PAIN MANAGEMENT

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KNEE

Common causes of knee pain

The knee is the biggest and most complicated joint of the human body and it plays an indispensible role in supporting our body weight. When stationary, the knees can withstand up to 70% of one’s body weight and the pressure on it can increase several folds when walking, running, or when going up or down the stairs. Faced with such a laborious task, it is very prone to wear and tear, strain and injuries.

Common causes:

  1. OsteoarthritisAlso known as degenerative joint disease, or wear and tear of the knee, this may come as a natural process of aging but the onset could be earlier for people such as avid runners or obese people, whose knees need to withstand greater stress. In osteoarthritis, the cartilage that cushions and reduce friction between the bones in the knee joint are worn out, causing abrasion and pain when the bones rub against each other.
  2. Meniscus InjuryCommonly seen among sports athletes or labour workers, it is usually sustained when twisting or turning abruptly with the knees bent.
  3. Collateral Ligament InjuryCommonly caused by trauma, it is usually sustained when the knee suffers a blow from the medial or lateral side.
  4. Cruciate Ligament InjuryAs the cruciate ligaments are positioned deep in the knees, injuries are usually sustained only through heavy blows to the front or back of the upper region of the shin. It is usually coupled with other injuries like dislocation of the knee or collateral ligament injury.

TCM Perspective

Osteoathritis is commonly attributed to deficiency in the Liver and Kidney. In TCM theory, the Liver governs the storage of Blood, and Blood nourishes the tendons and ligaments, while the Kidney governs the bone. Physiologically, the functions of the Liver and Kidney start to degenerate from middle age and the lack of nourishment of the tendons and ligaments can cause pain. Coupled with wear and tear of the tissues, Qi and Blood circulation will be poor in the affected area, and this stagnation of Qi and Blood can also result in pain. Therefore, treatment of osteoarthritis usually includes herbal medication and acupuncture, both aimed to tonify the Liver and Kidney (to delay degeneration) and to promote circulation of Qi and Blood.

Commonly used herbs: 杜仲Eucommia ulmoides、续断Dipsacus asperoides、桑寄生Taxillus chinensis、狗脊Rhizoma Cibotii、牛膝Achyranthes bidentata

Meniscus Injury, Collateral Ligament Injury and Cruciate Ligament Injury are attributed to direct traumatic injury causing stagnation of Qi and Blood in the affected part. Treatment can include herbal medication, acupuncture, Tuina, external herbal medication and bandage, aimed to remove the stagnation of Qi and Blood and to promote tissue recovery.

Commonly used herbs: 桃仁Semen Persicae、红花Carthamus tinctorius、乳香Boswellia carterii、没药Commiphora molmol、骨碎补Davallia mariesii、牡丹皮Moutan Radicis
Cortex、赤芍Paeonia veitchii

Exercise: Lie flat on a mat with your hip and knees bent and foot on the ground. Fold a pillow into half and keep it between your knees. Start by squeezing the pillow with your knees and hold for 5 seconds, and then relax. You should feel the strain on the thigh muscles. Repeat for 10 times. You may gradually increase the duration and number of repetitions. This exercise aims to strengthen the thigh muscles which help to share the weight load of the body with the knees. This exercise can also be done while seated on a chair.

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Acupoint Massage:

Massaging the following acupoints can help to improve local Qi and Blood circulation, strengthen muscles, slows degeneration and promote tissue recovery. Massage each acupoint for 2-3 minutes until you feel slight soreness on each point.

Xue Hai (SP 10): On the inner side of the thigh, about 3 finger-width distance above the proximal-medial (upper-inner) corner of the patella bone.

Liang Qiu (ST 34): On the outer side of the thigh, about 3 finger-width distance above the proximal-lateral (upper-outer) corner of the patella bone.

Yang Ling Quan (GB 34): On the outer side of the lower limb, slightly diagonal (forward and downward) from the head of the fibula bone.

Yin Ling Quan (SP 9): On the depression of the inner side of the lower limb, just below the medial condyle of the tibia bone.

Kneeacupoints