Coccyx Pain · Qi Stagnation with Blood Stasis Pattern
Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 6 min
Body Area: Lower Back
Pattern Overview
Qi Stagnation with Blood Stasis is the most common pattern in coccyx pain, characterized by traumatic coccydynia, sharp fixed pain, and aggravation with sitting. The core pathogenesis is trauma causing Qi stagnation and Blood stasis in the coccygeal region, leading to pain, tenderness, and impaired function.
Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|---|
| Primary Symptoms | Sharp, stabbing pain at the coccyx, fixed location, worse with sitting |
| Associated Symptoms | Tenderness on palpation, difficulty lying on the back, pain on rising |
| Tongue and Pulse | Purple-dark tongue with petechiae, thin white coating, hesitant pulse |
| Pathogenesis | Trauma causing Qi stagnation and Blood stasis in the coccygeal collaterals |
| Etiology | Fall onto the buttocks, childbirth injury, prolonged sitting on hard surfaces |
Acupuncture Point Prescription
| Point | Location | Function |
|---|---|---|
| DU1 Changqiang | Midpoint between the tip of the coccyx and the anus | Local point; treats coccyx pain |
| BL32 Ciliao | In the second sacral foramen | Treats lower back and sacral pain |
| DU4 Mingmen | On the midline, between L2 and L3 spinous processes | Warms Kidney Yang; treats chronic coccyx pain |
| Ashi points | Tender spots around the coccyx | Local blood invigoration and pain relief |
Clinical Recommendation: Filiform needle, reducing method; cupping or pricking at Ashi points may be used to enhance blood stasis resolution. Instruct the patient to use a cushion with a cutout to reduce local pressure.
Herbal Formula
Base Formula: Fu Yuan Huo Xue Tang (复元活血汤)
Composition:
Bupleurum (Chai Hu), Angelica (Dang Gui), Peach Kernel (Tao Ren), Safflower (Hong Hua), Pangolin Scales (Chuan Shan Jia), Trichosanthes Root (Tian Hua Fen), Rhubarb (Da Huang), Licorice (Gan Cao)
Action: Invigorates blood, resolves stasis, promotes Qi flow, and reduces swelling.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|---|
| Severe pain | Add Ru Xiang, Mo Yao to relieve pain |
| Prolonged sitting aggravation | Add Yan Hu Suo, Wu Ling Zhi to invigorate blood |
| Weakness | Add Huang Qi, Dang Shen to supplement Qi |
Western Mechanism Reference
Traumatic coccydynia with local hematoma, ligament injury, and inflammatory response. Qi Stagnation with Blood Stasis corresponds to coccyx pain following trauma, where ligament damage and localized bleeding cause persistent pain and tenderness.
References
- Database + Textbook.
- WHO. (2023). Musculoskeletal pain. World Health Organization.
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