Muscle pain - Wokingham, Berkshire

1. Overview

Muscle pain (myalgia) is one of the most common forms of pain that people experience. It can occur in any muscle in the body — arms, neck, shoulders, back, legs or across multiple areas simultaneously — and ranges from mild achiness and stiffness to severe, disabling pain that significantly restricts movement and daily activities. People often mistake neck pain and shoulder pain for a trapped nerve when it is in fact muscular tension and myofascial restriction, frequently accompanied by a reduced range of motion that worsens without treatment.

Acupuncture provides long-term relief of muscle pain by stimulating the nervous system, releasing endogenous pain-relieving chemicals, reducing muscle tension and improving local circulation. Unlike pain medications, which only mask symptoms, acupuncture and Chinese herbal medicine address the underlying patterns of tension, stagnation and deficiency that drive persistent muscle pain. I have helped many people with tense muscles causing them discomfort and restricted movement.

2. Symptoms

Muscle pain presents in a variety of ways depending on the cause, location and severity:

Acute muscle soreness — immediate pain and tenderness during or shortly after exercise or physical effort; typically resolves within a few hours
Delayed onset muscle soreness (DOMS) — the familiar aching, stiffness and tenderness that develops 24 to 72 hours after unaccustomed or intense exercise, including heavy weight lifting and resistance training; most pronounced at 48 hours; caused by microscopic muscle fibre damage and the resulting inflammatory response
Myofascial pain and trigger points — localised areas of extreme muscle tenderness (trigger points) that refer pain to other areas when pressed; often described as a tight knot in the muscle; common in the neck, upper back, shoulders and gluteal muscles; can produce headaches, restricted movement and chronic tension
Muscle tension and stiffness — persistent tightness and reduced range of motion, particularly in the neck, shoulders and upper back; frequently related to stress, poor posture, prolonged sitting or repetitive strain
Muscle spasms and cramps — sudden, involuntary contractions producing acute, sharp pain; can occur in any muscle but are particularly common in the calves, back and neck
Widespread muscle pain — diffuse myalgia affecting multiple muscle groups simultaneously; can be a feature of fibromyalgia, viral illness, long COVID, chronic fatigue syndrome or systemic inflammation

3. Causes

Muscle pain has many possible causes, ranging from acute physical injury to chronic constitutional patterns. The most common include:

Weight lifting and resistance training — heavy resistance exercise, weight lifting and bodybuilding cause microscopic tears in muscle fibres that trigger an inflammatory response, producing DOMS in the 24 to 72 hours following a training session. Eccentric muscle contractions (where the muscle lengthens under load, as in the lowering phase of a bicep curl or squat) cause the most muscle fibre damage and the most pronounced DOMS. Insufficient recovery time between sessions, sudden increases in training load and poor lifting technique all worsen post-exercise muscle pain and increase injury risk
Sports injuries and overuse — acute muscle strains (tears), pulled muscles and overuse injuries from running, cycling, swimming, team sports and other activities; repetitive strain from occupational or sporting movements that chronically overload specific muscle groups
Stress and emotional tension — chronic psychological stress is one of the most significant causes of persistent muscle tension and pain; stress causes sustained sympathetic nervous system activation and elevated cortisol that maintains the muscles in a state of chronic contraction, particularly in the neck, shoulders and upper back. In TCM, emotional tension is absorbed into the muscles as Qi and Blood stagnation in the sinews
Poor posture and sedentary work — prolonged sitting, desk work, screen use and poor posture create chronic asymmetric loading of the muscles of the neck, upper back and lower back; the affected muscles develop myofascial trigger points, restricted blood flow and increasing tension that eventually causes pain and reduced range of motion
Cold and damp exposure — cold, damp weather conditions can trigger or worsen muscle pain and stiffness, particularly in people with underlying constitutional cold or deficiency patterns; in TCM, Cold and Damp are recognised pathogenic factors that invade the muscles and sinews and cause Bi syndrome (painful obstruction)
Fibromyalgia and myofascial pain syndrome — fibromyalgia produces widespread, chronic muscle pain, tenderness and stiffness, often with fatigue, sleep disturbance and cognitive changes; myofascial pain syndrome involves localised trigger points that cause referred pain patterns
Systemic illness and post-viral muscle pain — viral infections and post-viral conditions including long COVID frequently produce diffuse muscle aching (myalgia) as part of the systemic inflammatory response or its aftermath
Deficiency and chronic depletion — overwork, inadequate sleep, nutritional deficiency and chronic exhaustion deplete the body’s ability to nourish and repair the muscles; in TCM terms, Qi, Blood and Kidney Jing deficiency leads to under-nourished sinews and muscles that are more prone to pain, stiffness and slow recovery

