Acupuncture Treatment Protocol

Acupuncture Treatment of Knee Pain

Acupuncture Treatment of Knee pain
Acupuncture Treatment of Knee pain

Knee pain is one of the common condition that can affect people of all ages and backgrounds. Everyone experiences knee pain in any form once in their life either due to trauma or due to any pathological condition. Knee pain is any discomfort or pain experienced in or around the knee joint. The knee joint is a complex structure that allows for movement and supports the body’s weight, making it vulnerable to various injuries and conditions.


1. Injuries: Knee pain often results from injuries, such as ligament sprains, meniscus tears, or fractures. These injuries can be caused by sports activities, accidents, falls, or sudden twisting motions.

2. Arthritis: The most prevalent form of arthritis affecting the knee is osteoarthritis, a degenerative condition that occurs due to wear and tear of the joint over time. Rheumatoid arthritis, an autoimmune disease, and gout can also cause knee pain.

3. Tendonitis: Tendonitis refers to the inflammation of tendons, which are the thick cords that connect muscles to bones. In the knee, patellar tendonitis (also known as jumper’s knee) and quadriceps tendonitis are common.

4. Bursitis: The knee has fluid-filled sacs called bursae that help cushion and reduce friction between bones, tendons, and ligaments. When these bursae become inflamed, usually due to overuse or repetitive activities, it can cause knee pain.

5. Meniscus tears: The menisci are C-shaped pieces of cartilage located between the thigh bone (femur) and the shin bone (tibia) within the knee joint. A sudden twist or overuse can cause a tear in the meniscus, resulting in knee pain.

6. Overuse and repetitive stress: Engaging in activities that involve repetitive motions, such as running, jumping, or kneeling, can lead to knee pain due to overuse and strain on the joint.

7. Obesity: Excessive weight puts added stress on the knee joint, leading to increased wear and tear, which can result in pain and discomfort.

8. Other conditions: There are several other conditions that can cause knee pain, including tendinitis, ligamentous injuries (such as ACL or PCL tears), dislocation, patellofemoral pain syndrome, and more.


The symptoms of knee pain can vary depending on the underlying cause, but common signs and symptoms include:

1. Pain or discomfort, ranging from mild to severe.
2. Swelling or inflammation around the knee joint.
3. Stiffness or limited range of motion.
4. Difficulty bearing weight or walking.
5. Clicking, popping, or grinding sensations during movement.
6. Instability or a feeling that the knee may give way.
7. Redness or warmth around the knee joint (inflammatory conditions).

Diagnosis and Treatment:

To diagnose the cause of knee pain, a healthcare professional will typically perform a thorough physical examination, review the medical history, and may order additional tests such as X-rays, MRI scans, or blood tests.

Treatment options for knee pain depend on the underlying cause and severity of the condition. They may include:

1. Rest: Avoiding activities that exacerbate the pain and giving the knee time to heal.

2. Physical therapy: Exercises and stretches to improve strength, flexibility, and stability of the knee.

3. Medications: Over-the-counter pain relievers (e.g., acetaminophen, ibuprofen) or prescription medications for more severe pain and inflammation.

4. RICE therapy: Rest, ice, compression, and elevation to reduce pain and swelling.

5. Assistive devices: The use of crutches, braces, or orthotics to support the knee and promote healing.

6. Injections: Corticosteroid injections or hyaluronic acid injections to reduce inflammation and provide pain relief

Mechanism of Acupuncture in Knee pain

Activation of endorphins: Acupuncture stimulates the release of endorphins, which are natural pain-relieving and mood-enhancing substances produced by the body. Endorphins can help reduce pain perception and promote a sense of well-being, providing relief from knee pain.

Modulation of neurotransmitters: Acupuncture may affect the levels of various neurotransmitters in the body, such as serotonin and dopamine. These neurotransmitters play a role in pain perception, mood regulation, and the body’s response to pain. By modulating neurotransmitter levels, acupuncture can help alleviate knee pain and improve overall well-being.

Regulation of blood flow: Acupuncture is believed to promote blood circulation in the body, including the knee joint. Improved blood flow can facilitate the delivery of oxygen, nutrients, and immune cells to the affected area, supporting the healing process and reducing inflammation that may contribute to knee pain.

Stimulation of nerve fibers: Acupuncture involves inserting needles into specific acupuncture points, which are located near nerves. The insertion of needles stimulates nerve fibers, sending signals to the brain and spinal cord. This stimulation can activate the body’s natural pain-modulating mechanisms, leading to pain relief.

Promotion of Qi flow: According to traditional Chinese medicine, acupuncture aims to balance the flow of Qi, the body’s vital energy, along meridians or energy pathways. When Qi is blocked or imbalanced, it can lead to pain and illness. By targeting specific acupuncture points, acupuncture helps restore the smooth flow of Qi, promoting healing and reducing knee pain.

Regulation of inflammation and immune response: Acupuncture has been found to modulate the immune system and reduce inflammation. In knee pain conditions associated with inflammation, such as arthritis or tendonitis, acupuncture may help regulate the immune response and alleviate inflammation, thereby reducing pain and promoting healing.

Acupuncture Treatment of Knee Pain

Aims during the treatment of Knee Pain with Acupuncture are listed below:

  • Reduce the pain.
  • Strengthen the muscles associated with Knee Joint.
  • Increase the local blood flow in the knee.

The acupuncture treatment protocol can be divided to local point selection and distal point selection.

The local points are located in and around the knee joints which act locally for the benefit of knee pain. Some are listed below:

DUBI (ST 35)








The distal points are used distally mostly to reduce the pain and improve the range of motion of Knee joint. Some of the distal points are:






Dr. Ishwar Gyawali is Consultant Acupuncturist and Ayurveda Physician from Kathmandu, Nepal. He had completed BAMS (Bachelor of Ayurveda Medicine and Surgery), a five and half year course on Ayurveda Medicine from Kirtipur Campus affiliated to Tribhuvan University ,Institute Of Medicine, Nepal under scholarship in 2011. He had completed his MD in TCM from Nanjing University Of Chinese Medicine in 2016 under scholarship of Ministry of Education, Nepal. With an experience of Serving for Government of Nepal for 2 years and private practise for more than 5 years, he has sound knowledge in Ayurveda as well as Chinese Medicine. He is a registered Doctor in NAMC (Nepal Ayurveda Medical Council ) both as a physician as well as TCM/Acupuncture Specialist.