jibai: Blood Stasis uses Tao Hong Si Wu Tang.

  3. WHO. (2023). Headache disorders. World Health Organization.

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