↑ reinforcing ↓ reducing ⊥ even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.
1. Painful Obstruction with Liver and Kidney Deficiency
Clinical manifestations: Dull, aching pain deep in the knee joint; soreness and weakness in the lower back; the knees feel weak and heavy; stiffness that improves with gentle movement; fatigue and a pale complexion; pain worse in cold, damp weather; better with warmth; brought on by ageing, chronic overuse, a long-standing untreated injury, or overwork; eased by warmth, rest, gentle strengthening exercise, or moxibustion.
Tongue: Pale, thin body, thin white coating. Pulse: Fine and Weak, especially deep at the rear (Kidney) position, may be Slow.
Treatment principle: Dispel Wind-Dampness, relieve painful obstruction, supplement Liver and Kidneys.
Note: moxa applicable on the tonifying points.
2. Wind-Cold-Damp
Clinical manifestations: Pain distinctly worse in cold, damp weather; a cold sensation in the knee; heaviness and stiffness, especially in the morning; swelling without redness or heat; pain eased by warmth; stiffness improves with gentle movement; worse after prolonged sitting or rest; brought on by cold and damp exposure, sitting on cold surfaces, sudden weather changes, or overexertion; eased by warmth and heat packs, gentle movement once warmed up, dry conditions, or moxibustion.
Tongue: Pale or slightly swollen body, white greasy coating, moist surface. Pulse: Moderate and Tight, or Soggy.
Treatment principle: Dispel Wind-Dampness, warm the channels, unblock the channels.
Note: moxa applicable.
3. Painful Obstruction due to Damp-Heat in Channels
Clinical manifestations: Redness and local heat at the knee; hot, painful swelling; pain relieved by cold, aggravated by warmth; a heavy, aching sensation in the legs; thirst and dark urine; irritability and restlessness; brought on by hot humid weather, spicy or greasy food, alcohol, or an acute flare of a chronic injury; eased by cool compresses, cooling food and drinks, rest, or avoiding heat on the area.
Tongue: Red body, possibly slightly swollen, yellow greasy coating. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat, dry Dampness, clear Damp-Heat from the Lower Burner, support the Spleen.
Note: no moxa.
4. Qi and Blood Stagnation
Clinical manifestations: Fixed, stabbing pain that worsens with pressure; worse after prolonged sitting or standing and with emotional stress; better with gentle movement and warmth; brought on by an old injury, prolonged static posture, stress and frustration, or overexertion; eased by gentle movement, warmth, avoiding prolonged sitting or standing, or gentle massage once the acute pain settles.
Tongue: Dark purple body with stasis spots, distended tortuous sublingual veins, thin white coating. Pulse: Wiry, Choppy.
Treatment principle: Invigorate Blood, dispel stasis, move Qi, alleviate pain.
Note: no moxa.
5. Qi and Blood Deficiency
Clinical manifestations: A dull, aching knee pain with a feeling of weakness; worse with prolonged standing or walking; general fatigue and shortness of breath; a pale complexion and nail beds; dizziness or lightheadedness; eased by rest and warm nourishing food; brought on by overwork, chronic illness, poor diet, or a long recovery from injury; also eased by gentle graded exercise or moxibustion.
Tongue: Pale body, may be thin with tooth marks, thin white coating. Pulse: Fine, Weak.
Treatment principle: Tonify Qi, nourish Blood, strengthen the Spleen.
Note: moxa applicable on the tonifying points.