Coccyx Pain - Qi Stagnation with Blood Stasis Pattern
TCM differentiation and treatment for coccyx pain with Qi
Coccyx Pain · Qi Stagnation with Blood Stasis Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 6 min
Body Area: Lower Back
Pattern Overview
Qi Stagnation with Blood Stasis is the most common pattern in coccyx
pain, characterized by **traumatic coccydynia, sharp fixed pain, and
aggravation with sitting. The core pathogenesis is trauma causing Qi
stagnation and Blood stasis in the coccygeal region**, leading to pain,
tenderness, and impaired function.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|
| Primary Symptoms |
|---|
location, worse with sitting |
| Associated Symptoms |
|---|
the back, pain on rising |
| Tongue and Pulse |
|---|
coating, hesitant pulse |
| Pathogenesis |
|---|
the coccygeal collaterals |
| Etiology |
|---|
sitting on hard surfaces |
Acupuncture Point Prescription
| Point | Location | Function |
|---|
| DU1 Changqiang |
|---|
anus | Local point; treats coccyx pain |
| BL32 Ciliao | In the second sacral foramen |
|---|
sacral pain |
| DU4 Mingmen |
|---|
| Warms Kidney Yang; treats chronic coccyx pain |
| Ashi points | Tender spots around the coccyx |
|---|
invigoration and pain relief |
Clinical Recommendation: Filiform needle, reducing method; cupping
or pricking at Ashi points may be used to enhance blood stasis
resolution. Instruct the patient to use a cushion with a cutout to
reduce local pressure.
Herbal Formula
Base Formula: Fu Yuan Huo Xue Tang (复元活血汤)
Composition:
Bupleurum (Chai Hu), Angelica (Dang Gui), Peach Kernel (Tao Ren),
Safflower (Hong Hua), Pangolin Scales (Chuan Shan Jia), Trichosanthes
Root (Tian Hua Fen), Rhubarb (Da Huang), Licorice (Gan Cao)
Action: Invigorates blood, resolves stasis, promotes Qi flow, and
reduces swelling.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|
| Severe pain | Add Ru Xiang, Mo Yao to relieve pain |
|---|
| Prolonged sitting aggravation |
|---|
invigorate blood |
| Weakness | Add Huang Qi, Dang Shen to supplement Qi |
|---|
Western Mechanism Reference
Traumatic coccydynia with local hematoma, ligament injury, and
inflammatory response. Qi Stagnation with Blood Stasis corresponds to
coccyx pain following trauma, where ligament damage and localized
bleeding cause persistent pain and tenderness.
References
1. Database + Textbook.
2. WHO. (2023). Musculoskeletal pain. World Health Organization.
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Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly
Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.