Knee Pain

Knee pain affects apparently 25% of us … so drug manufacturers love it!

Every drug you take must be metabolised by your body, slowing it down. Some drugs have unpleasant side-effects for which you may be taking additional drugs!

You have two knees and they’re built strong but hard to repair when one goes wrong. Look after them carefully! However, Chinese medicine and acupuncture have lots to offer.

This page looks at knee pain from the point of view of Chinese medicine: I’ve simplified a complicated subject, so please don’t think that what you read here is all there is to say!

Mention knee pain to acupuncturists and most will instantly think of one particular cause even though it’s not usually the most common except in old people. And not everyone is old! So let’s get that one out of the way!

1. Kidney Deficiency and Knee pain

Older people have walked further than younger people. Age uses up their jing essence. They notice age-related deficiencies in their backs and knees. What kind of knee pain is this?

• Nearly always occurs in both knees, though one knee may be worse than the other
• Pain develops over time: at first you hardly notice it, but it recurs more frequently as time goes on
• Nearly always a bit painful: this is a chronic condition and won’t easily disappear
• Not swollen (swelling occurs when caused by other factors than age alone)
• A good sleep or rest temporarily eases the pain
• Worsens with exercise or use, especially if you are carrying something heavy or walking upstairs or uphill – or just standing for too long!
• It’s not just pain, but weakness and unreliability too

• Knees may feel cold, and like warmth – otherwise not much affected by the weather, though you yourself may prefer warmth to cold
• Usually comes with other signs of Kidney deficiency such as lumbar backache, loss of hearing, ear noises (tinnitus) and dizziness (meaning a sense of disorientation in space, often with light-headedness). For more on a common form of Kidney deficiency (there are several kinds, see Kidney Syndromes), click on Kidney Yang Deficiency.
• Kidney deficiency pain doesn’t begin suddenly and it does gradually worsen as you age, though there’s lots you can do about it
• Your kidney pulses will probably be weaker than your other pulses.

Treatment of Kidney Deficiency Knee pain

I treat many people in their 70s and 80s, and a few into their 90s. Many have knee pain, and acupuncture is often highly effective, preventing recurrence of the pain for some months unless the patient gets over-exhausted (by which I mean that, after strain or stress, their energy doesn’t improve even after several nights of good sleep).

However, the patient usually needs an acupuncture treatment every few months to maintain improvement. They are usually happy with this arrangement because treatment helps them feel better in many other ways – not just in their knees!

For kidney deficiency, there are also Chinese herbal formulae. The exact formula depends on your symptoms, not least on whether you are more Kidney Yin or Kidney Yang deficient, but all the formulae start with then adapt to your particular circumstances liu di huang wan.

What can you do to help?

• Starting 30 years ago …
• … get fit, not least by strengthening your legs and knees BUT! be careful not to overstrain yourself. (Overstrain? For example, over-lifting weights or damaging them. How do you know if you are over-lifting, putting too much strain on your knees? If you recover after a good night’s sleep, you probably haven’t overstrained them. But if pain or stiffness or weakness takes two or three days to get back to normal health, you are probably overstraining them. When young, you can do this occasionally, and not much harm is done. But as you age into your thirties, forties and later, beware! It is easy to let pride, arrogance and the desire to keep up with others cloud your judgement and …)

• … learn to sleep well, and to get enough sleep, regularly and …
• … if possible, ask an acupuncturist to advise you about your constitutional needs, for instance what kinds of food to avoid and then help you with good nutritional advice. Eating food appropriate to your type is very important in the long run. Also, learn to chew well: chewing helps your digestion extract more nourishment from food.
• What if you forgot, 30 years ago? Start now, with the same advice. And go for regular walks, gradually increasing distances, but not to the point where you get exhausted.
• If in pain from kidney deficiency (knee pain, back pain, nagging head pain etc, see Kidney Yin deficiency for example), get some good acupuncture for a start!
• Don’t overwork.
• Remain active physically and mentally. Continue to work if congenial: having to adapt to circumstances everyday keeps your yang energy circulating.
• Be careful not to get too cold … and wrap up well against the damp too! These are the subjects of the next category below, to which ageing makes you more vulnerable.

2. Knee pain from Cold and Damp

This knee pain is common, at least in cold, wet climates. Modern advice for ice for knee (and other) trauma is, well … wrong! Ice helps pain and inflammation short term but is poor advice for long-term knee health because ice is cold, and damp easily ‘invades’. What are the symptoms?

• More usually affects one knee only, or one knee is much worse than the other
• Starts fairly quickly – even, it might seem, suddenly
• Symptoms are worse when exposed to Cold and/or Damp. ‘Cold’ is pretty obvious, but ‘damp’ is not necessarily what you’d expect: it can mean rain, but for some it means humidity. For others it means the build-up to a thunderstorm (though this usually means they are susceptible to ‘Wind‘ as well.) It can certainly mean exposure to water as in swimming pools. Some very damp-forming foods can worsen it too (that page also lists foods that fight damp.)
• This kind of knee pain often makes the knee very stiff, even rigid, or difficult to bend.
• Damp frequently causes swelling, and your legs or knees may feel heavy.
• This kind of knee pain improves, at least temporarily, from application of warmth, whether it be a warm shower, a warm bath, a warm beanbag, or warm, dry weather, as found in warm countries.
• If you keep moving the pain usually ameliorates somewhat until you sit to rest when it returns. Movement and warmth, and the warmth generated by movement usually helps while you keep moving.
• Your pulse, if affected by Cold, is slower than normal.
• Remember the symptoms, because they can happen to anyone of any age, for instance if you fall heavily on your knee without actually breaking it. Even more so if you fall on ice (‘cold’ and ‘damp’) without taking immediate action to treat it.

Treatment for Knee pain caused by Cold and Damp

• If you’ve got the chronic condition of this, keep your knees warm and away from damp … but you’ve probably worked that out for yourself!
• Avoid foods that may weaken your resistance to Damp and Cold. Read our pages on Damp-forming foods, then our page on Cold foods.
• Whatever you eat, chew well. Damp arises in your body partly from weakness in your digestion (your ‘Spleen‘ energy). The wrong foods can weaken how well your Spleen resists and mends your problem.
• Acupuncture early on may reduce the time you take to heal. Moxa would be used, almost certainly.

• There are several well-used herbal formulae for knee pain from Cold and Damp. Bu zhong yi qi tong is more appropriate if the main problem is damp, but it could be adapted for Cold-type knee pain by adding other herbs.
• Try not to take NSAIDs like paracetemol which does reduce acute pain and inflammation but also prevents neutrophils triggering repairs, so your condition becomes chronic. You won’t realise this until later, when, still taking your medications, you’ll count the months since your problems began. For more on this click Suppression. The longer you’ve been taking such painkillers, the longer you’ll take to get better.
• Gentle walks? Certainly!
• If you want to know more about how Chinese medicine understands the invasion of external pathogenic influences like Cold and Damp, about 2000 years ago a Chinese doctor wrote a major thesis on it, in the process founding a hugely important ‘school’ and sytem of treatment, used to this day. It’s quite different from Western medicine so comes with very different solutions! Read about it! It’s called the ‘Six Stages of Disease caused by invasion of Cold’. (But it applies to Damp too.)