From the practitioner letters
When the pain will not stay put — two points, two patches, and fifty presses.
Will Sheppy, L.Ac. · Guest contributor · August 2026
Most of the people I see for wandering pain are women in their fifties and sixties. The pain usually starts on the side of the body — the hip, or a low back ache that sits out toward the flank, in the quadratus lumborum region. But it does not stay there. By the time they sit down across from me, the pain is everywhere and nowhere, and many of them are carrying a fibromyalgia diagnosis or a decade of pain history that never quite resolved into an explanation.
This week I got a letter from Dr. Xuelan Qiu — Dr. Lan, the pharmacist behind the Botanical Biohacking formulas on the Chorus shelf and in my clinic — about exactly this patient. She writes to practitioners most weeks. This one was about two acupuncture points, a pair of Chinese herbal pain patches, and a detail most people skip.
The short version
Pain that moves from joint to joint has a name in Chinese medicine: wind-bi. Because the pattern travels, the traditional approach treats it across the body rather than in one spot — here, a small herbal patch at GV 14 on the upper back and another at GB 31 on the outer thigh. Dr. Lan's point is that the patch at GB 31 should be pressed firmly about fifty times after it goes on. In my clinic, that pressing is also the best homework I can give a patient.
What Dr. Lan described
Dr. Xuelan Qiu — “Dr. Lan” — Botanical Biohacking
Her patient is a woman in her forties whose pain surfaces where she least expects it, quiets when she rests, then rises somewhere new. Nothing structural explains the picture. Imaging is clean. And the pain has started, in her words, to organize the patient's weeks — which is the part that patients feel most and that charts record least.
“Wandering pain — the shoulder yesterday, the knee today, the hip tomorrow. It is the signature of wind-bi. The pain moves because the pathogen is wind, and wind by nature does not settle.”
— Dr. Lan, Botanical Biohacking practitioner letter, August 2026
Wandering pain has an old name
Bi (痕) means painful obstruction — the classical category for joint and muscle pain. The tradition sorts it by how the pain behaves rather than by which tissue is involved, and wind-bi is the variety that migrates. Wind, in this system, is the quality of things that move, change, and arrive suddenly. A pain that keeps changing address is described as wind the same way a fever that comes and goes is described as alternating.
What the pattern looks like
- It moves. Shoulder one week, knee the next, hip after that — without an injury to explain the change.
- It is diffuse. Patients gesture at a whole region rather than pointing to a spot.
- Rest quiets it, but does not finish it. The pain settles and then reappears somewhere else.
- Heat alone underperforms. A heating pad helps the spot it is on and does nothing for where the pain goes next.
- Weather registers. In the Willamette Valley, the wet months make this pattern louder.
When it is not this pattern
Migrating joint pain is also how several medical conditions announce themselves. See a physician rather than reaching for a patch if any of these are present:
- Hot, swollen, red joints, especially one at a time.
- Fever, night sweats, or unexplained weight loss.
- Morning stiffness lasting more than an hour, which points toward inflammatory arthritis.
- A rash, a recent tick bite, or new neurological symptoms.
Why two points, top and bottom
The Ao Yi patch is small — sized to sit on a single acupuncture point rather than blanket a region the way a drugstore patch does. That size is the whole design: it is meant to be placed the way a needle is placed. For a pattern that travels, Dr. Lan pairs two points at opposite ends of the body.
GV 14 — Da Zhui, the great hammer
In the depression below the spinous process of C7, where the neck meets the upper back. Classically the meeting point of the six yang channels, and the point the texts reach for when the body is holding onto something it has not managed to clear.
GB 31 — Feng Shi, the wind market
On the mid-lateral thigh, at the fingertip of the arm hanging at the side. Its name means the place where wind gathers and is traded — the classical address for wind on the leg. It also sits on the gallbladder channel, which runs the lateral line of the body: the same side-of-the-body territory where my patients' pain usually starts.
“Top and bottom. Yang channel and gallbladder channel. The two patches work as a pair the way the pattern moves — across the body, not in one place.”
— Dr. Lan, Botanical Biohacking practitioner letter, August 2026
The fifty presses
Here is the part of the letter I would not have guessed. Once the GB 31 patch is on, Dr. Lan has the practitioner press it — firm rhythmic pressure with the pad of the thumb, straight down into the point through the patch, fifty times.
Why she insists on it
“This is what I want other practitioners to know: the pressing is not decoration. It is what allows the patch to achieve its full delivery.” Her closing line is the one I keep thinking about: a patch is not a bandage. It is a slow needle. And the pressing is what turns it on.
What I see in clinic
I have been using these patches with pain patients for a while, and the pressing is where Dr. Lan's letter and my experience meet — though I came at it from a different direction. For me the pressing is not primarily a delivery technique. It is homework.
