Inflammaging: Chronic Inflammation, Tissue Breakdown, and the TCM Perspective

Inflammaging is more than a theory—it's increasingly recognised as a driver of degenerative and inflammatory changes in older patients (50 +). Here’s how Traditional Chinese Medicine interprets and addresses these changes using targeted, clinically applicable strategies.

Connective Tissue and Hydration Loss

Collagen turnover decreases with age, and chronic inflammation degrades extracellular matrix components, accelerating:

• Loss of joint lubrication (via reduced synovial fluid quality)

• Skin and mucosal dryness

• Decreased viscoelasticity of tendons and fascia

The progressive dehydration of connective tissue contributes to mechanical stiffness, fascial adhesions, and a heightened perception of bodily discomfort.

This decline in connective tissue quality doesn’t just affect joints—it underlies a broad range of age-related symptoms. Below are three common examples, among many, where chronic inflammation and tissue degeneration manifest in clinical practice:

Spinal Degeneration & Pain

Age-related inflammation accelerates intervertebral disc degeneration and facet joint arthropathy, leading to reduced hydration in discs and increased structural stress. This creates chronic back or neck pain, stiffness, and nerve sensitivity. In TCM, this pattern is seen as Bi syndrome affecting the spine—linked to qi and blood stagnationcombined with kidney deficiency.

• TCM Strategy: Herbal formulas like Du Huo Ji Sheng Tang and Shu Jing Huo Xue Tang are used to nourish kidney energy, move stagnation, and promote structural resilience.

• Clinically, these herbs may support anti-inflammatory effects, improve microcirculation, and reduce pain—offering non-opioid adjuncts for spinal degenerative conditions.

Itchy Dermatitis of Ageing

As skin thins with age, it becomes prone to irritant reactions, dryness, and low-level inflammation—presenting as persistent, itchy dermatitis. This may resemble eczema or xerosis, exacerbated by compromised barrier function and chronic inflammo-immune activity.

• Evidence: Multiple RCTs and meta‑analyses indicate that internally and externally applied TCM herbs are effective in reducing itching and dermatitis severityannallergy.org+5jintegrativederm.org+5frontiersin.org+5verywellhealth.comfrontiersin.org+1jintegrativederm.org+1.

• Formulas such as Xiao Feng San or Qing Re Chushi ointment have shown benefits in immune modulation, cytokine balancing, and improving skin barrier integrity.

Chronic Wounds and Sluggish Healing

Ageing skin and vascular compromise increase the risk of chronic wounds—such as venous leg ulcers and diabetic foot ulcers. Inflammaging disrupts normal wound phases: excess inflammation prolongs tissue breakdown and prevents proper healing.

• A comprehensive pharmacological review identified 24 botanical TCM drugs—including Centellae Herba, Aloe vera, and multi-herbal formulations—that show anti-inflammatory, antibacterial, and pro-angiogenicactivity in both preclinical and clinical wound modelsverywellhealth.compmc.ncbi.nlm.nih.gov+1frontiersin.org+1.

• These herbs support accelerated fibroblast proliferation, angiogenesis, and collagen synthesis, making them excellent adjuncts in wound management protocols.

Clinical Relevance for Healthcare Professionals:

By integrating TCM herbs into care plans for eample; spine degeneration, chronic itch, or non-healing wounds, we harness multifaceted anti-inflammatory, circulatory, and regenerative actions that align biologically with known ageing mechanisms. These are well-supported by both pharmacological and clinical data—offering credible, synergistic options in integrative medicine practice.