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 DimensionManifestations
Primary SymptomsSharp, stabbing pain at the coccyx, fixed location, worse with sitting
Associated SymptomsTenderness on palpation, difficulty lying on the back, pain on rising
Tongue and PulsePurple-dark tongue with petechiae, thin white coating, hesitant pulse
PathogenesisTrauma causing Qi stagnation and Blood stasis in the coccygeal collaterals
EtiologyFall onto the buttocks, childbirth injury, prolonged sitting on hard surfaces

Acupuncture Point Prescription

PointLocationFunction
DU1 ChangqiangMidpoint between the tip of the coccyx and the anusLocal point; treats coccyx pain
BL32 CiliaoIn the second sacral foramenTreats lower back and sacral pain
DU4 MingmenOn the midline, between L2 and L3 spinous processesWarms Kidney Yang; treats chronic coccyx pain
Ashi pointsTender spots around the coccyxLocal 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 SymptomsAdditions/Subtractions
Severe painAdd Ru Xiang, Mo Yao to relieve pain
Prolonged sitting aggravationAdd Yan Hu Suo, Wu Ling Zhi to invigorate blood
WeaknessAdd 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

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

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