Trapezius Pain - Qi Stagnation with Blood Stasis Pattern

TCM differentiation and treatment for trapezius pain with

Trapezius Pain · Qi Stagnation with Blood Stasis Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Neck

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Pattern Overview

Qi Stagnation with Blood Stasis is a common pattern in trapezius pain,

characterized by **chronic trigger points, sharp fixed pain, and

aggravation at night. The core pathogenesis is stagnation of Qi and

Blood in the trapezius collaterals from chronic muscle tension**,

leading to trigger point formation, pain, and impaired healing.

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Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
**Primary Symptoms**

fixed location, worse at night |

**Associated Symptoms**

tenderness on palpation |

**Tongue and Pulse**

coating, wiry-hesitant pulse |

**Pathogenesis**

tension |

**Etiology**

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Acupuncture Point Prescription

PointLocationFunction
**GB21 Jianjing**
Relaxes the shoulder and neck muscles, disperses Wind
**BL11 Dashu**1.5 cun lateral to T1, on the upper back

the Bladder meridian; treats neck and shoulder pain |

**LR3 Taichong**

metatarsals | Soothes Liver Qi and regulates Qi flow |

**Ashi points**Tender trigger points in the trapezius muscle

Local blood invigoration and pain relief |

Clinical Recommendation: Filiform needle, reducing method; cupping

at Ashi points may be used to enhance blood stasis resolution. Trigger

point needling is recommended for stubborn points.

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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, invigorates blood,

resolves stasis, and relieves pain.

Modifications

Associated SymptomsAdditions/Subtractions
Severe painAdd Ru Xiang, Mo Yao to relieve pain
Trigger pointsAdd Yan Hu Suo, Wu Ling Zhi to invigorate blood
Chest tightness

depression |

DizzinessAdd Bai Zhi, Man Jing Zi to disperse Wind and stop pain

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Western Mechanism Reference

Chronic trigger points with sustained muscle tension, local

microcirculatory disturbance, and metabolic accumulation. Qi Stagnation

with Blood Stasis corresponds to chronic trapezius pain with trigger

points, where sustained muscle tension and impaired microcirculation

contribute to pain persistence.

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References

1. Textbook Standard.

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

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Explore More

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relief.

research papers and clinical case studies on TCM shoulder health.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM

Disclaimer: This guide is for educational purposes only. Consult a licensed healthcare provider.