In our consultation room in Luen Wo Hui, Fanling, we often hear local residents say: "I sleep a full eight hours every night but I'm still exhausted when I get up. My whole body aches and my arms and legs feel heavy. I had blood tests and X-rays and the reports say nothing's wrong. What's going on with my body?" Long-term tiredness and aching all over are very common in Hong Kong. They may be linked to routine, stress, diet and sleep quality, or be an early sign of a health problem.
This article explains the common causes of long-term fatigue, which situations a doctor should rule out first, how Chinese medicine understands "deficiency pain", everyday adjustments you can make, and when to see a doctor promptly. It is health education and cannot replace an in-person consultation with a registered clinician. We do not promise you will "have more energy after a few sessions".
What Is Chronic Fatigue?
"Chronic fatigue" is an everyday term, usually meaning tiredness that lasts a long time (for example, several months) and does not clearly improve with rest. It often comes with aching muscles, headaches, waking unrefreshed and poor concentration. Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) has specific diagnostic criteria and is considered only after a doctor has ruled out other causes; not all long-term tiredness is this condition.
There can be many reasons behind tiredness, such as iron-deficiency anaemia, thyroid problems, diabetes, sleep apnoea, depression or anxiety, medication side effects, or not having fully recovered from an infection. So the first step is not rushing to take tonics, but finding out whether there is a health problem that needs treatment.
Common Symptoms
Everyone is different, but these are common complaints linked to long-term fatigue:
- Waking unrefreshed: you sleep enough but are still very tired when you get up, and feel sleepy during the day.
- Aching and dull pain all over: the neck, shoulders, back, arms and legs ache, the location changes, and it is worse when you are tired.
- Heavy limbs and no energy: you want to sit down after a short walk or a little housework.
- Poor concentration and memory: easily distracted, "brain fog"; some people also have headaches or a poor appetite.
- "Crashing" after activity: after doing more one day, you feel especially drained for the next day or two and take longer to recover.
Note: a "normal check-up" does not mean nothing is wrong
A routine health check may not include every test. If tiredness persists or gets worse, describe your symptoms fully to a doctor, who can decide whether more blood tests (such as haemoglobin, iron, thyroid and blood sugar) or a sleep assessment are needed.
*Note: the above is not a self-diagnosis tool.
How Chinese Medicine Sees It: "Excess Pain" and "Deficiency Pain"
Chinese medicine broadly divides pain into two types. This is for understanding only and should not be applied to yourself:
- Excess pain ("blockage causes pain"): usually linked to sprains or stagnation of qi and blood; the pain is in a fixed spot and pressing makes it worse.
- Deficiency pain ("lack of nourishment causes pain"): usually linked to qi and blood deficiency or a weak spleen and stomach; it shows as dull aching, weakness and pain that moves around, feels better with gentle massage and is worse when you are tired.
Chinese medicine regards "the spleen and stomach as the source of qi and blood". Irregular meals, frequent cold drinks, staying up late and long-term stress may weaken digestion, leading to "spleen deficiency with damp": tiredness, heavy limbs, poor appetite and loose stools. Whether it is actually qi deficiency, blood deficiency, damp or liver qi stagnation can only be judged by a registered Chinese medicine practitioner after a full traditional examination.
Two Common Myths
Myth 1: "Feeling tired? Take ginseng and drink chicken soup to build yourself up?"
Not necessarily. Chinese medicine has a saying that a "deficient body cannot take tonics": if your digestion is already weak, or your constitution tends towards heat or damp, taking lots of tonics on your own may cause a dry mouth, spots or bloating. Before taking tonics, have your pattern assessed by a registered Chinese medicine practitioner, especially if you take Western medicine, are pregnant or have a long-term condition.
Myth 2: "Aching all over? A hard massage will loosen it up?"
For people with "deficiency pain", the body is already very tired; overly hard massage may not help, and some people feel even more tired afterwards. Technique and pressure should be adjusted to your constitution and the assessment.
When to Be Extra Careful
Most tiredness is not an emergency. But if you notice any of the following warning signs, see a doctor promptly rather than relying on rest or Chinese medicine care alone:
- Unexplained weight loss, persistent fever or heavy night sweats.
- Breathlessness, chest pain or a racing heart, or getting out of breath after a short walk.
