Breast pain (Treatment of Pain with Chinese Herbs and Acupuncture) Part 1

Breast pain is a disorder characterised by distension and pain in one or both breasts, or on the nipple, or even aggravation of breast pain by touching the clothing. In some cases, the breast pain may refer to the chest or axillary regions. It occurs in both men and women, but mostly women, especially those between the ages of 20 and 40 years. The pain varies in nature, and may be distending, stabbing, contracting, burning, slight, severe, or bearing-down. Distending pain is the most frequently encountered, and it is generally accompanied by disorders of menstruation such as dysmenorrhoea or irregular menstruation, or of lactation or the emotions.

Breast pain may be attributed to any of the following diseases in Western medicine: acute or chronic mastitis, perimastitis, hyperplasia of the mammary glands, galactoschesis, stagnation mastitis, and fibrosclerosis of breast and lobule of mammary gland.

Aetiology and pathology

Invasion of External factors

Bad lifestyle habits with lack of attention to wearing proper clothing, especially during the breast-feeding period, and lack of personal hygiene, may leave the individual vulnerable to the invasion of External Cold or Toxic Heat, leading to stagnation of Qi in the collateral and blockage in the breast, or retention of milk, causing breast pain.

Emotional disorders

There is a saying in TCM that the Liver is in charge of the nipples, because the Liver channel penetrates the diaphragm, covers the hypochondriac regions and chest, and contacts the nipples. Excessive anger, stress, frustration and unhappiness may impair the physiological function of Liver, slowing down the flow of Qi and causing stagnation of the Liver-Qi, and blockage of the collateral in the breast, and distending breast pain follows. Since the circulation of Qi brings about the circulation of Blood, the Qi stagnation results in Blood stagnation. Long-standing stagnation of the Liver-Qi may cause stagnation of the Blood in the breast, resulting in a severe stabbing breast pain. Prolonged persistence of Liver-Qi stagnation may also generate Liver-Fire, leading to burning and damage of the collateral in the breast, and a burning breast pain.

Excessive meditation and thinking, or invasion of the Spleen by Liver-Qi, may impair the Spleen’s physiological function of transportation and transformation, causing Damp-Phlegm to form. If this blocks the collateral in the breast then breast pain is triggered.

Bad diet

Eating of too much raw or cold food may cause impairment of the Yang in the Spleen and Stomach, leading to the formation of Cold and Damp in the body. Eating of too much fatty, sweet and some highly flavoured food may also impair the Spleen and Stomach and cause Damp-Heat or Excessive-Heat to form. The Stomach channel passes through the breast, so if Damp-Phlegm, Damp-Heat or Excessive-Heat accumulates in the Stomach and Spleen it may travel along the Stomach channel to the breast, blocking the collateral in the breast and causing breast pain.

Accumulation of milk in the breast

Excessive production of milk beyond the needs of the infant may cause a constant fullness in the breast and impede the Qi and milk circulation, so breast pain follows. Extreme emotional upsets and excessive thinking, or eating of too much sweet, fatty or highly flavoured food during the breast-feeding period, may cause the Qi to stagnate and Heat to form in the breast, so breast pain follows.

Senility and weakness of the body

Decline of the Kidney-Qi after middle age, constitutional weakness, excessive bleeding in menstruation or after labour, prolonged sickness, excessive strain, or lack of sufficient and nutritious food, can all cause deficiency of the Qi and Blood, or even of the Kidney-Essence. When the Penetrating and Directing Vessels are empty, the bieast is not nourished, and breast pain occurs.

Treatment based on differentiation


Differentiation of Excess and Deficiency

Breast pain, generally speaking, can be caused either by Excessive factors or Deficient factors. However, it is mostly caused by Excessive factors. Even if it is caused by Deficient factors, there is often a mixture of Excess and Deficiency. The key method to differentiate Excess and Deficiency is to see if the breast is hard or soft. If the breast pain is accompanied by a hard breast, it is usually caused by Excessive factors, whereas breast pain accompanied by a soft breast is usually caused by Deficient factors.

—    Generally speaking, Excessive causes include: invasion of External Cold, stagnation of Liver-Qi, accumulation of Damp-Phlegm, stagnation of Blood, accumulation of milk, hyperactivity of Toxic Fire, etc.

—    Deficient causes include deficiency of Qi and Blood, and deficiency of Yin of Liver and Kidney.

Differentiation of character of the pain

—    Acute onset of breast pain with a contracting feeling, aggravation of the pain by exposure to cold, or aversion to cold, is usually caused by invasion of cold.

