Sacroiliac Joint Pain - Damp-Heat Bi Pattern

TCM differentiation and treatment for sacroiliac joint

Sacroiliac Joint Pain · Damp-Heat Bi Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Lower Back


Pattern Overview

Damp-Heat Bi is an inflammatory pattern in sacroiliac joint pain,

characterized by **inflammatory sacroiliitis, burning pain, swelling,

and redness. The core pathogenesis is accumulation of Damp-Heat in

the sacroiliac region**, causing acute inflammation, joint edema, and

severe pain.


Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

sacroiliac region |

Associated Symptoms

movement, fever, dry mouth |

Tongue and Pulse

and rapid pulse |

Pathogenesis Damp-Heat accumulating in the sacroiliac region
Etiology

inflammation (e.g., ankylosing spondylitis) |


Acupuncture Point Prescription

Point Location Function
BL23 Shenshu Lower back, 1.5 cun lateral to L2

Kidney Qi, clears Heat and drains Dampness |

SP9 Yinlingquan Below the medial condyle of the tibia

Transforms Dampness and drains Heat |

BL32 Ciliao In the second sacral foramen

sacral pain |

Ashi points Tender spots around the sacroiliac region

clearing of Damp-Heat |

Clinical Recommendation: Filiform needle, reducing method; may

combine with pricking and cupping at Ashi points to drain Damp-Heat.


Herbal Formula

Base Formula: Si Miao Wan (四妙丸)

Composition:

Atractylodes (Cang Zhu), Phellodendron (Huang Bai), Achyranthes (Niu

Xi), Coix Seed (Yi Yi Ren)

Action: Clears Damp-Heat, reduces inflammation, promotes diuresis,

and relieves pain.

Modifications

Associated Symptoms Additions/Subtractions
Severe burning pain

detoxify |

Swelling Add Ze Xie, Che Qian Zi to promote diuresis
Fever Add Shi Gao, Zhi Mu to clear Heat and generate fluids

Western Mechanism Reference

Inflammatory sacroiliitis with elevated inflammatory cytokines, immune

dysregulation, and sacroiliac joint edema. Damp-Heat Bi corresponds to

inflammatory sacroiliitis, often seen in ankylosing spondylitis or

reactive arthritis, where immune-mediated inflammation causes sacroiliac

joint pain and stiffness.


References

1. Textbook Standard.

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


Explore More

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research papers and clinical case studies on TCM joint 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.