Ankle Sprain · Damp-Heat Bi Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 6 min
Body Area: Ankle


Pattern Overview

Damp-Heat Bi is an acute inflammatory pattern following ankle sprain, characterized by significant swelling, redness, burning pain, and localized warmth. The core pathogenesis is Damp-Heat accumulation at the injury site, causing intense inflammation and fluid exudation.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsSevere swelling, redness, burning pain in the ankle
Associated SymptomsLocalized warmth, limited movement, possible fever
Tongue and PulseRed tongue with yellow greasy coating, slippery and rapid pulse
PathogenesisDamp-Heat accumulating at the injury site
EtiologySevere sprain with significant inflammatory response, infection

Acupuncture Point Prescription

PointLocationFunction
SP9 YinlingquanBelow the medial condyle of the tibiaTransforms Dampness and drains Heat
GB34 YanglingquanDepression below the head of the fibulaRelaxes tendons and reduces pain
BL60 KunlunDepression between lateral malleolus and Achilles tendonUnblocks the Bladder meridian; reduces swelling
Ashi pointsTender spots around the ankleLocal clearing of Damp-Heat

Clinical Recommendation: Filiform needle, reducing method; may combine with pricking and cupping to drain Damp-Heat. Avoid strong manipulation in the acute phase.


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 SymptomsAdditions/Subtractions
Severe swellingAdd Ze Xie, Che Qian Zi to promote diuresis
Burning painAdd Jin Yin Hua, Lian Qiao to clear Heat and detoxify
FeverAdd Shi Gao, Zhi Mu to clear Heat and generate fluids

Western Mechanism Reference

Acute inflammatory swelling, increased vascular permeability, and neutrophil infiltration. Damp-Heat Bi corresponds to severe ankle sprains (grade II-III) with significant inflammatory response, or cases complicated by infection.


References

  1. Textbook Standard.
  2. WHO. (2023). Musculoskeletal pain. World Health Organization.

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