The knee is the largest joint in the body and is where your thigh bone and shin bone meet. The knee is structured to support our weight and locks into position so we can stand upright. It acts as a hinge joint so we can walk and is able to withstand stresses such as twists and turns.
Osteoarthritis is a degenerative disease and can cause the inner surfaces of the knee joint to become damaged and to have restricted movement. The causes are:

• The cartilage becomes rough and thin
• The bone underneath the cartilage reacts by growing thicker and becoming broader.
• All the tissues in your joint become more active than normal, as if your body is trying to repair the damage.
• The surfaces of the knee can form bony spurs called osteophytes.
• The joint may swell and produce extra fluid
• The capsule and ligaments slowly thicken and contract.

The above changes are due to the inflammatory process and an attempt by the body to repair the damage. In some cases, the repair does not work and your knee becomes damaged. This causes pain and instability at the knee, which then leads to putting weight on other joints. This makes symptoms gradually worse and more persistent over time.

The main symptoms of osteoarthritis of the knee are:
• Pain
• Stiffness
• Creaking, crunching and grinding sensation when you move the joint
• Swelling
• Giving way because your muscles have become weak or the joint structure is less stable
• Your knee not moving as freely or as far as normal
• Your knees becoming bent and bowed
• The muscles around your joint looking thin or wasted.

Acupuncture has derived from traditional Chinese medicine and has been practiced for thousands of years, it promotes balance between the body and the environment. Acupuncture is carried out by inserting slender metal needles into the skin at specific points of the body, in this case it would be around the knee.
According to traditional Chinese medicine, health is governed by the flow of energy (known as qi) throughout the body along pathways called meridians. When this energy flow is interrupted or becomes unbalanced, it can affect health. Precise insertion of acupuncture needles is said to restore the flow of qi and improve health.
A well-placed needle sets off a cascade of events, producing a signal that travels along the spinal cord to the brain, triggering a release of neurotransmitters called endorphins and enkephalins, which is believed to help reduce the sensation of pain. Research also suggests that inserting an acupuncture needle can help to reduce inflammation due to production of cortisol, which is a hormone that helps control inflammation.
A research study was carried out by Corbett, et al (2016), to compare the effectiveness of acupuncture with other physical treatment for alleviating pain due to knee Osteoarthritis. A systematic review of 114 trials was done to collect the data. The results indicated that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short term. However, there is a need for more evidence to support this.

Corbett, M. S., Rice, S. J. C., Madurasinghe, V., Slack, R., Fayter, D. A., Harden, M., Sutton, A. J., MacPherson, H., and Woollacott, N. F. (2016) Acupuncture and other physical treatments for the relief of pain due to Osteoarthritis of the knee: Network meta-analysis. Journal of Acupuncture Association of Chartered Physiotherapists. Volume 28, Number 1, Spring 2016, pp 11-24.


Ammit Mistry

Ammit (Chartered Physiotherapist)