The Yin Yang of Chronic Pain: Tension, Rest & Recovery
Updated: Oct 22
Have you ever had a sore neck or back that eases off, then comes straight back? Often the sore spot isn't the whole story. In Chinese medicine, we look at the balance of yin and yang, and in people with long-standing pain I usually find imbalances in two places: in the muscles, and in the rhythm of activity and rest.
Chronic pain conditions are often held in place by imbalances between yin and yang elements within our bodies and lives. Below I'll go through the two I see most, what the research says about rest and sleep, and how I work with them.
What is the yin yang of chronic pain?
Yin and yang describe opposing forces that depend on each other, like tension and release, or activity and rest. When they're in balance, the body moves, works and recovers smoothly. When one side dominates for long enough, something eventually gives, and pain is often where it shows up.
Yin yang imbalance 1: tight muscles vs weak muscles
The first imbalance is physical: muscles that are too tight at the front of the body, paired with muscles that are weak and underactive at the back. A very common situation in the clinic is someone coming in for pain in the neck or back, where to really help we have to work on the tension in the front of the body.
Our modern lifestyles, with prolonged sitting and screen time, promote a posture where muscles such as the SCM (the muscle at the side of your neck), pecs and hip flexors shorten and tighten at the front. That puts extra strain and pressure on the muscles of the back, such as those along the spine and the glutes.
Those back muscles can become inhibited and weak through a phenomenon called "reciprocal inhibition". When one muscle contracts, the opposing muscle is inhibited to allow the movement. When we sit in the same positions for long periods, this sets up an imbalance. Pain often occurs in the weakest, most vulnerable areas as a warning signal that something needs addressing.
I go through these patterns in detail in upper cross syndrome and lower cross syndrome. Tight spots in these muscles are often trigger points, which I explain in what a trigger point is.
Yin yang imbalance 2: activity vs rest
The second imbalance is between activity and rest, and 21st century life tends to favour activity. Productivity and constant achievement are rewarded, while rest, recovery and stillness lose importance.
Nature works in cycles of expansion and contraction. Every inhalation is naturally followed by an exhalation. If you’re focused on getting as much inhalation as possible, without allowing for appropriate exhalation, you’re going to run into problems pretty quickly. If your body’s ability to recover is compromised, this will affect your ability to heal from chronic pain.
I talk about this in more depth in pain, stress and fatigue, including how unmanaged stress gets stored in the body.
Does sleep affect chronic pain?
Sleep is one of the clearest places where rest and pain meet, and the research suggests the link runs both ways. A 2024 systematic review and meta-analysis in the journal Pain by Runge and colleagues pooled 16 studies from 11 study populations, with over 116,000 adults followed over time. It found that sleep problems were associated with a higher risk of later developing chronic musculoskeletal pain, and that people with chronic musculoskeletal pain were more likely to go on to have sleep problems in the short term.
The authors noted that many of the estimates were very uncertain and that the two-way nature of the relationship needs further research. Even so, it fits what I see in clinic: poor sleep and pain feed each other, which is one reason recovery is such a big part of the picture.
What helps with the yin yang of chronic pain?
The aim is to rebalance both sides: release and strengthen the muscles, and build real recovery back into your week. That means:
breaking up long periods of sitting, and stretching the front of the body
strengthening the back of the body, including the upper back and glutes
protecting your sleep, with regular hours and a wind-down routine
scheduling genuine rest, not just collapsing after a busy day
and, when things are really stuck, using treatments like acupuncture to reset the pattern
How does acupuncture help with chronic pain?
An acupuncturist's job is to assess and work with your particular web of imbalances that are keeping you trapped in a chronic pain cycle. Our goal is to help break that cycle and help restore a more comfortable natural rhythm for you.
Physically, I look for trigger points in the tight muscles and use dry needling, trigger point acupuncture, motor point acupuncture or distal points to help them release. I also look at the bigger picture of your stress, sleep and recovery, because that's often what's keeping the muscles switched on.
What does the research say? A 2018 individual patient data meta-analysis in The Journal of Pain by Vickers and colleagues pooled data from 39 trials and 20,827 patients with chronic pain. Acupuncture reduced pain more than no acupuncture, and the effect decreased by only about 15% after a year.
That's what the research reports. In the clinic, our goal is long term improvement, and we take a more holistic and individualised approach than could be replicated in a study.
I usually suggest a block of at least 6 sessions to see how you respond, then plan from there. Often people notice improvements within the first few sessions, but for chronic conditions it's important to allow the cumulative effects to build over a series. Read more on how long acupuncture takes to work and how often to come.
FAQs: The Yin Yang of Chronic Pain
Q: What does yin yang mean for chronic pain?
A: Yin and yang describe opposing forces that depend on each other. In chronic pain I usually see imbalances between tight and weak muscles, and between activity and rest.
Q: Why do I get neck or back pain from sitting?
A: Sitting tightens the muscles at the front of the body, such as the hip flexors, pecs and the SCM in the neck. This strains the muscles in the back, which can become weak and underactive, and pain often shows up in the weakest areas.
Q: What is reciprocal inhibition?
A: When one muscle contracts, the opposing muscle is inhibited to allow the movement. If you hold the same position for long periods, this can set up an imbalance between the two.
Q: Does poor sleep make chronic pain worse?
A: Research suggests sleep problems and chronic musculoskeletal pain are linked in both directions.
Q: Can acupuncture help with chronic pain?
A: Research suggests acupuncture can reduce chronic pain, and I use it alongside movement, stress and recovery strategies. I usually suggest a block of at least 6 sessions to see how you respond.
Ready to break the chronic pain cycle?
If you'd like to try acupuncture for chronic pain, you're welcome to come and see me. I'll work out what's keeping the cycle going and put together a plan with you.
If you'd like to try acupuncture for chronic pain in Sydney's eastern suburbs, consider Acupuncture Grove in Bondi Junction. You can book online here or reach out with any questions here.
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Gavin Martin-Rentz is an AHPRA-registered acupuncturist and Chinese medicine practitioner at Acupuncture Grove, Bondi Junction, Sydney, with over 10 years in practice.
Acupuncture Grove services Bondi Junction, Bondi Beach, Coogee, Clovelly, Bronte, Waverley, Randwick, Maroubra, Double Bay, Watsons Bay, Vaucluse and surrounding Sydney suburbs.
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