pain: November 2009 Archives

Osteoarthritis of the knee

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Basic TCM Knowledge regarding Osteoarthritis of the Knee In Traditional Chinese Medicine

Osteoarthritis (Degenerative Joint Disease) is mostly related to Fixed Bi and Painful Bi.


Fixed Bi Syndrome: The chief manifestations include pain and heavy sensation in the relatively fixed areas of body limbs or joints, numbness of the muscles, aggravation of the condition in rainy days, white greasy tongue coating, and soft slow pulse.

Painful Bi Syndrome: The chief manifestations include severe pain in the limbs and joints as if being stabbed or pricked. In the worst cases, there is fixed pain that is alleviated by warmth but aggravated by cold, better in the daytime but worse at night, limited movements of the joints, no local redness nor feverish sensation, cold sensation in the affected parts, thin white tongue coating, wiry tense pulse.

knee_osteoarthritis.jpgPathogenesis

Wind, cold and dampness invasion causes the blockage of the Qi and blood in the meridian. In modern medicine, it is related to aging, endocrine disorder as well as trauma and improper posture.

Clinical manifestations
 
The onset of osteoarthritis of the knee is insidious. Initially, there is articular stiffness, seldom lasting more than 15 minutes; this develops later into pain on motion of the affected joint(s) and is made worse by activity or weight bearing and relieved by rest. Deformity may be absent or minimal; however, varus deformity of the knee is not unusual.

Imaging

Radiographs may reveal narrowing of the joint space, sharpened articular margin, osteophyte formation and lipping of the marginal bone, and thickened, dense subchondral bone. Bone cysts may also be present.

Major pattern differentiation

Fixed Bi:
Pain fixed in the knee joint accompanied by heaviness, stiffness and numbness, sometimes slight swelling.

Painful Bi:
Severe pain in the knee joint, aggravated by cold and alleviated by heat.

Treatment Principle:
Expel wind, Cold and dampness, improve the meridian circulation and regulate Qi and blood.

Major Acupuncture points and needle techniques

Acupuncture points for knee:

Xiyan (Ex.), Dubi (ST35), Zusanli (ST 36), Yanglingquan (GB 34)

Alternative Therapies:

Auricular therapy
Corresponding area (Knee), Sympathetic, Shenmen

ear points chart.jpg
Subcutaneous needling therapy
Select local point or tender points
Seven-star needle tapping and cupping

Read paper on Osteoarthritis of the Knee for Rachel Peterman's Clinical Acupuncture Practice II class at New York College of Traditional Chinese Medicine in Mineola, NY.

She gives an overview of Osteoarthritis of the knee, and Western and TCM treatment approaches.

Rachel H. Peterman, M.S., DHEd(c), J.D.

Osteoarthritis of the Knee.pdf


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This page is a archive of entries in the pain category from November 2009.

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