⚡ Pain, Fatigue & Mitochondrial Crosstalk

Pain, Fatigue &the Mitochondria

A Traditional Chinese Medicine informed clinical perspective.

A TCM-Informed Clinical Perspective

Low-grade chronic inflammation in ageing patients quietly sensitises pain receptors and disrupts mitochondrial energy production. This results in a clinical constellation often seen in older adults:

• Persistent, nonspecific muscle or joint pain

• Reduced physical resilience and easy fatigability

• Non-restorative sleep and heightened sensory sensitivity

• “Idiopathic” fatigue that doesn’t respond to conventional therapies

Emerging biomedical evidence highlights a bidirectional relationship: inflammation impairs mitochondrial function → lower ATP output → more reactive oxygen species (ROS) → further inflammation → more mitochondrial damage. This vicious cycle underpins syndromes like fibromyalgia, chronic fatigue, and frailty. 💡

🧠 TCM Interpretation

From a Traditional Chinese Medicine (TCM) standpoint, this clinical picture is interpreted as a combination of:

• Qi deficiency (particularly of Spleen and Lung), leading to poor energy production and sluggish recovery

• Damp accumulation, causing heaviness, slowed metabolism, and impaired sleep

• Yin deficiency, with internal heat and restlessness disrupting repair

• Liver constraint, contributing to tension, irritability, and disrupted sleep-wake cycles

In TCM, these patterns guide treatment toward restoring systemic balance, supporting energy metabolism, clearing internal heat, and enhancing organ-level regulation—rather than focusing solely on symptom suppression.

🧩 Clinical Utility of TCM in Mitochondrial–Inflammatory Syndromes

• Holistic root-targeting: TCM’s systemic framework addresses mitochondrial impairment not as an isolated issue, but as one aspect of a broader dysfunction in qi, fluids, and organ coordination.

• Complementing standard care: By restoring energy regulation and reducing inflammatory burden, TCM interventions support recovery, improve quality of life, and help break the inflammation–mitochondrial damage cycle.

• Personalised approach: Variations in TCM patterns (e.g., “qi deficiency” vs “yin deficiency”) allow nuanced, individualised treatment—tailored to a patient’s deeper constitutional state.

✅ Supporting Evidence

1. Chinese herbal medicine for chronic fatigue
A large meta-analysis of 84 RCTs (n = 6,944) found that Chinese herbal medicine significantly reduced fatigue scores (WMD –1.77, 95% CI –1.96 to –1.57, p < 0.001) in chronic fatigue syndrome, alongside improvements in mood and inflammatory markers.
Reference: Zhao, J., et al. (2022). Frontiers in Pharmacology, doi:10.3389/fphar.2023.1266803

2. Acupuncture ameliorates mitochondrial stress
A controlled clinical study demonstrated that acupuncture reduced ROS-induced metabolic imbalance and improved biomarkers of cellular energy metabolism in patients with fatigue—suggesting acupuncture directly supports mitochondrial function impaired by inflammation.
Reference: Lu, C., et al. (2015). Evidence-Based Complementary and Alternative Medicine, PMC4579316

💡 Clinical Takeaways

• If your patient—particularly one aged 60 and older, or even in their 40s or 50s with chronic stress, hormonal changes, or low-grade inflammation—presents with multisite pain, unrelenting fatigue, and poor sleep, especially without clear biomedical pathology, consider the role of inflammation–mitochondrial dysfunction.

• Traditional Chinese Medicine offers system-level interventions that support energy metabolism, reduce inflammatory burden, and promote tissue repair—addressing root causes rather than isolated symptoms.

• These strategies can be safely integrated with standard care, helping to enhance resilience, reduce symptom burden, and support meaningful recovery—particularly in complex, idiopathic, or treatment-resistant cases