4. Muscle pain in Chinese medicine

In traditional Chinese medicine (TCM), muscle pain falls within the broad category of “Bi syndrome” (painful obstruction) — a condition in which the flow of Qi and Blood through the channels, muscles and sinews becomes blocked, producing pain, stiffness and restricted movement. The specific pattern determines the treatment approach:

Qi and Blood stagnation in the sinews — the most common pattern in acute and subacute muscle pain, including post-exercise soreness and DOMS from weight lifting; characterised by fixed, aching or sharp pain that is worse on pressure and worse for rest, better for gentle movement; bruising or dark discolouration if trauma is involved; a purple or dark tongue. Treatment moves Qi and Blood in the affected channels, opens the collaterals and disperses stagnation using local and distal acupoints, cupping and herbal formulae such as Xue Fu Zhu Yu Tang (Drive Out Stasis from the Mansion of Blood) or Juan Bi Tang modifications
Cold-Damp Bi (painful obstruction) — muscle and joint pain that is markedly worse in cold, damp weather; pain has a heavy, fixed, cold quality; better for warmth and movement; worse for cold and rest; common in people who work outdoors, swimmers or athletes training in cold conditions. In TCM, Cold and Damp pathogens invade the muscles and sinews, constricting the channels and obstructing Qi and Blood flow. Treatment expels Cold and Damp, warms the channels and stops pain using moxibustion, warming acupoints and formulae such as Juan Bi Tang or Du Huo Ji Sheng Wan
Wind-Damp Bi (moving painful obstruction) — pain that moves from muscle to muscle or joint to joint, sometimes with an achy feeling in multiple locations; associated with generalised myalgia, weather-sensitive symptoms and the sensation of heaviness in the limbs. Treatment expels Wind and Damp from the channels and sinews
Qi and Blood deficiency with under-nourished sinews — muscles that are chronically achy, weak, prone to cramping, slow to recover from exercise and easily fatigued; worse for exertion and after illness; accompanied by pallor, fatigue, poor sleep and a pale tongue. The sinews and muscles are inadequately nourished by Qi and Blood, which cannot generate and repair muscle tissue effectively. Treatment tonifies Qi and Blood and nourishes the sinews with formulae such as Ba Zhen Tang (Eight Treasure Decoction) and Gui Zhi Fu Ling Wan modifications
Liver and Kidney deficiency with sinew and bone weakness — chronic, deep-seated muscle and joint pain in older patients or those who have been ill or overworked for a long time; weakness of the muscles and sinews alongside lower back aching, fatigue and knee weakness; the Liver governs the sinews and the Kidney governs the bones — when both are deficient, the musculoskeletal system lacks its fundamental support. Treatment nourishes Liver and Kidney with moxibustion and formulae such as Du Huo Ji Sheng Wan and You Gui Wan
Heat Bi (hot, red, swollen muscle or joint pain) — muscle or joint pain with heat, redness, swelling and acute inflammation; associated with acute sports injuries, acute muscle tears or inflammatory muscle conditions. Treatment clears Heat, resolves swelling and moves Blood in the affected area

5. Acupuncture for muscle pain

Acupuncture is highly effective for muscle pain, providing both immediate relief during each session and cumulative long-term benefit across a course of treatment. Its mechanisms of action for muscle pain include:

Stimulating specific acupoints with fine sterile needles instantly triggers the release of endogenous opioids (endorphins, enkephalins), serotonin and other neurotransmitters that activate the body’s natural pain-relief system — providing immediate pain reduction that accumulates with each successive session
Reducing muscle tension and spasm by activating the inhibitory interneurons of the spinal cord and modulating the motor neuron drive to the affected muscles; needling directly into trigger points or tense muscle bands releases the muscular contraction and allows the muscle to return to its resting length
Improving local blood flow to the muscle, removing accumulated metabolic waste products (including lactate and inflammatory mediators such as substance P, bradykinin and prostaglandins) and delivering oxygen and nutrients needed for tissue repair
Reducing local and systemic inflammation by modulating cytokine levels and the activity of inflammatory pathways — particularly relevant for post-exercise muscle damage from weight lifting and resistance training, where the inflammatory response drives DOMS
Reducing serum creatine kinase (CK) levels after strenuous exercise — CK is a marker of muscle fibre damage and elevated CK reflects the degree of exercise-induced muscle injury; acupuncture’s ability to reduce CK indicates it directly supports muscle recovery at the cellular level
Addressing the emotional and stress components of muscle tension through HPA axis regulation and the relaxation response, peeling away successive layers of tension with each treatment session and allowing the muscles to progressively release their accumulated holding patterns

Research evidence

A systematic review and meta-analysis published in the Journal of Strength and Conditioning Research (2022), including 6 RCTs from 7 international databases, found that acupuncture intervention after intense exercise significantly decreased muscle soreness rating (SMD: −0.49; 95% CI: −0.73 to −0.24; P < 0.001), reduced serum creatine kinase (SMD: −0.91; 95% CI: −1.27 to −0.56; P < 0.001) and improved maximal isometric force (SMD: 0.54; 95% CI: 0.16 to 0.93; P = 0.006), with the peak effect occurring at 72 hours post-exercise — confirming that acupuncture is particularly effective for delayed onset muscle soreness from weight lifting and strenuous exercise. A systematic review and meta-analysis by Xiong et al. (2024) published in Frontiers in Neurology, including 10 RCTs involving 852 patients and searching 7 databases to November 2023, found that acupuncture significantly reduced pain intensity (VAS), improved Pain Rating Index and Present Pain Intensity scores in myofascial pain syndrome compared to conventional treatments. A comprehensive evidence map published in Frontiers in Medicine (2025), analysing 111 systematic reviews of acupuncture for 35 musculoskeletal pain conditions across 6 databases to August 2024, confirmed positive short-term effects of acupuncture across most musculoskeletal pain comparators.

6. Cupping therapy for muscle pain

Cupping therapy is one of the most effective treatments available for muscle tension and myofascial pain, and is frequently used alongside acupuncture at this clinic for patients presenting with muscle pain. Cups applied to the back, shoulders, neck, legs or arms create a sustained negative pressure that lifts the fascial layers, decompresses the underlying muscle tissue, promotes local blood flow and breaks down the fascial adhesions that develop around chronic trigger points and areas of tension.

In TCM, cupping moves stagnant Qi and Blood in the sinews and channels, expels Cold and Damp from the muscles and opens the superficial pathways, making it particularly effective for Cold-Damp Bi syndrome and post-exercise muscle soreness. Athletes and active patients — including weight lifters — often find that cupping on the back, shoulders and legs in the 24 to 48 hours following heavy training sessions significantly reduces the severity and duration of DOMS. Heat therapy with an infrared TDP lamp applied to the affected muscles before or during acupuncture treatment further relaxes the muscle tissue, improves local circulation and enhances the overall therapeutic effect.

7. Chinese herbal medicine for muscle pain

Chinese herbal medicine provides daily therapeutic support between acupuncture sessions, accelerating recovery and addressing the underlying constitutional pattern that makes the individual susceptible to persistent or recurrent muscle pain. Key formulae used in clinical practice include:

Juan Bi Tang (Expel Painful Obstruction Decoction) — the primary formula for Wind-Cold-Damp Bi syndrome; effective for muscle and joint pain that is worse in cold and damp conditions; warms the channels, expels Wind-Cold-Damp and stops pain
Du Huo Ji Sheng Wan (Pubescent Angelica and Loranthus Pill) — for chronic muscle and joint pain with underlying Liver and Kidney deficiency; combines pain-relieving herbs with Qi, Blood and Kidney tonics; effective for long-standing muscle weakness and pain in older patients or those with constitutional deficiency
Xue Fu Zhu Yu Tang (Drive Out Stasis from the Mansion of Blood) — for Qi and Blood stagnation muscle pain with a fixed, stabbing quality; moves Blood, removes stasis and stops pain; useful for post-injury and post-exercise muscle pain with a stagnation component
Shu Jing Huo Xue Tang (Relax the Channels and Invigorate the Blood) — for muscle pain with pronounced Blood stasis and channel obstruction; particularly effective for post-sports injury muscle pain in the limbs and for DOMS following heavy weight training
Ba Zhen Tang (Eight Treasure Decoction) — for muscle pain arising from Qi and Blood deficiency; the muscles are under-nourished and slow to recover; applicable to chronic myalgia in people who are fatigued, anaemic or recovering from illness
Individual herbs — Yan Hu Suo (Corydalis), one of the most potent herbal analgesics in the TCM pharmacopoeia, directly moves Qi and Blood and stops pain and is incorporated into many muscle pain formulae; Du Huo (Pubescent Angelica) and Qin Jiao (Large Leaf Gentian) expel Wind-Damp from the muscles and sinews; Wei Ling Xian (Clematis root) is specific for muscle and joint stiffness and restricted movement

All herbs prescribed at this clinic are pharmaceutical-grade granule extracts supplied by Sun Ten (Taiwan). An online Chinese herbal medicine consultation is available for those who cannot attend in person.

