KNEE PAIN

Clinical Manifestations
  • Knee pain
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Numbness and heaviness of the extremities
  • Soreness and fixed pain of joints
  • Stiffness or numbness of the muscles or skin
  • Pain worse on cloudy or rainy days
  • Maybe peripheral or systemic edema
  • Pain is alleviated by pressure and warmth
  • Pain lingers and is recalcitrant to treatment
  • Worse during cloudy or wet weather
  • Limited movement
  • Edema
  • Maybe stifling sensation in chest
  • Maybe anorexia or indigestion
  • Maybe abdominal distention
  • Maybe loose or semi-liquid stools
  • T: Pink or Pale
  • C: Greasy and white
  • P: Slow, moderate and soft
Treatment Principle
  • Expel Damp
  • Clear the channels
Herb Formulas
Points
Clinical Manifestations
  • Excruciating sharp, stabbing joint pain
  • Pain alleviated by warmth and aggravated by Cold
  • Pain with fixed location
  • Few joints are involved
  • The joints cannot be flexed or extended
  • No local redness or Heat
  • Painful area often feels cold to the touch
  • Pain worse at night and better during the day
  • Pain mostly affects low back and lower extremities
  • Pain intense but short lived
  • Pain changes over days or weeks
  • Ankylosis (stiffness) of joint
  • Aversion to Cold
  • Maybe chills with a slight fever
  • Anhidrosis
  • Frequent nocturnal urination
  • T: Pink or Pale
  • C: Thin and white (thicker than for Wind-Bi)
  • P: Superficial and tight or Wiry and tight - maybe slow
Treatment Principle
  • Warm the channels
  • Activate Qi and Blood.
Herb Formulas
Points
Clinical Manifestations
  • Painful joints
  • Heavy and painful sensations at fixed locations in lower back and extremities with weakness and stiffness or hypertonicity and immobility
  • Aversion to Cold
  • Attraction to warmth
  • Palpitations
  • Pain in the midline and back during pregnancy
  • Pain worse at night General coldness
  • Sallow complexion
  • Wandering pain
  • Pale complexion
  • Shortness of breath
  • May be paresthesia and numbness
  • Cold pain in the low back and knees
  • Limited movement
  • Soreness, weakness and numbness of the joints
  • Tinnitus
  • Muscle spasms
  • Dizziness
  • T: Pale
  • C: Thin and white or White and moist
  • P: Thin, weak and slow or Deep, thready and weak or slippery
Treatment Principle
  • Disperse Wind-Dampness
  • Stop Bi pain
  • Tonify the Kidneys and Liver
  • Tonify Qi
  • Nourish the Blood
Herb Formulas
Points
Clinical Manifestations
  • Unproductive cough or
  • Scanty, sticky phlegm or
  • Sometimes blood-streaked sputum
  • Dry mouth
  • Dry throat
  • Low back and knees sore and weak
  • "Steaming Bone" tidal fever
  • Night sweats
  • Malar flush
  • Maybe hoarse voice
  • Maybe pain in shin, foot, and heel
  • Spermatorrhea
  • Irregular menses
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Lungs and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Aching and heaviness in the lower back
  • Poor muscle tone with flabby muscles
  • A tendency to be overweight
  • Poor posture
  • Sallow complexion
  • Fatigue
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools
  • Shortness of breath
  • T: Pale and flabby - may have teethmarks
  • C: White and greasy
  • P: Slippery or soft
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
Herb Formulas
Points
Clinical Manifestations
  • Body cold
  • Limbs icy
  • Complexion white and shiny
  • Low back, knees and abdomen feel cold and painful
  • Lower abdomen feels cold and painful
  • Loose stools containing undigested food
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Dysuria
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm and Reinforce the Spleen and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Ligament pain
  • Hypermobility of the knee with a sensation of instability
  • Fragile sinews
  • Distention and pain in the sides or flanks
  • Maybe low back pain
  • Difficulty standing up
  • abdominal distention
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Tension
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink
  • C: Thin and white
  • P: Wiry
Treatment Principle
  • Soothe the Liver
  • Clear Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Fatigue
  • Muscle spasms with alternating flexion and extension of the extremities
  • Prostration
  • Clonic convulsions
  • Dizziness - worse with stress or anger
  • Insomnia
