Health Resources

Syndrome Differentiation: Addressing Both the Symptoms and the Root Causes

The knee joint is one of the primary weight-bearing joints of the human body, constantly enduring daily movements such as standing, walking, and climbing stairs. Once pain occurs, it not only limits mobility but also severely impacts the quality of life. In Singapore, due to the humid climate, air-conditioned environments, and sedentary lifestyles, knee pain has become one of the most common clinical complaints.

Common conditions causing knee pain include osteoarthritis, synovitis, meniscus injuries, chondromalacia patellae, rheumatoid arthritis, and gout. It is essential to identify the underlying cause for targeted treatment rather than blindly relying on painkillers.

Traditional Chinese Medicine (TCM) has a long-standing understanding of knee pain, categorizing it under "Bi Syndrome" (Bi Zheng). TCM believes its onset is closely related to factors such as the invasion of Wind, Cold, Dampness, or Heat, Liver and Kidney deficiency, malnourishment of tendons and bones, and Qi and Blood stasis. It is commonly seen in the elderly, those with sports injuries, manual laborers, and individuals who sit or stand for prolonged periods.

Common Symptoms of Knee Joint Pain

  • Aching, distending pain, stiffness, or sharp pain in the knee area.
  • Worsening symptoms after physical activity; in severe cases, pain that wakes one up at night.
  • Limited range of motion (flexion and extension), or joints feeling unusually cold or hot.
  • Difficulty squatting, weakness when walking, or "crepitus" (grating/clicking sounds).

Common TCM Patterns of Knee Pain

  1. Wind-Cold-Damp Bi Type: The knee joint is sensitive to cold, with pain intensifying in cold weather. Mobility is restricted due to pathogens obstructing the meridians.
  2. Damp-Heat Bi Type: Characterized by redness, swelling, heat, and pain in the knee, often accompanied by a dry mouth and yellow urine.
  3. Qi and Blood Stasis Type: Recurring knee pain following an injury, with pain occurring at a fixed location, often manifesting as sharp pain or persistent swelling.
  4. Liver and Kidney Deficiency Type: Commonly seen in seniors, manifesting as knee weakness, dull pain, lower back soreness, and general fatigue.

TCM Treatment Methods

Dr Li Rui points out that TCM treatment for knee pain emphasizes "Syndrome Differentiation" and a "Combined Internal and External" approach, focusing on the root cause to harmonize Qi and Blood and warm the meridians:

  • Acupuncture Therapy: Utilizing acupoints such as Xiyangguan (GB33), Zusanli (ST36), and Yanglingquan (GB34) to unblock meridians and alleviate pain and swelling.
  • Herbal Regulation: Based on the specific pattern, formulas like Duhuo Jisheng Tang, Si Wu Tang, or Shentong Zhuyu Tang are used to tonify the Liver and Kidneys and dispel wind and dampness.
  • Cupping, Guasha, and External Poultices: Effective for Cold-Damp and Stasis types, providing rapid relief of local discomfort.
  • Dietary Therapy: Soups such as Eucommia & Pork Bone Soup or Yam & Chicken Feet Soup help strengthen tendons, bones, and nourish the Kidneys.

In Singapore, high humidity and heat combined with long hours in air-conditioned rooms can lead to Wind-Cold-Damp pathogens invading the knee joint, worsening the pain. Many patients seek quick fixes through short-term painkillers or steroid injections, ignoring fundamental regulation. This can lead to the gradual degeneration of knee function and a much longer recovery period.

Prevention and Daily Care Recommendations

  • Avoid sitting on damp ground and keep air-conditioning from blowing directly on the knees.
  • Engage in appropriate low-impact exercises like Tai Chi, swimming, or brisk walking to enhance joint stability.
  • Manage body weight to reduce the load on the knee joints.
  • Seek professional TCM regulation promptly and avoid delaying treatment.

Dr Li Rui is a senior registered TCM physician at the Shanghai Chinese Medical Centre in Singapore. She specializes in treating various types of bone and joint pain as well as chronic musculoskeletal injuries. By combining herbal medicine, acupuncture, and dietary therapy, she provides personalized regulation plans for her patients. If you or your family members are troubled by knee pain, you are welcome to book an appointment with Dr Li Rui at our Yishun clinic. Let the systematic care of TCM help you regain effortless mobility and a comfortable life.