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.