  • Dream-disturbed sleep
  • Sore low back and knees
  • Nocturnal emissions
  • Often the patient is on the verge of shock
  • Low-grade fever
  • T: Deep red
  • C: Thin or Peeled
  • P: Weak and faint
Treatment Principle
  • Nourish Yin
  • Extinguish Endogenous Wind
Herb Formulas
Points

Clinical Manifestations
  • Ligament pain
  • Hypermobility of the knee with a sensation of instability
  • Fragile sinews
  • Weakness in the legs and knees with lower back stiffness
  • Cramps
  • Brittle nails
  • Dizziness
  • Blurred vision
  • Impaired vision
  • Dry eyes
  • Night blindness
  • Tinnitus
  • Headache
  • Nervousness
  • Insomnia with much dreaming
  • Excessive irritabiloity
  • Vertigo
  • Palpitations
  • Dry throat
  • Thirst
  • Five Sole Heat
  • Night sweats
  • Light menses or
  • Late menses or
  • Amenorrhea
  • T: Red
  • C: Little
  • P: Thready, wiry and rapid
Treatment Principle
  • Nourish Yin
  • Nourish the Liver
Herb Formulas
Points
Clinical Manifestations
  • Facial complexion pale and sallow
  • Both cheeks slightly red
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome), weakness
  • Tinnitus, deafness
  • Forgetfulness
  • Low back and knees sore and painful
  • Throat dry and painful
  • Five sole heat
  • Low-grade fever
  • Night sweats
  • Irritability
  • Insomnia
  • Stools difficult to pass
  • Constipation
  • Spermatorrhea
  • Irregular menses or
  • Scanty menses or
  • Amenorrhea
  • Vaginal discharge
  • T: Red
  • C: None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Liver and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Lumbago: low back feels cold, weak and aching
  • Feeling chilled
  • Aversion to cold
  • Cold limbs
  • General debility
  • Pale face
  • Urinary frequency with abundant, clear urine or
  • Oliguria with edema
  • Maybe nocturia
  • Lassitude
  • Withdrawn, subdued behavior
  • Knees feel cold and aching
  • Dizziness
  • Tinnitus
  • Impotence, spermatorrhea, premature ejaculation
  • Low libido
  • Female infertility ("uterus cold and infertile")
  • Maybe anorexia
  • Maybe loose stools
  • Maybe chronic diarrhea or "cock crow" diarrhea
  • T: Pale and swollen
  • C: Thin and white
  • P: Deep and thready - maybe slow
Treatment Principle
  • Warm and Reinforce Kidney Yang.
Herb Formulas
Points
Clinical Manifestations
  • Lumbago: low back feels cold, weak and aching
  • Feeling chilled
  • Aversion to cold
  • Cold limbs
  • General debility
  • Pale face
  • Urinary frequency with abundant, clear urine or
  • Oliguria with edema or
  • Incontinence of urine
  • Maybe nocturia
  • Dribbling after urination
  • Lassitude
  • Withdrawn, subdued behavior
  • Knees feel cold and aching
  • Dizziness
  • Tinnitus
  • Hearing deficit
  • Impotence, spermatorrhea, premature ejaculation
  • Low libido
  • Female infertility ("uterus cold and infertile")
  • Vaginal discharge
  • Spermatorrhea
  • Premature ejaculation
  • Maybe anorexia
  • Maybe loose stools
  • Maybe chronic diarrhea or "cock crow" diarrhea
  • T: Pale and swollen with teethmarks
  • C: Thin and white
  • P: Deep and thready - maybe slow
Treatment Principle
  • Warm and Reinforce Kidney Yang.
  • Consolidate the Kidneys
  • Conserve Qi
Herb Formulas
Points
Clinical Manifestations
  • Low back, knees and legs painful and weak
  • Foot pain
  • Light-headedness
  • Vertigo
  • Tinnitus
  • Diminished hearing
  • Five sole Heat
  • Chronic dry, sore throat
  • Toothache
  • Wasting and thirsting disorder (Xiao Ke)
  • Dizziness
  • Muscular weakness
  • Dry skin
  • Deafness
  • Steaming bones
  • Delayed closing or unclosed fontanel in infants
  • Tidal fevers
  • Loose teeth
  • Dripping urine
  • Thirst
  • Dry tongue
  • Numbness and weakness at the waist and knees
  • Heel pain
  • Dry mouth
  • Dry throat
  • Blurred vision
  • Urinary incontinence
  • Spontaneous and nocturnal emissions
  • Night sweats
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Enrich Yin
  • Nourish the Essence of the Liver and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Dizziness
  • Tinnitus or deafness
  • Poor memory
  • Aching, soreness or weakness of the low back
  • Spermatorrhea or
  • Premature ejaculation
  • Aching in the bones
  • Aching in the leg and heel
  • Dry mouth
  • Thirst
  • Night sweats
  • Five Sole Heat
  • Malar flush
  • Low grade fever in the afternoon
  • Dry throat, maybe recurrent sore throat
