Coccyx Pain · Wind-Cold-Damp Bi Pattern

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


Pattern Overview

Wind-Cold-Damp Bi is a common pattern in coccyx pain, characterized by cold-dampness type pain, heavy sensation, and aggravation in cold and damp weather. The core pathogenesis is invasion of Wind-Cold-Damp pathogens into the coccygeal region, causing obstruction of Qi and Blood flow and chronic pain.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsCold and heavy pain at the coccyx, worse in cold/damp weather
Associated SymptomsRelief with warmth, heavy sensation, limited sitting tolerance
Tongue and PulsePale red tongue with thin white coating, floating and tense pulse
PathogenesisWind-Cold-Damp pathogens obstructing the coccygeal collaterals
EtiologyExposure to cold and damp, prolonged sitting on cold 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
BL23 ShenshuLower back, 1.5 cun lateral to L2Tonifies Kidney Qi; disperses Cold-Damp
Ashi pointsTender spots around the coccyxLocal pain relief and meridian unblocking

Clinical Recommendation: Filiform needle, even method; moxibustion may be added to warm the meridians and disperse cold and damp.


Herbal Formula

Base Formula: Du Huo Ji Sheng Tang (独活寄生汤)

Composition:
Angelica pubescens (Du Huo), Loranthus (Sang Ji Sheng), Eucommia (Du Zhong), Achyranthes (Niu Xi), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Rehmannia (Shu Di), White Peony (Bai Shao), Ginseng (Ren Shen), Poria (Fu Ling), Licorice (Gan Cao), Saposhnikovia (Fang Feng), Gentiana (Qin Jiao), Asarum (Xi Xin), Cinnamon (Rou Gui)

Action: Disperses Wind-Cold-Damp, tonifies Liver and Kidney, strengthens tendons and bones.

Modifications

Associated SymptomsAdditions/Subtractions
Severe cold painAdd Fu Zi, Gui Zhi to warm meridians
Heavy sensationAdd Fang Ji, Yi Yi Ren to drain Dampness
Chronic painAdd Huang Qi, Dang Shen to supplement Qi

Western Mechanism Reference

Cold-dampness type pain with local vasoconstriction, increased muscle tension, and reduced tissue perfusion. Wind-Cold-Damp Bi corresponds to coccyx pain exacerbated by cold and damp environments, where reduced blood flow and increased muscle tension contribute to pain persistence.


References

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

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