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Occipital Stiffness

How Chinese medicine differentiates stiffness at the back of the head and nape into the six patterns you'll actually meet in practice, and the points for each. Distinct from this site's Stiff Neck and Occipital Headache 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. Stiffness of the neck with fever, severe headache, a rash or sensitivity to light needs urgent medical assessment (possible meningitis).
General Acupuncture Points

Acupuncture points traditionally used for occipital (nape) stiffness — 3 key points, used across the patterns below rather than tied to just one.

PointKey action
G.B.-20Expels exterior Wind. Extinguishes interior Wind. Subdues Liver-Yang.
DU-14Clears Heat. Releases the Exterior and expels exterior Wind. Regulates Nutritive and Defensive Qi.
SI-3Regulates the Governing Vessel and extinguishes interior Wind. Expels exterior Wind. Benefits sinews.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Greater Yang Attack of Wind

Clinical manifestations: Mild stiffness and pain at the nape; mild sweating; aversion to wind and drafts; mild chills; low-grade fever; nasal congestion with clear discharge.
Tongue: Normal colour, thin white moist coat. Pulse: Floating and moderate.
Treatment principle: Releases the Exterior, expels Wind-Cold and harmonizes Defensive and Nutritive Qi.
Note: This site's decks have no Six-Stage patterns — no pattern link is given here.

2. Greater Yang Attack of Cold

Clinical manifestations: Sudden severe, board-like stiffness; no sweating despite fever; strong chills worse with cold; widespread body aches.
Tongue: Normal colour, thin white moist coat. Pulse: Floating and tight.
Treatment principle: Releases the Exterior with force, induces sweating, expels Cold and relaxes the sinews.
Note: moxa is appropriate. No Six-Stage slide exists — no pattern link is given here.

3. Painful Obstruction with Wind-Cold-Damp

Clinical manifestations: Aching, heavy neck and shoulder pain; worse in cold, damp weather; heaviness or numbness; limited range of motion that improves with movement.
Tongue: Pale, swollen, tooth-marked, white greasy coat. Pulse: Wiry and tight, or soggy.
Treatment principle: Dispels Wind, Cold and Dampness, tonifies Qi and invigorates the channels.
Note: moxa is appropriate. This site's decks have no Bi-syndrome slide, confirmed absent many times — no pattern link is given here.

4. Blood Stagnation View full pattern →

Clinical manifestations: Fixed, stabbing pain; stiffness worse at night; dark or purplish complexion, lips and nails; history of injury or repetitive strain.
Tongue: Purple or dusky, stasis spots, distended sublingual veins. Pulse: Choppy or wiry.
Treatment principle: Invigorates Blood, dispels stasis, moves Qi and relieves pain.
Note: no moxa. Linked to this site's own Liver-Blood-stasis slide per the discoloration-marker rule.

5. Phlegm in the Channels

Clinical manifestations: Heavy, numb sensation; a feeling of a lump or obstruction; puffy eyelids; chest tightness; excessive phlegm.
Tongue: Purple with stasis spots, white greasy coat, distended sublingual veins. Pulse: Wiry-choppy or wiry-slippery.
Treatment principle: Dispels Wind-Damp, drains Dampness, transforms Phlegm and unblocks the collaterals.
Note: Mixed Deficiency/Excess. This site's decks have no Phlegm-in-the-channels slide, confirmed absent many times — no pattern link is given here.

6. Kidney and Liver Yin Deficiency View full pattern →

Clinical manifestations: Dull persistent stiffness worse with fatigue; dizziness; tinnitus; dry eyes and blurred vision; night sweats; heat in the palms, soles and chest.
Tongue: Red, thin, cracked, dry, little or no coat. Pulse: Thin, rapid and wiry.
Treatment principle: Nourishes Liver and Kidney Yin, moistens the sinews and clears deficiency Heat.
Note: no moxa (Yin deficiency with heat signs).
Related conditions

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