TRADITIONAL CHINESE MEDICINE APPROACHES IN TREATING KNEE PAIN

​Traditional Chinese Medicine (TCM; 中醫 zhōng yī) has been used for centuries to treat a wide range of health conditions, including knee pain. TCM incorporates various modalities such as acupuncture, herbal medicine, cupping therapy, and Tui Na massage. 

Here are some TCM approaches that have been explored for knee pain:

Acupuncture (针灸 zhēn jiǔ): Acupuncture involves the insertion of thin needles into specific acupunture points on the body to stimulate energy flow (Qi) and equalizes the Qi and blood (气血 Qì xuè), which can help to reduce inflammation, release pain-relieving endorphins, promote blood circulation, loosen tight muscles. and promote healing. Some studies suggest that acupuncture can provide pain relief and improve knee function in individuals with knee osteoarthritis or other knee-related conditions.  There are around 361 acupuncture points in a human body but below are just some pressure points that are effective for relieving knee pain.
  • Stomach 35 (Calf’s Nose) - Located just before the kneecap on the outside of the indentation.
  • Stomach 36 (Three Mile Point) - Located below your kneecap and to the outside of the shinbone.
  • Spleen 9 (Shady Side of the Mountain) - Located below the kneecap on the inside portion of the knee and at the top of the shinbone.
  • Gall Bladder 34 (Sunny Side of the Mountain) - Located on the outside portion of the knee and at the top of the shinbone.
  • Bladder 53 (Commanding Activity) - Located in the back of the knee on the outside where the crease starts when the knee is bent.
  • Bladder 54 (Commanding Middle) - Located at the back of the knee in the center of the crease.
  • Liver 8 (Crooked Spring) - Located at the inner side at the back of the knee where the crease ends when the knee is bent.
  • Kidney 10 (Nourishing Valley) - Located at the inside edge of the knee crease between two tendons.

Chinese Herbal Medicine (中药 Zhōngyào): Traditional Chinese herbal formulas may be prescribed to address the underlying causes of knee pain and reduce inflammation. Herbal remedies are often tailored to the individual's constitution and specific symptoms.  Chinese herbs not only can address different kinds of pain but even target different pain locations.  Unlike western anti-inflammation medicine used for treatment, which should not be taken for long periods of time to simply mask the symptoms, Traditional Chinese Medicine corrects the underlying imbalances.  However, getting the correct formulation is key.  Some common formulas include;
  • Du Huo Ji Sheng Tang (独活寄生汤) - An ancient herbal remedy, comprised of 14 Chinese herbs.  It is a powerful herbal combination that supports joints and reduces inflammation.  Traditionally used to treat both osteoarthritis and rheumatoid arthritis.  
  • Shu Jing Huo Xue Tang (疏經活血汤) - An ancient herbal remedy, comprised of 16 Chinese herbs. It is mostly used to treat joint pain and stiffness, swollen joints and numbness in the skin with the root cause of "Dampness invading the Channels joints and muscles".  Such patients typically exhibit slow pulses.
  • Juan Bi Tang (蠲痹汤) - An ancient herbal remedy, comprised of 9 Chinese herbs. TCM practitioners used this to fight patterns like Painful Obstruction with Qi and Blood Deficiency.
  • Si Miao San (四妙散) - An ancient herbal remedy, comprised of 4 Chinese herbs.  This is used for joint pain that is hot in nature. It targets lower body damp heat which has symptoms of swelling or redness on the skin or joints on the legs or feet.  
  • Shen Tong Zhu Yu Tang (身痛逐瘀汤) - This herbal remedy addresses the sharp pain and general pain throughout the body that does not respond to other treatment.

Cupping Therapy (拔罐 Báguàn): Cupping involves placing heated cups on the skin to create suction, which is believed to stimulate blood flow and reduce muscle tension. While cupping is commonly used to effectively reduce pain in different systems throughout the body, it is most effective when combined with other treatment options planned by TCM practitioners.  Cupping can help to treat knee pain in the following ways:
  • Reduced inflammation — Cupping can help release tension in the muscles and tissue surrounding the knee thereby promoting the removal of scar tissue and reduce inflammation.
  • Increased flexibility — After cupping therapy, tension around the knee area is released, thereby muscles and tissues become more flexible.
  • Improved circulation — Cupping increases the blood flow to the target area, promoting the flow of oxygen and nutrients to the affected tissue, thereby speeding up the process of healing.
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Massage Therapy (推拿 tuī ná): Tui Na is a form of Chinese therapeutic massage that involves manipulation of the body's energy channels or meridians (疏通經絡 shū tōng jīng luò)” to improve blood circulation (氣血循環 qì xuè xún huán) and alleviate pain. Tui Na massage may be used to relieve muscle tension and improve joint mobility.  National Library of Medicine Evaluation has concluded that Tuina produced superior effects for pain, negative emotions, and disability over time.
If you're considering TCM for knee pain, here are a few things to keep in mind:
  • Consultation: Seek guidance from a qualified and licensed TCM practitioner. They can assess your condition, medical history, and recommend appropriate treatment plans for you.
  • Integration: TCM treatments can be used in conjunction with conventional medical care to provide a holistic approach to pain management.
  • Individual Variability: Responses to TCM treatments can vary widely among individuals. What works well for one person may not have the same effect for another.
  • Safety: Ensure that the TCM practitioner is experienced and follows appropriate safety protocols, especially if you have underlying health conditions or are taking medications. All Singapore TCM practitioners should be registered under the TCM Practitioners Board (TCMPB).  You can check if the physician is registered on TCMPB’s portal.
As with any healthcare decision, it's important to make informed choices based on your individual needs and preferences. Collaborate with healthcare professionals to determine the most suitable and effective approach for managing your knee pain.


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References
Acupuncture Points for Knee Pain
Atlas of Acupuncturology
How Effective is Traditional Chinese Medicine for Knee Osteoarthritis?