Knee pain may occur in one or both of the knee joints, or the muscles and tendons around the joints. Generally, according to TCM theory, it can be caused by invasion of the knee joints by external wind, cold, damp and heat, deficiency of the liver and kidney, or deficiency or stagnation of the Qi and blood.
Causes: Weakness of the defensive Qi may cause failure of the skin pores to open and close properly. Consequently, external pathogenic factors can easily invade the body and knees, causing stagnation of the Qi and blood circulation, so that knee pain occurs. Invasion of wind, cold, damp, heat usually happens when a person is exposed to strong winds or cold whilst sweating after physical exercise or physical work, has been walking in water or has lived in a damp place for a long time. When external pathogenic factors invade the channels, muscles and joints around the knee, they block the channels, slow down the circulation of Qi and blood and limit the joint movement, and cause knee pain.
Bad diet: Bad diet, such as eating too much of sweet or fatty food, or drinking too much alcohol, may impair the spleen and stomach, leading to the formation of damp and heat in the body. When damp-heat flows downward to the lower limbs, it blocks the channels, causing knee pain.
Stagnation of Qi and blood: Qi and blood should circulate freely in the channels. If they stagnate because of various causes, such as overstrain, physical trauma or inappropriate operation on the knee, they block the channels, leading to pain and swelling in the knee joint. Stagnation can be caused by eating too much of cold or raw food, which causes damp phlegm to form in the body and block the channels, leading to knee pain.
Liver and kidney deficiency: Overstrain, prolonged sickness, a weak constitution and old age may all cause consumption of the Qi and blood, and deficiency of the liver and kidney. The tendons are not properly nourished by the liver and the bone is not properly nourished by the kidney, causing knee pain with weakness.
Qi and blood deficiency: Overstrain, irregular eating habits, a poor diet and prolonged illness may cause consumption or diminished production of the Qi and blood, so the knees are not sufficiently nourished, and knee pain follows. In addition, excessive bleeding during the menstrual period, or chronic bleeding conditions such as haemorrhoids, may result in a gradual and constant blood loss, eventually leading to deficiency.
Local Ah Shi points
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi.
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