Knee Pain

Knee Pain in an Active City

Seattle is a city of runners, hikers, cyclists, and people who climb stairs for fun. It is also a city where knee pain is one of the most common reasons people seek care — from the tech worker whose knees ache after long days at a standing desk to the weekend hiker whose IT band is inflamed, to the older adult managing the progressive wear of osteoarthritis. Knee pain is not a single condition. It is a location where many different problems converge.

The GoodMedizen approach addresses the knee as part of the whole kinetic chain. In most cases, knee pain is not primarily a knee problem — it is a hip, foot, gait, or inflammatory problem that expresses itself at the knee. Treating the joint alone, without addressing what is loading it, produces limited and temporary results.

Common Causes of Knee Pain

• Osteoarthritis — cartilage loss and joint degeneration that causes pain, stiffness, and reduced range of motion, especially in the morning or after activity
• Runner's knee (patellofemoral pain syndrome) — pain around or behind the kneecap with stairs, squatting, and running, often driven by hip weakness or poor mechanics
• IT band syndrome — sharp lateral knee pain in runners and cyclists from iliotibial band tightness and hip abductor weakness
• Patellar tendinitis — jumper's knee, pain below the kneecap with running and jumping activities
• Bursitis — inflammation of the bursae (fluid-filled cushions) around the knee joint
• Meniscus irritation or injury — the shock-absorbing cartilage discs between the femur and tibia, commonly irritated in twisting injuries or aging
• Systemic inflammation — rheumatoid arthritis, gout, and other inflammatory conditions that affect the knee joint

Signs and Patterns

• Pain localized to the front, back, inside, or outside of the knee
• Stiffness after sitting or in the morning
• Swelling, warmth, or visible puffiness around the joint
• Pain that worsens with stairs, squatting, kneeling, or prolonged walking
• A clicking, grinding, or catching sensation in the joint
• Instability or the feeling that the knee might give out
• Pain that improves with rest but returns immediately with activity

How We Look at It — The Assessment

• Musculoskeletal evaluation — palpation of the joint, surrounding tendons, and bursae; range of motion; assessment of hip, foot, and gait mechanics
• Inflammatory markers — hs-CRP and ESR where systemic inflammation is suspected
• Uric acid — to rule in or out gout, which commonly affects the knee
• Metabolic panel — metabolic syndrome and blood sugar dysregulation accelerate osteoarthritis progression
• Nutrient assessment — vitamin D, omega-3 index, and magnesium, all of which affect joint inflammation and cartilage health
• Imaging coordination — we refer for X-ray or MRI where indicated and work collaboratively with orthopedic and physical therapy providers

The Chinese Medicine Lens

The knee is the domain of the Kidney in Chinese medicine — it is the joint most associated with Kidney Qi and essence, which is why knee weakness and pain commonly increase with age and with depletion. Bi syndrome (painful obstruction syndrome) is the classical framework: wind, cold, and dampness invade the channels, blocking Qi and blood flow through the joint. Cold-damp Bi presents with aching, heavy pain relieved by warmth. Damp-heat Bi presents with swelling, redness, and heat in the joint. Blood stasis presents with fixed, sharp, or stabbing pain, often worse at night.

Local needling — including points KI3, ST35, SP9, GB34, and Xiyan (the "eyes of the knee") — combined with warming techniques and systemic Kidney support is the standard approach. Athletes often respond quickly because the tissue is healthy and circulation is good; older adults and those with long-standing degeneration benefit from longer courses of treatment that rebuild essence and circulation simultaneously.