Hypochondriac Pain Worsened by Coughing and Breathing

How Chinese medicine differentiates hypochondriac pain that worsens with coughing and breathing into the five patterns you'll actually meet in practice, and the points for each. Distinct from this site's Costochondritis, Rib Pain and Intercostal Neuralgia pages. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Rib-side pain that worsens with breathing, especially with fever, breathlessness or a recent injury, needs medical assessment first (possible pleurisy, rib fracture or lung infection).

General Acupuncture Points

Acupuncture points traditionally used for hypochondriac (rib-side) pain that worsens with coughing and breathing — 3 key points, used across the patterns below rather than tied to just one.

Point	Key action
LIV-3	Subdues Liver-Yang. Extinguishes interior Wind. Promotes the smooth flow of Liver-Qi.
LIV-14	Promotes the smooth flow of Liver-Qi and harmonizes Liver and Stomach.
ST-36	Benefits Stomach and Spleen. Tonifies Qi and Blood. Tonifies the Original Qi.

The Five Patterns

↑ reinforcing ↓ reducing ⊥ even method.

1. Liver Qi Stagnation Turning into Heat View full pattern →

Clinical manifestations: Distending or burning rib pain worse with coughing; irritability and anger; bitter taste; dry, scanty cough.

Tongue: Red edges, thin yellow coat. Pulse: Wiry and rapid.

Treatment principle: Smooths Liver Qi and clears emerging Heat to relieve the distension and calm the irritable cough.

LIV-3 ↓ LIV-14 ↓ LIV-2 ↓

Note: no moxa.

2. Liver Fire Insulting the Lungs View full pattern →

Clinical manifestations: Sharp, fixed rib pain with a forceful, hacking cough; bitter taste and dry throat; red face and eyes; sticky phlegm that is hard to expectorate.

Tongue: Red with redder sides, dry yellow coat. Pulse: Wiry and rapid.

Treatment principle: Subdues ascending Liver Fire and restores Lung function to stop the violent cough.

LIV-3 ↓ LIV-2 ↓ REN-22 ⊥

Note: no moxa.

3. Phlegm-Heat in the Lungs View full pattern →

Clinical manifestations: Oppressive chest and rib pain worse with coughing; copious thick yellow or green sputum; body heat; thirst; restlessness.

Tongue: Red, possibly swollen front, yellow greasy coat. Pulse: Slippery and rapid.

Treatment principle: Clears Lung Heat and transforms sticky Phlegm to reduce airway obstruction and ease the mechanical rib strain.

ST-40 ↓ BL-13 ↓ REN-22 ⊥ LU-7 ↓

Note: no moxa.

4. Phlegm-Fluids in the Hypochondrium View full pattern →

Clinical manifestations: Sharp, pulling, one-sided rib pain; a sensation of fluid shifting with movement; shortness of breath, unable to lie flat; visible rib-side fullness.

Tongue: Pale, puffy, tooth-marked, white slippery coat. Pulse: Deep and wiry, possibly slippery.

Treatment principle: Expels retained fluids from the hypochondriac space and strengthens the Spleen to prevent recurrence.

LIV-14 ↓ G.B.-34 ↓ ST-40 ↓ ST-36 ↑

Note: moxa is appropriate. Linked to this site's own Phlegm-Fluids-obstructing-the-Lungs slide, the closest match.

5. Rebellious Lung Qi

Clinical manifestations: Sharp, stabbing rib pain triggered by forceful coughing; a sensation of Qi rushing upward; a hacking cough with thin white phlegm; shortness of breath.

Tongue: Normal or light red, thin white coat. Pulse: Wiry and forceful at the right front position.

Treatment principle: Redirects rebellious Lung Qi downward to its natural descending path, reducing the violent cough mechanics.

LU-7 ↓ BL-13 ⊥ REN-22 ⊥

Note: no moxa. This site's decks have no standalone Rebellious-Lung-Qi slide — no pattern link is given here.

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