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


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.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsSharp, stabbing pain in the trapezius muscle, fixed location, worse at night
Associated SymptomsTrigger points, limited neck movement, tenderness on palpation
Tongue and PulseDark red tongue with petechiae, thin white coating, wiry-hesitant pulse
PathogenesisQi stagnation and Blood stasis from chronic muscle tension
EtiologyProlonged poor posture, chronic stress, sedentary work

Acupuncture Point Prescription

PointLocationFunction
GB21 JianjingMidpoint of the shoulder, on the trapezius muscleRelaxes the shoulder and neck muscles, disperses Wind
BL11 Dashu1.5 cun lateral to T1, on the upper backUnblocks the Bladder meridian; treats neck and shoulder pain
LR3 TaichongDorsum of the foot, between the 1st and 2nd metatarsalsSoothes Liver Qi and regulates Qi flow
Ashi pointsTender trigger points in the trapezius muscleLocal 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.


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 tightnessAdd Yu Jin, He Huan Pi to soothe Liver and relieve depression
DizzinessAdd Bai Zhi, Man Jing Zi to disperse Wind and stop pain

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.


References

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

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