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Osteoarthritis of the Knee - A Chinese Medicine Perspective
What is Osteoarthritis of the Knee
Osteoarthritis, the most common form of arthritis, is a progressive degenerative disease characterised by gradual loss of joint cartilage, resulting in loss of movement and pain. It is the leading cause of disability among non-institutionalized adults, and is associated with major impacts on physical function and mobility.
Osteoarthritis is a commonly seen condition both by orthodox medical practitioners as well as practitioners of Chinese medicine and Acupuncture. It occurs in 80% of people aged over 65 [1] and is characterised by symptoms such as joint cartilage loss, restriction of movement, pain, crepitus and joint swelling [1, 2].
Conventional methods of treatment comprises the use of NSAIDs (non-steroidal anti-inflammatories), analgesic pharmaceutical drugs, muscle strengthening exercises and weight loss with limited positive results and in some causing adverse side-effects [2].
Acupuncture has been show to be a safe and highly effective method in treating symptoms associated with Knee Osteoarthritis (KOA) including the repair of cartilage [2,4,5,6] within the knee joint itself.Acupuncture has been practiced for well over 3000 years and there is evidence that it may have been used to treat arthritis as far back as 5000 years ago. The mummified man Ötzi, estimated to have lived 5300 years ago, was found in the Austrian/Italian alps in 1991. Tattoo like marks found on his body correspond to acupuncture points that would have been used to treat the arthritis in his back, hip joints, right knee and left ankle [7].
The points found by the researches represent a meaningful treatment for arthritis even in today’s acupuncture clinics. In fact, at Kurrajong Natural Medicine Centre, we would use most of these points on a daily bases when treating patients with arthritis of this type.
How Does Traditional Chinese Medicine (TCM) view Osteoarthritis
Osteoarthritis in Chinese medicine is classified as “Painful Obstruction Syndrome”. And as the knees are influenced by the Kidney energy, it is important to differentiate knee pain due to Kidney deficiency from that due to Painful Obstruction Syndrome (POS). When pain in the knee(s) is due to Kidney deficiency, the knee pain is usually in both knees and develops gradually over a long time. Furthermore, the knees feel weak and possibly cold, especially if Kidney-Yang is deficient. This type of knee pain is not affected by weather and the knees would not be swollen.
When the knee pain is due to invasion of pathogenic factors, the knee pain is more often one-sided and it starts fairly suddenly It is definitely affected by weather, usually worsening with rainy or damp weather, and the knee may be swollen which indicates retention of Dampness.
Painful Obstruction Syndrome of the knee often occurs from a combination of factors, i.e.: an invasion of exterior Cold and Damp and a previous local stagnation of Qi (body’s bio-electricity) due to an old injury.
Acupuncture has been show to be a safe and highly effective method in treating symptoms associated with Knee Osteoarthritis (KOA) including the repair of cartilage [2,3,4,5] within the knee joint itself [3].
Osteoarthritis (OA) is unfortunately not curable using conventional treatment methods, however, it is manageable and the condition can improve to some degree depending on how advanced the arthritis is before treatment can begin, the age of the patient and their overall physical constitution and health.
Acupuncture is reported to be more effective in the treatment of OA than conventional methods and physiotherapy and unlike physiotherapy it has been shown to regenerate cartilage in the knee joint to some degree [8].
In TCM clinics like Kurrajong Natural Medicine Centre, arthritis is a commonly seen presentation. Fortunately, acupuncture and Chinese herbal medicine have been shown to help many people to better manage this condition. To discuss how the practitioner at Kurrajong Natural Medicine Centre may be able to help, simply call (02) 4573 0784
What You Can Do to Help Yourself
The Arthritis Foundation of America suggests the following:
Practicing these habits can slow down OA, keep you healthy and put off surgery as long as possible.
- Maintain a Healthy Weight: Excess weight worsens OA. Combine healthy eating with regular exercise to maintain a healthy weight.
- Control Blood Sugar: Many people have diabetes and OA. Having high glucose levels can make cartilage stiffer and more likely to break down. Having diabetes causes inflammation, which also weakens cartilage.
- Maintain Range of Motion: Movement is medicine for joints. Make a habit of putting your joints through their full range of motion, but only up to the point where it doesn’t cause more pain. Gentle stretching, raising and lowering legs from a standing or seated position, daily walks and hobbies such as gardening can help. But listen to your body and never push too hard.
- Protect Joints: Make sure to warm up and cool down when doing exercise. If you play sports, protects joints with the right gear. Use your largest, strongest joints for lifting, pushing, pulling and carrying. Watch your step to prevent falls. Balance rest and activity throughout the day.
- Relax: Find ways to reduce or avoid stress through meditation, listening to music, connecting with friends and family, doing fun activities, and finding ways to relax and recharge.
- Choose a Healthy Lifestyle: Eating healthy food, not smoking, drinking in moderation and getting good sleep will help you to feel your best.
References:
1. Selfe, T. K., & Taylor, A. G. (2008). Acupuncture and osteoarthritis of the knee: a review of randomized, controlled trials. Family & community health, 31(3), 247–254. doi:10.1097/01.FCH.0000324482.78577.0f
2. Taru Manyanga, Maria Froese, Ryan Zarychanski, Ahmed Abou-Setta, Carol Friesen, Michael Tennenhouse and Barbara L Shay. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2014; 14-312
3. Marciocia, G. (1994) The Practice of Chinese Medicine: The Treatment of Disease with Acupuncture and Chinese Herbs, Edinburgh: Elsevier Churchill Livingstone.
4. Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8.
5. Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.
6. McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Australian Acupuncture and Chinese Medicine Association Ltd; 2017. http://www.acupuncture.org.au.
7. Ice Age Acupuncture? Acupuncture Today – June, 2000, Vol. 01, Issue 06. https://www.acupuncturetoday.com/mpacms/at/article.php?id=27608
8. Zhang, Y., Bao, F., Wang, Y., & Wu, Z. (2016). Influence of acupuncture in treatment of knee osteoarthritis and cartilage repairing. American journal of translational research, 8(9), 3995–4002.
9. Arthritis Foundation of America. https://www.arthritis.org/diseases/osteoarthritis last visited 1st Jul. 2021