Acupuncture and Knee Pain

What is knee pain?

Knee pain is a fairly common complaint among both children and adults. According to the American Academy of Orthopaedic Surgeons, more than 11 million visits are made to physicians' offices each year because of a knee or knee-related problem. It is the most often treated anatomical site by orthopedists, and one of the most oft-examined sites among general practitioners.

The knee is the largest joint in the body. It is made up of the lower end of the thighbone (or femur), which rotates on the upper end of the shinbone (tibia), and the kneecap, which slides in a grove on the end of the femur. The knee joint also contains several muscles, which straighten the leg and bend the leg at the knee; tendons, which attach the muscles to the bones; ligaments, which help control motion by connecting bones; and cartilage, which serves to cushion the knee or help it absorb shock during motion.

Because of its size, and because it is such a complex structure, it is also one of the most frequently injured joints. Knee injuries can be caused by several factors. Most complaints of knee pain result from some form of trauma, such as a torn or ruptured ligament; a broken or fractured kneecap; torn cartilage; or an accident that causes damage to the area or strains the knee beyond its normal range of motion. Other conditions that can lead to knee pain are infections; arthritis; hemarthrosis (blood in the knee joint); cysts; and bone tumors. Being overweight can also contribute to knee problems by causing excess strain on ligaments and cartilage.

Who suffers from knee pain?

Many athletes experience knee injuries, particularly to the knee ligaments. Nearly everyone has become familiar with the acronym ACL, which stands for anterior cruciate ligament. ACL tears can be caused by rapidly twisting or changing directions; slowing down when running; or landing from a jump. Injuries to the medial collateral ligament (MCL) are usually caused by contact on the outside of the knee.

Knee pain isn't restricted to professional athletes, however. As people get older, the amount of cartilage in the knee decreases, and many ligaments begin to lose some of their elasticity, making them more susceptible to pain and/or injury.

What can acupuncture do?

Studies have shown acupuncture to be effective in relieving certain types of knee pain, especially arthritic conditions of the knee and knee joint. A 1999 study comparing electroacupuncture to ice massage and transcutaneous nerve stimulation (TENS) for subjects with osteoarthritis found that acupuncture decreased pain and stiffness levels and increased muscle strength and flexion in the knee. Another study published that same year suggested that patients with patellofemoral pain syndrome might benefit from weekly acupuncture treatments. Smaller studies have confirmed that acupuncture is beneficial in reducing knee pain, stiffness and physical disability in patients with knee and knee-related problems. It can ease the discomfort some subjects feel while waiting for knee surgery, and in some cases, it may even be considered an alternative to surgery.

As with any other form of care, however, remember that not all patients will respond to acupuncture. Make sure to discuss the situation thoroughly with your acupuncturist before undergoing treatment for knee/leg pain (or any other condition).

References

Ernst E, Lee MH. Sympathetic effects of manual and electrical acupuncture of the tsusanli knee point: comparison with the hoku hand point sympathetic effects. Exp Neurol Oct 1986;94(1):1-10.
Fang Z. Arthralgia treated by acupuncture within "chifu" area. J Tradit Chin Med Sep 1999;19(3):207-9.
Jensen R, Gothesen O, Liseth K, Baerheim A. Acupuncture treatment of patellofemoral pain syndrome. J Altern Complement Med Dec 1999;5(6):521-7.
Myhal D, Lebel E, Leung CY, Camerlain M. Radioisotope study of the effect of acupuncture on the articular vascularization of the knee. Union Med Can Dec 1981;110(12):1046-8. French.
Shafshak TS. Electroacupuncture and exercise in body weight reduction and their application in rehabilitating patients with knee osteoarthritis. Am J Chin Med 1995;23(1):15-25.
Wu ZM, Chen CG. Treatment of hydrarthrosis of the knee with manual manipulation and herbs. J Tradit Chin Med Dec 1998;8(4):251-3.
Yurtkuran M, Kocagil T. TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee. Am J Acupunct 1999;27(3-4):133-40.
Zhang WB, Aukland K, Lund T, Wiig H. Distribution of interstitial fluid pressure and fluid volumes in hind-limb skin of rats: relation to meridians? Clin Physiol May 2000;20(3):242-9.

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