—    Acute sharp breast pain, or chronic pain with acute aggravation after emotional upset, or breast pain with a moving nature, with distension of the breast, depression, headache or dysmenorrhoea, is usually caused by stagnation of Liver-Qi.

—    Chronic breast pain with a stabbing nature and fixed location, aggravation of the breast pain at night, a purplish colour of the tongue and menstrual flow, is usually caused by stagnation of Blood.

—    Breast pain with formation of nodules, soft in nature, heaviness of the body, nausea, loose stool, a poor appetite and a greasy tongue coating, is usually caused by accumulation of Damp-Phlegm.

—    Acute onset of breast pain with a burning feeling, redness and swelling of the breast, thirst, fever, constipation, formation of carbuncles or furuncles with pus on the breast, or a red tongue, is usually caused by hyperactivity of Toxic Fire.

—    Chronic and slight breast pain with intermittent aggravation, or aggravation of the breast pain by exertion and during the day, with tiredness, or an aversion to cold, is usually caused by deficiency of Qi and Blood.

—    Chronic and slight breast pain with intermittent aggravation, or aggravation of the breast pain during the menstruation period, with poor vision and memory, hair loss, lower back pain, or weakness of knees, is usually caused by deficiency of the Liver and Kidney.



Symptoms and signs

Acute occurrence of breast pain, aggravation of pain on exposure to cold, a feeling of contraction in the breast, an aversion to cold, a runny nose with a white discharge, headache, generalised body pain, a thin and white tongue coating and a superficial and wiry pulse.

Principle of treatment

Dispel Cold, warm the channel and sedate the pain.




Cinnamon Twig Decoction and Correct Qi Heaven Fragrant Powder

Gui Zhi Ramtdus Cinnamomi 12 g

Bai Shao Radix Paeoniae Alba 6 g

Sheng Jiang Rhizoma Zingiberis Recens 6 g

Wu Yao Radix Linderae 10 g

Chen Pi Pericarpium Citri Reticulatae 10 g

Zi Su Ye Folium Perillae 6 g

Xiang Fu Rhizoma Cyperi 10 g


•    Gui Zhi and Bai Shao used concurrently can dispel Wind and Cold so as to relieve External symptoms.

•    Sheng Jiang and Zi Su Ye, pungent and Warm herbs, help Gui Zhi to dispel External Wind and Cold. They also warm the channels and relieve the breast pain.

•    Wu Yao, a pungent and Hot herb entering the Liver channel, expels Cold and promotes Qi movement in the breast so as to relieve the breast pain.

•    Chen Pi and Xiang Fu promote circulation of the Liver-Qi so as to relieve breast pain.


1.    If there is severe breast pain, add Yan Hu Suo Rhizoma Corydalis 10 g to invigorate the Qi and Blood circulation and stop the pain.

2.    If there is severe cramp in the breast, increase the dosage of Bai Shao Radix Paeoniae Alba to 15 g and add Zhi Gan Cao Radix Glycyrrhizae Praeparata 6 g to moderate the speed of Qi circulation and harmonise the collateral so as to stop the pain.

3.    If there is a severe aversion to cold, add Zhi Fu Zi Radix Aconiti Praeparata 9 g to expel Cold and warm the channels.

4.    If there is lower abdominal pain, add Xiao Hui Xiang Fructus Foenieuli 6 g and Rou Gui Cortex Cinnamomi 6 g to warm the Lower Burner and Kidney and disperse Cold.

Patent remedy

Jing Fang Bai Du Pian Schizonepeta and Ledebourieila Tablet to Overcome Pathogenic Influences


LI-4 Hegu, TE-5 Waiguan, BL-12 Fengmen, LU-7 Lieque, PC-6 Neiguan and CV-17 Tanzhong. Reducing method is used on these points. Moxibustion is employed on the first four points.


•    Invasion of external Cold causing breast pain usually has an acute onset. LI-4, TE-5 and LU-7 are used here to promote sweating in order to dispel the External Cold.

•    BL-12 dispels Wind and relieves External symptoms.

•    CV-17 and PC-6 regulate the Qi circulation in the chest and breast, and harmonise the collateral and channels in order to eliminate blockage in the breast.

•    Moxibustion dispels Cold and warms the channels. Modifications

1.    If there is severe breast pain, add PC-4, the Accumulation point, and ST-40, the Connecting point, to harmonise the collateral and sedate the pain.

2.    If there is generalised body pain, add BL-63, the Accumulation point, and BL-64, the Source point, to eliminate pathogenic factors at the Greater Yang level of the body.