Teaching a patient to press their own patches between appointments does two things at once. It gives longer and better results than a treatment that stops when they walk out my door, because the pattern does not get to reset over the week. And it changes something harder to measure: a person who has been in pain for ten years, who has been told their imaging is clean and their labs are normal, is usually convinced that pain is something that happens to them. Handing them a point, a patch, and fifty presses hands them back some control. They have a tool. That matters as much as the herbs do.
What I do differently than most is set expectations first. These patches are strong. They are warming, and they can create an itchy sensation — and if a patient is not told that in advance, they will assume something is wrong and take it off. It is not an allergic reaction; it is the patch working. I tell people what they are going to feel before they feel it.
On wear time: take a patch off after about four hours, then reapply over the next couple of days if you want to keep the momentum. I have not run into skin reactions in that window. Leave a single patch on well past it and you can absolutely get redness — that is where the trouble starts, not with the herbs themselves.
On the Chorus shelf
Ao Yi Acupoint Patches
Point-sized herbal patches from Miao minority medicine — ten to a bag.
Shop Ao Yi PatchesHow to use the pair
- Place one patch at GV 14, in the hollow just below the bony bump at the base of the neck.
- Place one at GB 31, mid-outer thigh, where your fingertip lands with your arm hanging straight down.
- Press the GB 31 patch fifty times — thumb pad, straight down, firm and rhythmic. Firm, not bruising.
- Remove after about four hours. Reapply over the following days to hold the ground you gained.
- Expect warmth and some itch. That is the patch working. Redness that persists after removal is not — stop and let the skin recover.
- Skip it on broken or irritated skin, and check with your practitioner first if you are pregnant, on blood thinners, or have a history of skin allergy to topical herbs.
If you are working with an acupuncturist, this is a good thing to bring up rather than run alone — wandering pain generally wants an internal layer as well as a topical one, and a moving pattern is exactly the kind of thing worth having eyes on.
Common questions
Why does my pain move around my body?
Pain that migrates without a new injury is common and has several possible explanations, from central sensitization to early inflammatory arthritis. Chinese medicine calls the pattern wind-bi and treats it across the body rather than at one site. If your pain moves and comes with fever, swelling, or weight loss, get it looked at medically first.
How are Chinese herbal pain patches different from a drugstore patch?
Size and intent. A drugstore patch covers a painful area with a single analgesic. An acupoint patch is small enough to sit on one point and is placed by channel logic — which is why where you put it matters more than how much area it covers.
How long do you leave an herbal patch on?
About four hours, then take it off. You can reapply over the next few days. Leaving one on much longer is where skin redness tends to show up.
Is the itching normal?
Warmth and mild itch under the patch are the usual sensations and are not a reason to stop. Spreading rash, hives, or redness that persists well after removal are — take it off and let the skin settle.
Do I really need to press it fifty times?
Fifty is Dr. Lan's number, not a measured dose — there is no trial on it. What research supports is that self-applied pressure at acupuncture points has measurable effects on chronic pain, and that too much pressure causes problems. Firm and rhythmic beats hard.
References
- Wang C, Tan W, Huang X, et al. Curative effect of Dingqi analgesic patch on cancer pain: a single-blind randomized controlled trial. J Tradit Chin Med. 2013;33(2):176–180. doi:10.1016/s0254-6272(13)60121-1
- Zhu S, Song Q, Liu C, Yang D. Acupoint application for postherpetic neuralgia and its effect on related inflammatory factors and 5-HT. Zhongguo Zhen Jiu. 2024;44(2):158–162. doi:10.13703/j.0255-2930.20230628-k0004
- Murphy SL, Harris RE, Keshavarzi NR, Zick SM. Self-administered acupressure for chronic low back pain: a randomized controlled pilot trial. Pain Med. 2019;20(12):2588–2597. doi:10.1093/pm/pnz138
- Azietaku JT, Ma H, Yu XA, et al. A review of the ethnopharmacology, phytochemistry and pharmacology of Notopterygium incisum. J Ethnopharmacol. 2017;202:241–255. doi:10.1016/j.jep.2017.03.022
Citations retrieved from PubMed.
Further reading from Valley Health Clinic
- Ao Yi Acupoint Pain Patches: Needle-Free Herbal Support — the three-stage design of the patch and how to place it.
- Stem & Leaf LumBear: Three Guide Herbs for the Low Back — when the pain does settle in the lumbar spine.
- Tibetan Herbal Foot Soak: For Heavy, Swollen Feet — the evening half of a pain routine.
Adapted with permission from a Botanical Biohacking practitioner letter by Dr. Xuelan Qiu (“Dr. Lan”). Will Sheppy, L.Ac., practices at Valley Health Clinic in Albany, Oregon.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is educational and does not replace care from your own practitioner.