Acupuncture for Knee Pain: A Case Report

What Is Acupuncture?

Acupuncture is a traditional therapy that has been used for thousands of years for the treatment of various ailments such as pain, fertility concerns, low energy, mood swings, and even colds and flu. It involves the insertion of very fine needles at specific points on the body to promote healing through the stimulation and circulation of “Qi.” The specific points that are chosen are individualized to each patient, his/her history, and main concerns or health goals. From my experience, most patients find this treatment quite relaxing, even those that are normally afraid of needles!

Acupuncture for Knee Pain

As mentioned above, acupuncture can be used for a variety of ailments. One of these ailments is knee pain. It is important first to determine the root cause of the knee pain from a traditional Chinese medicine perspective, and then choose points to address this root cause. Acupuncture has been used quite extensively for knee pain, both in the East and the West, and there is a growing body of research to show its efficacy in treating chronic knee pain and osteoarthritis.¹

Meet Jane

Jane came in for a visit at 30 years old with the feeling that “something had snapped in her knee.” She was wearing a knee brace, had difficulty walking, and overall looked pretty defeated. She told me that this knee pain had been bothering her periodically ever since she injured it falling off a scooter seven years prior, and now she felt like she may need surgery. She had been diagnosed with a medial collateral ligament injury by her medical doctor and was waiting for an appointment with an orthopedic surgeon. In the meantime, she wanted to try acupuncture.

The Intake

As a naturopathic doctor, I told Jane that I wanted to get her whole story. We talked about her knee injury, but we also talked about her exercise habits, diet, and social-support network, and she spoke a lot about the great deal of stress she experienced over the last seven years as she completed her postgraduate studies and started her career. I also learned that Jane was not only dealing with her knee injury, but also had, in the last seven years, been diagnosed with anemia and endometriosis (a condition where endometrial tissue moves outside of the uterus and results in very painful menstrual periods).

The Diagnosis

Since Jane was most interested in trying acupuncture for her knee pain, I decided to approach her case from a traditional Chinese medicine (TCM) point of view. From this perspective, Jane was presenting with “liver Qi stagnation.” In TCM, organs are not referred in the same way as we learn about them, and they encompass energetic, emotional, and physiological components that are not always pathological but emphasize a dynamic or balance that are linked through a specific set of meridians or pathways in the body. The liver is responsible for circulating blood and Qi (energy) through the body; when there is a dysfunction in an organ system, such as the case with Jane and her liver TCM diagnosis, the blood and Qi are said to get stuck or stagnated, contributing to pain. When liver Qi stagnation develops, often the person is overworked, under a lot of stress, and is keeping up a hectic lifestyle.² With less than optimal liver Qi and blood flow, Jane’s muscles, tissues, and organs would not be receiving sufficient blood and Qi, which would have made for sluggish or prolonged healing for something like a knee injury.

The First Treatment

Jane was looking forward to her first treatment while also maintaining a healthy skepticism. Her background in science was apparent, as she asked numerous questions to really try to understand how acupuncture works and what our approach would look like. After answering her questions, we started with needling local points around the knee to increase circulation of blood and Qi to that area, then also added in a few points to help promote the smooth flow of liver Qi. Once the needles were in, Jane was able to relax for 20 minutes to calming music.

After the treatment, Jane was excited to feel less pain and a slightly increased range of motion in her knee. I explained to her that much of the healing happens between appointments. I suggested some other naturopathic modalities and recommended she take vitamin D and bone broth, and I demonstrated a couple of simple hamstring stretches, We booked an appointment to follow up the following week.

Five Weeks of Treatment

Jane came in weekly for acupuncture treatments. At each of her visits, we would chat about her week, how things went, where she wanted things to go next, and end with a 15–20-minute acupuncture relaxation session. The points were specifically chosen each week depending on Jane’s report of her week and how she was feeling, but consistently worked on increasing circulation to the knee and promoting the smooth flow of liver Qi.

After five weeks of treatment, Jane was thrilled to report that she could now almost fully extend her knee. She was still short a few degrees of full extension but was back to going on short daily walks without the need of her knee brace. She reported still experiencing some pain after a long walk or in the morning on waking, but it was much more manageable than it had been when she first came to see me. She also happily reported that she had seen her orthopedic surgeon who was impressed with her progress so far. He suggested she continue what she was doing and recommended adding physiotherapy to her treatment. Jane followed the surgeon’s recommendation and started a twelve-week exercise program with a physiotherapist to help stretch and strengthen the muscles supporting her knees with the hopes of regaining full extension of her knee and preventing knee injuries in the future.

Ten Weeks of Treatment

We continued to meet weekly for the next five weeks. However, now we started incorporating fire-cupping treatments as well to help stretch and increase circulation to the muscles in the back of the legs. We alternated treatments so that one week was acupuncture and the following was cupping. We also talked about the importance of proper posture when sitting for long periods as was required for Jane’s work. Jane had also incorporated yoga and stretching into her daily routine.

By week ten, Jane had regained full extension of her knee, and she was going on regular long walks with minimal to no pain. She still reported experiencing some pain on the medial (or inside portion) of her knee, but she was looking forward to continuing to work on it. Jane also reported feeling more connected to her body. She talked about how much of a role the mind plays in pain and healing and felt more empowered in her own healing.

At this point, I suggested to Jane that we start to space out our treatments since she was doing so well. However, she informed me how helpful these weekly treatments were for managing stress in such a stressful, uncertain year and how much she enjoyed them, so we decided to continue with the weekly appointments.

Future Directions

As Jane continues to feel more confident with the healing of her knee injury, she has started thinking about working on other health concerns, such as her endometriosis. She is curious about alternative ways to manage her endometriosis. With research to show the efficacy of acupuncture in treating endometriosis,³ along with the collaboration of Jane’s medical specialist, this may be the next avenue Jane and I explore together.