3.    If there is distension of the breast, add LR-14, the Front Collecting point of the Liver, to promote the Qi circulation and relieve the distension.

4.    If there is nausea and vomiting, add CV-12, the Front Collecting point of the Stomach, to harmonise the Stomach and cause the Stomach-Qi to descend.


Symptoms and signs

Distension and pain in the breast, with aggravation before menstruation and alleviation after menstruation, pain related to the emotional situation and formation of soft nodules in the breast, accompanied by irritability, hypochondriac pain and distension,depression, a feeling of oppression across the chest, insomnia, a normal-coloured tongue with a white coating, and a wiry and tight pulse.

Principle of treatment

Smooth the Liver and circulate the Qi, relieve stagnation and sedate the pain.




Free and Relaxed Powder

Chai Hu Radix Bupleuri 10 g

Bai Shao Radix Paeoniae Alba 12 g

Dang Gui Radix Angelicae Sinensis IOg

Chuan Xiong Rhizoma Ligustici Chuanxiong 6 g

Dai Dai Hua Flos Citri Aurantii 6 g

Zhi Qiao Fructus Aurantii 10 g

Xiang Fu Rhizoma Cyperi 10 g

Zhi Gan Cao Radix Glycyrrhizae Praeparata 5 g


•    Emotional disturbance and stress may cause stagnation of the Liver-Qi and disturbance of the Qi movement in the breast, leading to breast pain. A normal tongue coating and colour show there is no obvious stagnation of Blood or weakness of the internal organs. The pulse shows stagnation of Qi, especially the Liver-Qi.

•    Chai Hu and Bai Shao smooth the Liver, promote its physiological function and relieve breast pain.

•    Dan Gui, in combination with Bai Shao, regulates and tonifies the Blood in the Liver and also moderates the Qi-circulating herbs.

•    Xiang Fu and Zhi Qiao can strengthen the function of the Qi-circulating herbs.

•    Since Qi is the guide of Blood, stagnation of Qi leads to stagnation of Blood, the difference being only in degree. That is why this prescription contains both Qi-moving herbs and Blood-moving herbs.

•    Chuan Xiong and Dai Dai Hua can promote the Qi and Blood circulation, especially the Blood circulation.

•    Zhi Gan Cao and Bai Shao harmonise the Liver and relieve breast pain.


I.  If there is severe breast pain, or severe distension of the breast, add Chuan Lian Zi Fructus Meliae Toosendan 10 g and Qing Pi Pericarpium Citri Retieulatae Viride 10 g to break up Qi stagnation in the Liver and stop the pain.

2.    If there is an occasional stabbing pain in the breast, add Yan Hu Suo Rhizoma Corydalis 10 g to promote the Blood circulation and relieve the pain.

3.    If there are nodules in the breast, add Yu Jin Radix Curcumae 10 g and Gua Lou Fructus Trichosanthis 10 g to promote the Qi circulation, soften the hard lumps and relieve the pain.

4.    If there are red spots on the breast or nipples, add Mu Dan Pi Cortex Moutan Radici 10 g to clear Heat in the Blood, remove Toxin and eliminate the red spots.

5.    If there is irritability and headache, add Xia Ku Cao Spica Prunella 10 g and Huang Qin Radix Scutellariae 12 g to clear Heat in the Liver, calm the Mind and relieve the headache.

6.    If there is a bitter taste in the mouth, add Zhi Zi Fructus Gardeniae 9 g to clear Heat in the Liver and Gall Bladder and remove the bitter taste.

7.    If there is pain radiating to the arm, add Tan Xiang Lignum Santoli 3 g and Dan Shen Radix Salviae 10 g to promote the Blood circulation in the Heart and relieve the pain.

8.    If there is insomnia and restlessness, add Duan Long Gu Os Draconis 15 g and Huang Lian Rhizoma Coptidis 5 g to clear Heat in the Heart, calm the Mind and improve the sleep.

9.    If there is nausea and a poor appetite, add Sha Ren Radix Aenophorae 5 g to harmonise the Stomach and improve the appetite.

10.    If there is irregular menstruation or dysmenorrhoea, add Shu Di Radix Rehmanniae Praeparata 10 g and Yi Mu Cao Herba Leonuri 10 g to regulate the menstruation and relieve the dysmenorrhoea.

11.    If there is constipation, add Da Huang Radix en Rhizoma Rhei 10 g to promote defecation and relieve the constipation.

Patent remedies

Shu Gan Wan Soothe Liver Pill

Xiao Yao Wan Free and Relaxed Pill

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