Chronic Conditions

Chronic conditions are where Western medicine often struggles most — and where TCM often gains its most loyal patients. Conditions like irritable bowel syndrome, chronic migraine, fibromyalgia, and autoimmune disorders are characterised by complex, fluctuating symptoms without a single identifiable cause. Western medicine can name and manage them; TCM claims to see patterns beneath the surface that explain why they persist.

Why Chronic Conditions Are Different

Acute illness follows a relatively straightforward narrative: pathogen invades, body fights, treatment helps, patient recovers. Chronic illness breaks this narrative. Symptoms persist for months or years. Tests may be normal. Multiple organ systems are often involved. Stress, sleep, diet, and emotions all modulate symptoms. This complexity is exactly where TCM's holistic, pattern-based approach gains traction.

Condition-by-Condition Comparison

Irritable Bowel Syndrome (IBS)

Western approach: IBS is diagnosed by Rome IV criteria after excluding structural disease. Treatment includes dietary modification (low-FODMAP diet), antispasmodics, loperamide or laxatives depending on subtype, and sometimes low-dose antidepressants for visceral hypersensitivity. CBT and gut-directed hypnotherapy are effective non-pharmacological options.

TCM approach: IBS may map to several TCM patterns — Liver overacting on the Spleen (stress-triggered diarrhoea), Spleen Qi deficiency (chronic loose stools and fatigue), or Cold-Dampness in the intestines (cramping with mucus). Treatment uses acupuncture and tailored herbal formulas. A Cochrane review found Chinese herbal medicine showed some benefit for IBS symptoms, though study quality was mixed. The individualised approach may explain why some patients improve with TCM after failing standardised Western protocols.

Chronic Migraine

Western approach: Triptans abort acute attacks; preventive medications include beta-blockers, topiramate, amitriptyline, and CGRP monoclonal antibodies (erenumab, fremanezumab). Botox injections are approved for chronic migraine. These are effective but carry side effect burdens.

TCM approach: Migraines are differentiated by pattern: Liver Yang rising (throbbing, one-sided pain with irritability), Blood stasis (fixed, stabbing pain), Phlegm-Dampness (heavy head, nausea), or Qi and Blood deficiency (dull pain worse with fatigue). Acupuncture has strong evidence for migraine prevention — a Cochrane review concluded it is at least as effective as prophylactic drugs, with fewer side effects.

Fibromyalgia

Western approach: Fibromyalgia is characterised by widespread pain, fatigue, cognitive dysfunction, and sleep disturbance. Approved medications include pregabalin, duloxetine, and milnacipran. Exercise is strongly recommended. Central sensitisation is the leading explanatory model.

TCM approach: Fibromyalgia patterns typically involve Qi and Blood stagnation, Liver-Spleen disharmony, or Kidney deficiency. Treatment combines acupuncture, herbal formulas, and tuina. Several studies suggest acupuncture provides meaningful pain reduction and improved sleep quality in fibromyalgia patients, particularly when combined with exercise.

Autoimmune Disorders

Western approach: Conditions like rheumatoid arthritis, lupus, and Hashimoto's thyroiditis are managed with immunosuppressants, biologics, and disease-modifying agents. These are effective but carry risks of infection and other complications from immune suppression.

TCM approach: TCM frames autoimmunity through concepts like Heat-Toxin, Yin deficiency with deficiency heat, or Damp-Heat — patterns that describe the body attacking itself in TCM language. Treatment aims to cool excess heat, nourish Yin, and regulate immune function rather than broadly suppressing it. Research is early-stage but intriguing: certain Chinese herbs show immunomodulatory (not just immunosuppressive) properties.

Allergies

Western approach: Antihistamines, nasal corticosteroids, leukotriene inhibitors, and allergen immunotherapy (allergy shots or sublingual tablets). Effective at symptom control but often require long-term daily use.

TCM approach: Allergic rhinitis is commonly treated as Lung Qi deficiency with Wind invasion. The formula Yu Ping Feng San (Jade Windscreen Powder) — astragalus, atractylodes, and siler — is classically used to strengthen defensive Qi. Acupuncture at points like LI20 (Yingxiang, beside the nostril) has shown benefit in several trials. A large German RCT published in the Annals of Internal Medicine found acupuncture superior to sham for seasonal allergic rhinitis.