  • Dry stools and/or
  • Constipation
  • Urine short and red
  • Heightened libido
  • If Heart Fire also Flares:
    Insomnia
    Frequent dreams
    Palpitations
  • If Liver Yang also Rises:
    Dizziness
    Blurred vision
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Subdue Fire
Herb Formulas
Points
Clinical Manifestations
  • Emaciation
  • Weakness
  • Spermatorrhea
  • Blurred vision
  • Aching and weak low back and knees
  • Daybreak diarrhea
  • Weight loss
  • Dizziness
  • Nocturnal emissions
  • T: Pink or Pale
  • C: White or None
  • P: Thready and frail or Deep, slow and weak
Treatment Principle
  • Nourish and replenish Yin
  • TonifY Jing
  • Augment Qi
  • TonifY and strengthen Yang
  • Nourish the Blood
Herb Formulas
Points
Clinical Manifestations
  • Dizziness
  • Tinnitus
  • Low back and knees weak and aching
  • In adults:
    Hair loss
    Graying or whitening of hair
    Weak sexual function
    Atrophy and weakness of feet with difficulty walking
    Poor memory
    Senility (premature or mature)
    Brittle bones
    Gradual deterioration of hearing
  • In children
    Retardation in mental and/or physical development
    Failure to thrive
    Late or incomplete closing of fontanel
    Poor bone development, brittle bones:
Treatment Principle
  • Reinforce the Kidneys
  • Benefit Jing
Herb Formulas
Points
Clinical Manifestations
  • Premature graying of the hair
  • Hair loss
  • Loose teeth
  • Spontaneous emissions
  • Nocturnal emissions
  • Weak and sore low back and knees
Treatment Principle
  • Enrich the Kidney Jing
  • Nourish the Liver Blood
Herb Formulas
Points
Clinical Manifestations
  • Urinary frequency
  • Urinary urgency
  • Painful urination or
  • Continuous dripping of urine or
  • Sudden interruption to the urinary stream
  • Turbid urine or
  • Pus and blood in the urine or
  • Sand and stones in the urine
  • In Damp-Heat Pouring Downward there may also be:
    Fever
    Thirst
    Dry mouth
    Low back pain
  • In Damp-Heat Crystallizes in Urinary Bladder there may also be:
    Colicky pain in the low back, possibly radiating to the groin
  • T: Red
  • C: Yellow
  • P: Slippery and rapid
Treatment Principle
  • Clear Heat
  • Eliminate Dampness by diuresis
Herb Formulas
Points
Clinical Manifestations
  • Worse with pressure
  • Better with Heat
  • Worse with Cold
  • The pain is deep and dull
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Better with pressure
  • Better with Cold
  • The pain is sharp and superficial
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Worse with pressure
  • Worse with Heat
  • Better with Cold
  • The pain is sharp and superficial
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Better with pressure
  • Better with Heat
  • The pain is deep and dull
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Excruciating stabbing pain in the extremities
  • Painful, numb bones and joints
  • Deformed bones and joints
  • Localized Cold sensation
  • Muscles and sinews atrophied
  • Pale, lusterless face
  • Cold body and limbs
  • Spine bent forward (hunched)
  • Weak, sore low back
  • Weak, sore knees
  • Profuse urination
  • Watery stools
  • Daybreak diarrhea
  • T: Pale
  • C: White P:
  • Deep and Weak
Treatment Principle
  • Warm the Yang
  • Augment Qi
  • Alleviate pain
Herb Formulas
Points
Clinical Manifestations
  • Knee pain appears with movement
  • Pain abates after getting started
  • Improved with warmth and massage
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Lassitude
  • Fatigue
  • Shortness of breath
  • Dizziness
  • Tinnitus
  • Palpitations
  • Emaciation
  • Lack of strength
  • Dry, rough eyes
  • Possible distended feeling in eyes
  • A pale, lusterless face
  • Possible malar flush
  • Restless
  • Insomnia
  • Poor memory
  • Dry, parched throat
  • Tasteless feeling in the mouth
  • Low back and knee soreness and weakness
  • Low grade fever
  • Five Sole heat
  • Possible sweating
  • Possible tremors of the hands and tongue
  • Scanty intake
  • Abdominal distention after meal
  • Loose stools
  • T: Red
  • C: Thin or Peeled
  • P: Empty and rapid or Thready and rapid
Treatment Principle
  • Tonify Qi and Blood
  • Promote urination
  • Activate the Blood
  • Dispel Blood Stasis
  • Nourish Yin
  • Generate fluids
  • Clear Heat
  • Drain Kidney Fire
  • Cool the Blood
Herb Formulas
Points
Clinical Manifestations
