Rib Pain - Liver Qi Stagnation Pattern

TCM differentiation and treatment for rib pain with Liver

Rib Pain · Liver Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Chest

Pattern Overview

Liver Qi Stagnation is the most common pattern in rib pain,

characterized by **intercostal neuralgia, distending pain, worsening

with stress, chest tightness, and frequent sighing**. The core

pathogenesis is emotional stress causing Liver Qi stagnation, which

obstructs the meridians in the rib area, leading to distending pain and

chest tightness.

Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

stress, chest tightness, frequent sighing |

Associated Symptoms

fullness, premenstrual tension |

Tongue and Pulse

pulse |

Pathogenesis Liver Qi stagnation obstructing the rib meridians
Etiology Chronic stress, emotional distress, prolonged sitting

Acupuncture Point Prescription

Point Location Function
LR3 Taichong

metatarsals | Source point of Liver meridian; soothes Liver Qi |

LR14 Qimen

nipple | Front-Mu point of Liver meridian; treats rib and chest pain |

PC6 Neiguan 2 cun above the wrist crease, between the tendons

Luo-Connecting point; relieves chest tightness and regulates Qi |

GB34 Yanglingquan Depression below the head of the fibula

He-Sea point of Gallbladder meridian; regulates Qi and relieves pain |

Clinical Recommendation: Filiform needle, reducing method; combine

with deep breathing exercises and stress reduction techniques.

Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi

Ke), Cyperus (Xiang Fu), Chuanxiong (Chuan Xiong), Tangerine Peel (Chen

Pi), Licorice (Gan Cao)

Action: Soothes Liver Qi, regulates Qi flow, relieves depression,

and stops pain.

Modifications

Associated Symptoms Additions/Subtractions
Pronounced depression

and calm the spirit |

Severe chest tightness

distension |

Insomnia Add Suan Zao Ren, Yuan Zhi to calm the spirit
Prolonged pain

pain |

Western Mechanism Reference

Intercostal neuralgia with stress-induced muscle tension, autonomic

dysfunction, and nerve sensitization. Liver Qi Stagnation corresponds to

rib pain related to stress and emotional factors, where autonomic

dysfunction and increased muscle tension contribute to intercostal nerve

sensitization and pain.

References

1. Database + Textbook.

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

Explore More

Personalized herbal protocols and acupressure tools for chest pain

relief.

research papers and clinical case studies on TCM chest 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.