Herbal Pharmacy Essentials: Bone, Joint & Muscle Health

If you run a TCM clinic, pain is probably one of your most frequent patient complaints. 

Among the different types of pain, those involving bone, joint and muscle conditions can account for a significant proportion. Some of the more common issues include:

  • Arthritis
  • RSI (repetitive stress injury) – tennis elbow, runner’s knee, golfer’s elbow
  • Low back pain – chronic, menstrual, or strain
  • Neck strains and whiplash
  • Chronic pain in the knee, shoulder, hips

Through your differential diagnosis, you’ll determine whether temperature plays a role in the injury, what lifestyle habits may be exacerbating the condition, and therapies needed to aid in repair and recovery.

Bone, Joint & Muscle Health Essentials: Four Formulas + Four Single Herbs

Below we highlight four classic formulas that address a wide variety of bone, joint and muscle conditions PLUS four single herbs that can be prescribed individually or added to a formula to enhance its effect. 

Short on time? Download our Bone, Joint & Muscle Health Essentials Quick Reference Guide PDF!

Bone, Joint & Health Health PDF


1. Warm the Channels & Nourish Blood to Relieve Pain

Dang Gui Si Ni Tang is prescribed for pain due to blood deficiency and cold conditions. This formula:

  • Warms the Channels
  • Disperses Cold
  • Nourishes the Blood
  • Removes the Blood Stasis

The ideal patient for Dang Gui Si Ni Tang presents with Cold in the channels due to Blood Deficiency and/or Jue Yin Cold. They may complain of pain in the waist, thighs, legs, feet, shoulders and/or arms.

Clinics will often see patients with this TCM pattern who complain of cold hands and feet (with or without pain) - for which Dang Gui Si Ni Tang is also suitable. Through its warming and gently moving actions, this formula also dispels blood stasis to relieve pain.

2. Dispel Wind Damp Cold Bi – 2 formulas

Du Huo Ji Sheng Tang (Angelica & Mistletoe Combination) is a powerful formula containing 14 herbs that work together to: 

  • Disperse Wind-Dampness
  • Scatter Cold
  • Stop Qi Pain 
  • Tonify the Kidneys and Liver
  • Tonify Qi and Nourish the Blood

Commonly used for chronic pain in the waist and knees area, Du Huo Ji Sheng Tang is also used in cases of inflexible or numb limbs and joints.

Patients will typically present one or more of the following patterns: 

  • Bi Syndrome with Kidney and Liver Deficiency
  • Bi Syndrome with Qi and Blood Deficiency 
  • Invasion of the muscles and bones by Wind-Cold-Damp
  • Atrophy disorder

Juan Bi Tang (Remitting Bi Decoction) differs from Du Huo Ju Sheng Tang in its focused action on removing stagnation and joint-pain obstruction without the nourishing actions of Du Huo Ji Sheng Tang. Juan Bi Tang:

  • Removes Wind-Dampness
  • Disperses Cold
  • Eliminates Joint Pain Obstructions
  • Circulates Qi and Blood 
  • Relieves Pain 

Juan Bi Tang is used for body joint pain, tight neck and back, cold hands and feet, inflexible waist and knee, and restricted body movement.

Patients will typically present one or more of the following patterns: 

  • Wind-Cold-Damp Bi
  • Muscular Atrophy due to Qi and Blood Stagnation
  • Joint Pain Obstruction due to Qi and Blood Stagnation

3. Heal Sports Injuries and Acute Painful Conditions

Shen Tong Zhu Yu Tang delivers pain relief while assisting in the muscle repair process. 

Ideal for athletes suffering from repetitive stress injury or acute injuries involving joints and soft-tissue (such as shin splints, runner’s knee, IT band syndrome), Shen Tong Zhu Yu Tang:

  • Invigorates the Circulation of Qi and Blood
  • Removes Blood Stagnation in the Channels and Collaterals
  • Unblocks Painful Obstructions
  • Expels Wind and Dampness

Shen Tong Zhu Yu Tang is especially effective for joint pain with blood stasis and obstruction of the meridians along the shoulder, arm, waist and leg, and thus is suitable for whole-body pain conditions.

Single Herbs

The following four herbs can be used alone or added to a formula to enhance its efficacy.

1. Hu Zhang – Bushy Knotweed Rhizome

Hu Zhang clears heat, resolves toxins, alleviates wind, disperses stasis and alleviates pain. It is used for joint pain and soft tissue injuries.

2. Gu Sui Bu – Drynaria Rhizome
Gu Sui Bu supplements the kidneys, strengthens the bones and increases bone density. It has the effects of healing injuries and relieving pain. Gu Sui Bu has a long history of use for bone loss. 

3. Xue Jie – Dragon's Blood Sap

Xue Jie invigorates the blood, promotes blood circulation, disperses stasis, and relieves bleeding and pain. It is a famous herb for alleviating bleeding, and healing martial arts and soft issue injuries. It is also helpful in regenerating muscles, bruises and fractures and healing sores.

4. San Qi – Notoginseng Root

San Qi alleviates bleeding, disperses blood, and reduces bone joint and soft tissue pain. It has such renowned blood benefits it was granted the title of “Blood Fair,” from its ancient use. San Qi has a unique benefit in that it relieves bleeding without causing stagnation, which is more suitable for people with bleeding and stasis. At the same time, San Qi promotes blood circulation to beautify the skin and enhance its natural glow.

That concludes our Bone, Joint & Muscle Essentials collection! 

These TCM formulas combine well with other therapies, including cupping, acupuncture, gua sha and tui na to gently aid the intricate network of sinews and connective tissue and assist in repair and recovery.

In a previous article in this series, we recommended some easy ways to build a granule herbal pharmacy – especially if you are just starting out. One such tip was to start with the most common formulas. All the formulas and single herbs featured in this Bone, Joint & Muscle collection are excellent inclusions for new pharmacies!

As with all articles in the Pharmacy Essentials series, Dr. Wang's use of the formulas are provided for educational purposes only. Stay tuned for our next article in the Pharmacy Essentials series!