removes obstructions from the channel. It should be needled at least 2 inches deep with
the patient lying on the opposite side and the leg slightly bent. Use of the warming
needle on this point is very effective.- G.B.-29 Juliao is an useful point to use in combination with G.B.-30.
- SP-12 Chongmen can be used as a local point especially when the pain extends to the
groin.
Knee
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. When it is due to Kidney
deficiency, the knee pain is usually bilateral and develops very gradually over a long period of
time. In addition, 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 it is due to invasion of pathogenic factors, the knee pain is more often unilateral (or it is
worse on one side) 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 Dampness and a previous local stagnation of Qi due to an old
accident.
Another frequent cause of knee pain is of course local stagnation of Qi and Blood from over-use
of the joint. This occurs in brick-layers, joggers, cleaners, etc. In this case, it is not strictly
speaking Painful Obstruction Syndrome but it is treated in exactly the same way.
Treatment
The treatment of acute and chronic cases is not significantly different so that they can be
discussed together. The most important factor to keep in mind when selecting points is to clearly
identify the channel involved according to the site of pain. Pain in the knee may occur in the
front along the Stomach channel, above the knee, inside the joint itself, on the inner aspect along
the Spleen and Liver channels and in the back of the knee in the popliteal crease (Figure
23.12(467)).
Distal Points
Three distal points can be used for knee pain according to the channel involved: