This pain is experienced deep inside the joint. The main points to use are:
- Xiyan extra points. These are a pair of points in two depressions medial and lateral to the
patellar ligament (Figure 23.16(471)). "Xiyan" means "knee-eyes". They are called
lateral and medial Xiyan, and the lateral one coincides with the point ST-35 Dubi. They
are best needled with the knee slightly flexed after placing a small pad under the patient's
knee. They should be needled at least 0.5 inch deep. The warming needle can be used
with good results unless the knee feels hot to the touch and is swollen (which denotes
Heat Painful Obstruction Syndrome). - ST-36 Zusanli, which expels Dampness, can also be used when the pain is felt inside the
knee joint.
Pain at the Back of the Knee
Pain in this area occurs much less frequently than in the front or sides of the knee. It is due to
invasion of Dampness in the Bladder channel. The main point is:
- BL-40 Weizhong which, besides being the local point for pain behind the knee, also
expels Dampness, and in particular Damp-Heat.
Ankle
Pain in the ankle is usually due to invasion of Damp-Cold and to local stagnation of Qi from
over-use of the joint. The main points to use are:
- SP-5 Shangqiu is one of the two main points to use (with G.B.-40 Qiuxu). Besides being
a local point, it expels Dampness, and, being the River point, it affects joints. It is usually
needled in combination with G.B.-40 Qiuxu. - G.B.-40 Qiuxu is used if the pain is on the outside of the ankle, and is often used with
warming needle. - ST-41 Jiexi is used if the pain is on the instep of the foot. It also expels Dampness. It
should be needled perpendicularly at least 0.5 inch.
Toes
The main points to use for pain in the toes are: