Understanding Winter Pain: Insights from Traditional Chinese Medicine

Biologically, What's Happening?

The idea that cold weather exacerbates joint pain is supported by various physiological mechanisms. Cold temperatures may not directly cause arthritis or structural damage to joints, but they do influence pain perception in the body. One primary factor is the viscosity of synovial fluid, which thickens in colder conditions. This thickening impairs the smooth movement of joints and increases stiffness (Jin & Zhang, 2022; Zhao et al., 2014).

Muscular and connective tissues tend to contract as the body conserves heat. This contraction can place additional strain on joints, leading to discomfort (Jin & Zhang, 2022; Shi et al., 2021). Falls in barometric pressure, commonly experienced prior to storms, further complicate matters. Research indicates that this drop can cause tissues around joints to expand slightly, which may increase pressure on nerves and heighten pain sensations for individuals with pre-existing joint inflammation (Gao et al., 2012; Li et al., 2020).

It has been clinically observed that colder weather can heighten nerve sensitivity, making pain feel sharper, even when inflammation levels remain unchanged (Zhang & Yang, 2025; Zhao et al., 2014). Furthermore, a reduction in physical activity during winter months tends to lead to decreased circulation and weaker muscles. This sets the stage for intensified seasonal aches, too (Zhao et al., 2014; Xugang & Cheng, 2023). But don't worry; you can start that new morning fitness routine with the Lunar New Year!

What About Chinese Medicine?

Traditional Chinese Medicine (TCM) provides a distinctive perspective on the relationship between cold weather and musculoskeletal pain. According to TCM, external factors such as cold and dampness can penetrate the body, particularly when its internal defenses are compromised due to stress or fatigue (Zheng et al., 2023; Shang et al., 2020). Such environmental influences obstruct the normal flow of Qi (energy) and blood, manifesting as what TCM terms Bi Syndrome or “painful obstruction” (Zheng et al., 2023).

In clinical practice, different manifestations of pain related to cold exposure are recognized. Cold Bi results in pain that improves with warmth, while Damp Bi leads to heavy, aching joints that worsen in humid conditions (Shang et al., 2020; Chen & Yong-hua, 2023). Another presentation, Wind Bi, sometimes called "wandering bi," is characterized by migratory pain.

TCM emphasizes a holistic view, focusing on how environmental changes influence the body's internal state. Despite variances in terminology, both biomedical and TCM frameworks converge on the key insights that increased sensitivity, reduced circulation, and tightened tissues contribute to pain perception (Zhao et al., 2014; Shang et al., 2020).

How We Treat

Where TCM becomes especially helpful is in how it approaches treatment. Acupuncture, for instance, is frequently applied to improve circulation, relax tight muscles, and modulate pain signaling (Jin & Zhang, 2022; Zhang, 2023). It stimulates the release of endogenous opioids, influences inflammatory processes, and enhances localized blood flow. This provides meaningful relief for conditions like chronic low back pain and osteoarthritis, particularly when integrated within comprehensive treatment plans (Zheng et al., 2023; Zhang, 2023).

Moxibustion, or "moxa," is the gentle heating of acupuncture points using mugwort. This technique is often employed alongside acupuncture during colder months. It is especially valued in TCM as it dispels cold and improves circulation. Evidence from recent studies indicates that techniques such as warm acupuncture and moxibustion have been effective for managing osteoarthritis pain (Zheng et al., 2023; Luo et al., 2019).

Incorporating warming herbs like ginger and cinnamon into herbal medicine also complements these physical therapies (Jin & Zhang, 2022; Chen & Yong-hua, 2023). TCM presents a variety of therapeutic approaches that address these seasonal challenges. Acupuncture, for instance, is frequently applied to improve circulation, relax tight muscles, and modulate pain signaling (Jin & Zhang, 2022; Zhang, 2023).

Things You Can Do at Home

In addition to professional treatments, self-care strategies can significantly mitigate winter-related pain. Maintaining warmth, especially in joints susceptible to cold-induced discomfort (such as knees and lower back), is crucial (Zhang & Yang, 2025; Xugang & Cheng, 2023). Gentle movement through activities like tai chi, qigong, or mild stretching keeps joints lubricated and muscles engaged. These activities are essential for maintaining health and alleviating stiffness (Zhang & Yang, 2025; Chen & Yong-hua, 2023).

Consuming warm, nutritious foods and ensuring adequate hydration are important aspects of sustaining circulation and promoting tissue health during colder periods. The overarching message is clear: cold weather does not create pain but rather highlights pre-existing vulnerabilities. An integrative approach that combines modern physiological understanding with the principles of TCM can provide effective strategies for individuals suffering from seasonal joint and back pain (Zheng et al., 2023; Zhang et al., 2020).

Quick Tips for Winter Wellness

1. Stay Warm: Dress in layers and keep joints covered.

2. Stay Active: Engage in gentle exercises to maintain mobility.

3. Eat Well: Incorporate warming foods into your diet.

4. Hydrate: Drink plenty of fluids to support circulation.

5. Seek Help: Consider acupuncture or herbal remedies for relief.

   
   

"Okay, great, but I don't have time!"

No judgment! Swing by the herbal pharmacy. On top of moxa products, we have some great liniments and over-the-counter formulas that can help you get back up and running and feeling better while you're on the go!

References:

• Chen, C. and Yong-hua, Z. (2023). Comparative Study of the Clinical Efficacy of Manipulation and Acupuncture in the Treatment of Knee Osteoarthritis. Frontiers in Medical Science Research, 5(6). https://doi.org/10.25236/fmsr.2023.050608

• Gao, X., Chong, C., Zhang, S., Cheng, K., & Zhu, B. (2012). Temperature and Safety Profiles of Needle-Warming Techniques in Acupuncture and Moxibustion. Evidence-Based Complementary and Alternative Medicine, 2012, 1-6. https://doi.org/10.1155/2012/168393

• Jin, M. and Zhang, R. (2022). Research Progress of Acupuncture and Moxibustion on Knee Osteoarthritis. Frontiers in Medical Science Research, 4(8). https://doi.org/10.25236/fmsr.2022.040810

• Li, Y., Wu, F., Wei, J., Lao, L., & Shen, X. (2020). The Effects of Laser Moxibustion on Knee Osteoarthritis Pain in Rats. Photobiomodulation Photomedicine and Laser Surgery, 38(1), 43-50. https://doi.org/10.1089/photob.2019.4716

• Luo, L., Liao, M., Peng, J., Ma, Q., Zhou, J., Zhu, L., … & Yu, S. (2019). Comparison of the Efficacy between Conventional Moxibustion and Smoke-Free Moxibustion on Knee Osteoarthritis: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2019, 1-8. https://doi.org/10.1155/2019/1291947

• Shang, J., Fan, W., Dou, Z., Wu, L., Lu, B., & Qian, J. (2020). The efficacy and safety of warming acupuncture and moxibustion on rheumatoid arthritis. Medicine, 99(34), e21857. https://doi.org/10.1097/md.0000000000021857

• Shi, X., Yu, W., Wang, D., Zhao, Y., Deng, X., Chen, C., … & Shi, S. (2021). A comparison of the effects of Chinese non-pharmaceutical therapies for pain control in knee osteoarthritis. Medicine, 100(8), e24501. https://doi.org/10.1097/md.0000000000024501

• Xugang, J. and Cheng, Y. (2023). Research Progress of Non-Surgical Treatment of Osteoarthritis of the Knee in Chinese Medicine. Frontiers in Medical Science Research, 5(10). https://doi.org/10.25236/fmsr.2023.051009

• Zhang, F. and Yang, D. (2025). Progress in the research of thunder-fire moxibustion and warm acupuncture-moxibustion combined with western medicine in treating knee osteoarthritis. Pakistan Journal of Medical Sciences, 41(6), 1783-1787. https://doi.org/10.12669/pjms.41.6.10621

• Zhang, J. (2023). Warm Acupuncture in the Treatment of Osteoarthritis of the Knee Joint. Highlights in Science Engineering and Technology, 36, 854-858. https://doi.org/10.54097/hset.v36i.6111

• Zhao, Q., Fang, J., Chen, L., Wu, J., Ni, J., Liu, F., … & Sun, J. (2020). Different kinds of acupuncture treatments for knee osteoarthritis: a multicentre, randomized controlled trial. Trials, 21(1). https://doi.org/10.1186/s13063-019-4034-8

• Zheng, L., Cheng, K., Wang, L., Wu, F., Deng, H., Tan, M., … & Shen, X. (2014). Effectiveness of moxibustion treatment as adjunctive therapy in osteoarthritis of the knee: a randomized, double-blinded, placebo-controlled clinical trial. Arthritis Research & Therapy, 16(3). https://doi.org/10.1186/ar4590

• Zheng, S., Shen, Q., Lyu, Z., Tian, S., Huang, X., Liu, Y., … & Fang, J. (2023). Effect of acupuncture or moxibustion at Acupoints Weizhong (BL40) or Chize (LU5) on the change in lumbar temperature in healthy adults: A study protocol for a randomized controlled trial with a 2 × 2 factorial design. Plos One, 18(10), e0291536. https://doi.org/10.1371/journal.pone.0291536