Trapezius Pain · Wind-Cold-Damp Bi Pattern

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


Pattern Overview

Wind-Cold-Damp Bi is a common pattern in trapezius pain, characterized by muscle tension and spasm, cold pain, stiffness, and aggravation in cold weather. The core pathogenesis is invasion of Wind-Cold-Damp pathogens into the neck and shoulder meridians, causing obstruction of Qi and Blood flow, muscle spasm, and trigger point formation.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsCold pain and stiffness in the trapezius muscle, worse in cold weather
Associated SymptomsRelief with warmth, limited neck movement, heavy sensation
Tongue and PulsePale red tongue with thin white coating, floating and tense pulse
PathogenesisWind-Cold-Damp pathogens obstructing the neck and shoulder collaterals
EtiologyNeck and shoulder exposure to cold, air conditioning drafts, poor sleeping posture

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
BL13 Feishu1.5 cun lateral to T3, on the upper backBack-Shu point of Lung meridian; disperses Wind-Cold
Ashi pointsTender spots in the trapezius muscleLocal pain relief and meridian unblocking

Clinical Recommendation: Filiform needle, reducing method; moxibustion may be added to warm the meridians and disperse cold. Combine with heat application and gentle massage.


Herbal Formula

Base Formula: Juan Bi Tang (蠲痹汤)

Composition:
Notopterygium (Qiang Huo), Angelica pubescens (Du Huo), Cinnamon Twig (Gui Zhi), Gentiana (Qin Jiao), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Saposhnikovia (Fang Feng), Mulberry Twig (Sang Zhi), Licorice (Gan Cao)

Action: Disperses Wind-Cold-Damp, warms the meridians, and relieves pain.

Modifications

Associated SymptomsAdditions/Subtractions
Severe cold painAdd Fu Zi, Xi Xin to warm meridians
Pronounced stiffnessAdd Shen Jin Cao, Tou Gu Cao to relax sinews
Shoulder heavinessAdd Fang Ji, Yi Yi Ren to drain Dampness
Chronic painAdd Huang Qi, Dang Shen to supplement Qi

Western Mechanism Reference

Muscle tension and spasm with cold-induced vasoconstriction, local ischemia, and trigger point formation. Wind-Cold-Damp Bi corresponds to trapezius pain exacerbated by cold exposure, where reduced blood flow and increased muscle tension contribute to trigger point formation and pain.


References

  1. Database + Textbook.
  2. Vas, J., et al. (2016). Acupuncture for myofascial pain. British Journal of General Practice, 66(647), e455-e462.
  3. WHO. (2023). Musculoskeletal pain. World Health Organization.

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