- Black stools, unusual bleeding or a clearly pale complexion.
- Persistently swollen lymph nodes in the neck, armpit or groin.
- A persistently low mood, loss of interest in everything, or thoughts of harming yourself (please tell family or a doctor immediately; in an emergency, call 999).
Take extra care: don't use Chinese medicine care instead of tests
Long-term tiredness can be a sign of anaemia, thyroid problems, diabetes or other illnesses. Chinese medicine care can support treatment but should not delay necessary medical tests. People already diagnosed with a long-term condition should not stop or change their medication on their own.
How It Is Usually Managed / What Clinics Commonly Do
At Ever-Health (Luen Wo Hui, Fanling), we first look at your routine, work stress, diet, sleep and past check-up results. If you have not had basic tests, or have any of the warning signs above, we will advise you to see a doctor first. Below is the step-by-step approach commonly used at the clinic (results vary from person to person and are not guaranteed):
1. Rule out medical causes first, then discuss care
Finding out whether there is a cause that needs medical follow-up is the most important first step. Once that is ruled out, we discuss care based on your constitution and lifestyle.
2. Chinese medicine pattern differentiation and acupuncture (depending on the individual)
A registered Chinese medicine practitioner takes your pulse, looks at your tongue and asks about your health to judge whether the pattern is qi deficiency, blood deficiency, spleen deficiency with damp or liver qi stagnation. Depending on the situation, acupuncture or moxibustion may be used at commonly chosen points such as Zusanli ST36, Zhongwan CV12 and Qihai CV6. If Chinese herbs are needed, they are prescribed according to the pattern and adjusted for any medication you take and your health. Experience of acupuncture varies; if you are nervous or have any contraindications, tell us first.
3. Easing accompanying muscle aches (depending on the individual)
If neck, shoulder or back aches are significant, a registered physiotherapist can provide gentle manual therapy, posture and stretching guidance based on an assessment, avoiding over-stimulation.
4. Sensible Things You Can Do Day to Day
- Go to bed and get up at regular times, use your phone less before bed, and keep naps short.
- Eat at regular times, have fewer cold drinks, and eat plenty of fresh vegetables and a moderate amount of protein.
- Do as much activity as you can manage, for example starting with a short daily walk; avoid overdoing it on good days and then being exhausted for several days.
- Pay attention to stress and mood, and seek professional support if needed.
When to See a Doctor
If tiredness has not improved after several weeks, is affecting work and daily life, or you have any of the warning signs above, arrange a medical check-up first. If other causes have been ruled out but you still have long-term tiredness and aching, you can also book an appointment with a registered Chinese medicine practitioner to discuss whether Chinese medicine care suits you.
Remember: the aim of Chinese medicine care is to support a healthy routine and gradually improve your constitution, not to replace necessary medical care. Individual cases should be judged at an in-person consultation.
Frequently Asked Questions
My check-up was normal, so why am I always so tired?
A routine check-up may not cover everything, and sleep quality, stress, daily routine and diet all affect your energy. If tiredness persists or gets worse, describe your symptoms fully to a doctor, who can decide whether more tests are needed. Once other causes have been ruled out, Chinese medicine care can be considered.
If I feel tired, can I buy ginseng or astragalus and take them myself?
Taking large amounts of tonics on your own is not recommended. If they do not suit your constitution, you may get a dry mouth, spots or bloating. A registered Chinese medicine practitioner should assess your pattern first, especially if you take Western medicine, are pregnant or have a long-term condition.
How long does Chinese medicine care take?
It varies with your constitution, routine and the cause of the tiredness. A registered Chinese medicine practitioner adjusts the plan according to the changes at each follow-up, and you still need to look after your sleep and diet during that time.
When should I see a Western-medicine doctor first?
See a doctor promptly if you have unexplained weight loss, persistent fever or night sweats, breathlessness or chest pain, unusual bleeding, swollen lymph nodes, or a persistently low mood.
Don't guess about tiredness: find the cause before starting care
If you are always tired however much you sleep and ache all over, visit Ever-Health in Luen Wo Hui, Fanling. We will first understand your situation, then discuss whether you need tests first, or whether Chinese medicine care, acupuncture or another option is suitable. This article is for reference only; individual cases should be judged at an in-person consultation.