8. Self-care and recovery

The following self-care measures support recovery from muscle pain and complement acupuncture and herbal treatment:

Adequate recovery between training sessions — weight lifters and athletes should allow sufficient rest between sessions targeting the same muscle groups (typically 48–72 hours for heavily worked muscles); progressive overload applied too rapidly without adequate recovery is one of the most common causes of persistent DOMS and chronic muscle pain; deload weeks and periodisation help to manage cumulative fatigue
Warm-up and cool-down — a proper warm-up before exercise increases muscle temperature, improves blood flow and reduces injury risk; a cool-down with gentle stretching helps to begin the recovery process and reduces the accumulation of metabolic waste products in the muscles
Heat and cold therapy — heat (warm bath, heat pad, heat therapy) relaxes muscle tension, increases local blood flow and is effective for chronic tension and Cold-Damp Bi syndrome; cold (ice pack) is more appropriate in the first 24–48 hours after an acute injury or immediately post-exercise to reduce acute inflammation; contrast therapy (alternating heat and cold) is used by many athletes to accelerate post-training recovery
Hydration and nutrition — adequate hydration is essential for muscle function and recovery; protein intake sufficient for muscle repair (generally 1.6–2.2g/kg body weight per day for active individuals) supports recovery from exercise-induced muscle damage; magnesium, vitamin D and omega-3 fatty acids all support muscle function and reduce inflammatory-driven muscle pain. Chinese food therapy recommendations for individual TCM patterns are provided as part of the consultation
Stress management — since chronic stress is a major driver of persistent muscle tension, addressing the stress component is an important part of long-term management; regular acupuncture, mindfulness, breathing exercises and adequate sleep all reduce the sympathetic nervous system activation that maintains chronic muscular holding patterns
Gentle movement and stretching — light movement and stretching of the affected muscles on rest days improves blood flow, reduces stiffness and supports recovery; vigorous exercise of the same muscle groups before DOMS has fully resolved risks compounding the muscle damage and delaying recovery

9. Treatment at my clinic

I treat muscle pain at my clinic in Wokingham, Berkshire, using a combination of acupuncture, cupping therapy, heat therapy and Chinese herbal medicine, individually tailored to the patient’s TCM pattern and the nature of their muscle pain. For acute post-exercise DOMS from weight lifting or sports training, a short intensive course of treatment (two to three sessions close together) produces rapid pain relief and accelerates recovery. For chronic muscle tension, myofascial pain syndrome or fibromyalgia, a sustained course of weekly treatment is recommended, with progressive improvement across successive sessions as layers of tension are released and the underlying constitutional pattern is addressed.

Visit the prices page for treatment costs. Related pages include back pain, sports injuries, neck pain, fibromyalgia and all pain conditions.

10. Frequently asked questions

Can acupuncture help with muscle pain from weight lifting?

Yes. Acupuncture is effective for delayed onset muscle soreness (DOMS) caused by weight lifting and strenuous resistance training. A systematic review and meta-analysis confirmed that acupuncture after intense exercise significantly reduces muscle soreness rating (by a standardised mean difference of −0.49), reduces serum creatine kinase (a marker of muscle fibre damage, reduced by an SMD of −0.91) and improves muscle strength recovery — with peak effectiveness at 72 hours post-exercise. It is an excellent addition to a weight training recovery protocol.

How does acupuncture relieve muscle tension?

Acupuncture releases muscle tension through several mechanisms: it triggers the release of endorphins and other natural painkillers; it directly releases trigger points and areas of chronic muscle contraction by needling into the tense tissue; it improves local blood flow and removes accumulated metabolic waste products; and it reduces the sympathetic nervous system activation that drives stress-related muscle tension. With each successive session, more layers of tension are released, allowing the muscle to progressively return to its natural resting length and full range of motion.

Is cupping therapy good for muscle pain?

Cupping therapy is excellent for muscle tension, myofascial pain and post-exercise DOMS. It creates a negative pressure that lifts the fascial layers, decompresses the underlying muscle, improves local circulation and breaks down fascial adhesions around trigger points. Many athletes, including weight lifters, use cupping as a key part of their post-training recovery protocol. It is particularly effective when combined with acupuncture during the same treatment session.

What is the TCM cause of muscle pain?

In traditional Chinese medicine, muscle pain is primarily understood as obstruction (Bi syndrome) — a blockage of Qi and Blood flow through the channels, sinews and muscles that deprives them of nourishment and produces pain and stiffness. The blockage can be caused by external pathogenic factors (Cold, Damp, Wind), trauma and Blood stasis (including post-exercise muscle damage), emotional tension causing Qi stagnation, or deficiency of Qi, Blood or Kidney essence that leaves the muscles under-nourished. Each pattern calls for a different acupuncture and herbal treatment approach, which is why individual assessment and TCM diagnosis is important.

How many sessions are needed for muscle pain?

For acute muscle pain from sports injuries or post-exercise DOMS from weight lifting, significant relief is typically achieved within two to four sessions. For chronic muscle tension, myofascial pain syndrome or fibromyalgia, a course of six to eight weekly sessions is usually recommended for meaningful sustained improvement, with maintenance sessions thereafter. Chinese herbal medicine taken daily between sessions significantly accelerates recovery and addresses the underlying constitutional patterns that make muscle pain recurrent.