Metatarsalgia - Blood Stasis Pattern

TCM differentiation and treatment for metatarsalgia with

Metatarsalgia · Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Foot


Pattern Overview

Blood Stasis is a chronic pattern in metatarsalgia, characterized by

**neuroma or stress fracture, sharp fixed pain, and aggravation at

night. The core pathogenesis is stagnation of blood in the forefoot

collaterals**, leading to chronic inflammation, fibrosis, and persistent

pain.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

fixed location, worse at night |

Associated Symptoms

possible neuroma on examination |

Tongue and Pulse

coating, hesitant pulse |

Pathogenesis Blood stasis obstructing the forefoot collaterals
Etiology

footwear |


Acupuncture Point Prescription

Point Location Function
SP4 Gongsun Medial foot, below the base of the 1st metatarsal

Luo-connecting point of Spleen meridian; treats foot pain |

BL60 Kunlun

tendon | Unblocks the Bladder meridian; treats foot pain |

SP10 Xuehai On the medial thigh, 2 cun above the patella

Invigorates blood and resolves stasis |

Ashi points Tender spots around the forefoot

invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; cupping

or pricking at Ashi points may be used to enhance blood stasis

resolution.


Herbal Formula

Base Formula: Tao Hong Si Wu Tang (桃红四物汤)

Composition:

Peach Kernel (Tao Ren), Safflower (Hong Hua), Angelica (Dang Gui),

Chuanxiong (Chuan Xiong), Red Peony (Chi Shao), Rehmannia (Sheng Di)

Action: Invigorates blood, resolves stasis, nourishes blood, and

relieves pain.

Modifications

Associated Symptoms Additions/Subtractions
Severe pain Add Ru Xiang, Mo Yao to relieve pain
Neuroma Add Dan Shen, San Leng to break up stasis
Swelling Add Ji Xue Teng to improve microcirculation

Western Mechanism Reference

Neuroma or stress fracture with local microcirculatory disturbance,

tissue fibrosis, and impaired healing. Blood Stasis corresponds to

metatarsalgia from Morton's neuroma or stress fracture, where chronic

inflammation and impaired microcirculation contribute to persistent

pain.


References

1. Textbook Standard.

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


Explore More

Personalized herbal protocols and acupressure tools for foot pain

relief.

research papers and clinical case studies on TCM foot health.


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.