  • Weakness of the knees
  • Soreness of the lower back
  • Lumbago
  • Atrophy of the leg muscles
  • Lower back weakness
  • Knee pain
  • Difficulty walking
  • Emaciation
  • Impotence
  • Poor memory
  • Dizziness
  • Night sweats
  • Five-sole Heat
  • Aggravation of the pain by Damp weather
  • Pale complexion
  • Profuse urination at night
  • Tinnitus
  • Hair loss
  • Sensation of warmth
  • Thirst
  • Dry skin
  • T: Red or Pale and flabby with teethmarks
  • C: Little or Thin and white
  • P: Thready and weak, especially in the Kidney positions
Treatment Principle
  • Tonify the Liver and Kidneys
  • Strengthen the tendons and bones
  • Eliminate Damp-Heat
  • Tonify Kidney Jing
  • Relieve rheumatic pain
Herb Formulas
Points
Clinical Manifestations
  • Vaginal tract bleeding after having stopped menstruating
  • The amount of Blood is sometimes excessive and sometimes scanty
  • The Blood is fresh red or pale red
  • Low back soreness or
  • Low back and knee soreness and weakness
  • Dizziness
  • Palpitations
  • Insomnia
  • Dry skin
  • Dry hair
  • Poor memory
  • Paleness
  • Fatigue
  • Scanty periods
  • T: Pale
  • C: Thin, white and dry
  • P: Thready and rapid or Weak
Treatment Principle
  • Nourish Blood
  • Tonify the Spleen
Herb Formulas
Points
Clinical Manifestations
  • The lower back feels hot either to the patient or practitioner
  • Pain in low back and knees
  • The pain is aggravated by Heat , humid or rainy weather and is not improved by rest
  • Aches and pains in the bones and sinews
  • Weakness or atrophy of lower extremities
  • Scanty yellow urine
  • Red, hot, swollen and painful feet or knees
  • Edema in lower legs
  • Leukorrhea (thick, yellow, foul-smelling)
  • Sores on lower extremities due to Damp
  • Redness, swelling and pain of the knees with burning sensations
  • Oliguria
  • Eczema
  • Irritability
  • Feverishness
  • Thirst
  • T: Normal
  • C: Yellow and greasy
  • P: Soft and and rapid
Treatment Principle
  • Eliminate Heat and Dampness
  • Ease the tendons
  • Stop pain
Herb Formulas
  • Er Miao San modified
  • Chinese Patent Medicines:
    Qian Jin Zhi Dai Wan
    Yu Dai Wan
    Shi Lin Tong Pian
Points
Clinical Manifestations
Treatment Principle
Herb Formulas
Points
  • Extraordinary channel involvement:
    Yinqiao channel involvement: (pain and stiffness in the knee with morning stiffness and sleep disorders) KI-6, KI-8, LU-7
    Yangqiao channel involvement: (pain and stiffness in the knee with morning stiffness and sleep disorders) SI-3, UB-59, UB-62
    Yinwei channel involvement: (sensitivity to weather changes, maybe a feverish sensation) KI-9, PC-6, SP-4
    Yangwei channel involvement: GB-35, GB-41, SJ-5
    Dai channel involvement: (pain in the lower limbs which is worse when getting started and with Cold and better with warmth and movement, belt-like pai radiating down to the medial aspect of the inner thigh, laxity and weakness of the ankles, dysmenorrhea and leukorrhea) GB-26, GB-41, SJ-5
    Chong channel involvement: (pain predominantly in the medial aspect of the knee, cold feet and legs, Blood Stasis induce lower back pain, gastralgia, dyspepsia and marked genital and gynecological pathology) REN-4, SP-4 or ST-30, ST-36
  • Bi Syndrome involvement: Moxa needle Heding, ST-35, Xiyan, needle REN-7, REN-12, UB-23
  • Five Element involvement:
    Water: bone disorders, hair loss, hearing loss, urinary dysfunction and lower back pain GB-39, or REN-3, UB-11, UB-60, UB-64
    Wood: disorders affecting the sinews, cramps, vision disorders, brittle nails, hepatobiliary disorders and difficulty gedtting started GB-34, LIV-1, LIV-3
    Earth: Muscle disorders, abdominal distention, diarrhea, dry lips and obssevie tendencies ST-41, ST-45, UB-57
  • Bone structure involvement: UB-11
  • Support problems: KI-14, REN-5, UB-23
  • Gestural dysfunction: ST-35, ST-38
  • Trigger Points:
    1. Adductor Longus Muscle: Pain in the anteromedial aspect of the thigh, leg and knee: The area around LIV-10 and LIV-11
    2. Vastus Meidalis Muscle: Pain in the anteror inferomedial aspect of the thigh and medial aspect of the knee: The area around LIV-9
    3. Biceps Femoris Muscle: Pain in the popliteal fossa radiating down the posterior aspect of the leg: The lower third od a line joining UB-37 and UB-40
    4. Rectus Femoris Muscle: Pain in the anterior aspect of the thigh and knee: The areas of Maibu