Knee PainKnee Pain

Why Do You Have Knee Pain?

 June 29, 2022

By  Juli Kramer

Knee pain takes different forms and can get worse over time. You might notice a burning sensation under your kneecaps, or tenderness and pain. Perhaps even walking short distances or standing in line at the grocery store feel agonizing.

You’re not alone. One in four adults report suffering from knee pain. And that number has increased over the past 20 years.

Knee Pain

Many people who experience knee pain visit doctors and physical therapists but cannot find relief. Surgery often looms as the first choice.

For example, over 800,000 knee replacement surgeries occur each year in the United States alone. Often people have serious complications and soon experience other joint pain and health problems.

However, their problems continue because the source of their knee pain doesn’t go away with surgery.

Hence, the more you understand what causes knee pain, the more likely it is that you can avoid “the knife.” You will have effective strategies to tackle the pain at its source to prevent future problems.

Understanding the Root Causes of Knee Pain

Knee Pain

Dr. David Goldstein, Lic. Ac., Dipl. O.M, acknowledges the high incidences of knee pain. He tells us that, “Unfortunately, knee pain doesn’t trail far behind low back pain (LBP) as one of the most common physical ailments. Like LBP, knee pain affects many of us as we age and is also prone to occur from injury and/or overuse.”

At the same time, Dr. Goldstein provides hopeful news. Understanding the root of the problem can help you find the solution.

So, what are the root causes of knee pain, according to Chinese medicine? 

Firstly, Dr. Goldstein shares that, “According to Chinese Medicine, the lower back and the knees are influenced by the Kidney energy.

This is evidenced by virtue of the physical location of the kidneys in the lower back (L-1/L-2 area), the Bladder channel (which has a close relationship with the Kidney energy) flowing directly down the back in two bilateral pathways (inner & outer), as well as the Kidney and Bladder channels that flow directly into the knees from opposite directions.”

Therefore, you need to identify if your knee pain comes from Kidney weakness or from Painful Obstruction Syndrome (POS).

Strengthen your Kidneys

Bilateral Knee Pain

Again, according to Dr. Goldstein, “When it is due to Kidney deficiency, the knee pain is usually bilateral and develops very gradually over a long period of time. In addition, the knees feel weak and possibly cold. This type of knee pain is not affected by weather and the knees would not be swollen.”

Unilateral Pain

He continues to say, “When it is due to invasion of pathogenic factors (POS), the knee pain is more often unilateral (or it is worse on one side) and it starts fairly suddenly. It is definitely affected by weather (usually worsening with rainy or damp weather) and the knee may be swollen (which indicates retention of Dampness).

POS of the knee often occurs from a combination of factors, (e.g., an invasion of exterior Cold and Dampness and a previous local stagnation of Qi due to an old accident.)”


Beyond Kidney weakness and POS, Another frequent cause of knee pain is, of course, local stagnation of Qi and Blood from overuse of the joint,” states Dr. Goldstein. Think of stagnation like a creek that gets block by trash and algae and cannot flow. The water turns dirty and stagnant. Qi can get stuck in the body as well.

“This stagnation occurs in bricklayers, joggers, cleaners, etc. In this case, it is not strictly speaking Painful Obstruction Syndrome but it is treated in exactly the same way.”


Michael Garrico, Co-Founder and Marketing Director at TotalShape, also notes an important internal source of knee pain – painkillers. As an ASCM and NCSF Certified personal fitness trainer and nutritionist, Garrico writes that, “Regular use of painkillers can also cause knee pain as joints are impacted negatively by the consumption of pain suppressants. It is one of the side effects that gets ignored.”

Acupuncture to cure the root causes of knee pain


As a licensed acupuncturist, Dr. Goldstein has active knowledge from treating his patients for knee pain. He says that, “The first and most important factor to keep in mind when preventing knee pain is to clearly identify the channel involved according to the site of pain.

Where the pain in the knee occurs informs treatment. Possible locations include:

  • In the front (along the Stomach channel)
  • Above the knee
  • Inside the joint itself
  • On the inner aspect (along the Spleen and Liver channels), and
  • In the back of the knee in the popliteal crease (along the Kidney and Bladder channels).

Once the location is established, acupuncture will be the preferred course of action, combined with knee-strengthening leg exercises, proper nutrition, hydration and rest.”

Dr. Goldstein notes that, “Many people ask, ‘Why isn’t exercise alone sufficient to strengthen the knees?’ Because while important, exercise alone doesn’t root out the underlying cause of pain. Acupuncture will open the blockages, resolve the pathogenic factors and strengthen the Kidney energy.

Exercise will strengthen the surrounding muscles, tendons, ligaments, joints, and connective tissue."

Proper Nutrition and Lifestyle Choices 

Dr. Goldstein finally adds that, "And, of course, proper nutrition, hydration and rest are essential ingredients in maintaining a healthy lifestyle, pain-free joints and preventing POS from reoccurring. Knee health may decline as we age, but it doesn’t have to be a painful experience.”

Kiran Gollakota, the co-founder and CEO of Lightyear Health adds that, "A lot of knee pain comes down to diet; if people do not eat a healthy diet, they gain weight as they grow older, which puts extra strain on the knees when walking. 

Additionally, a poor diet will not provide nutrients that are vital to supporting bone structure and muscles. Another culprit is caffeine, which blocks the absorption of calcium in your bones. This can lead to osteoporosis, and sore knees and other joints. People who are aging should try to eat more vegetables and drink less coffee. "

From a Chinese medicine perspective, these foods weaken different internal organ systems. Consulting with a licensed acupuncturist will help you narrow down which systems are struggling in your body so you can eat foods that match your needs.

Furthermore, eating according to your body constitution lets you know which foods are right for your body. Take the Body Constitution Quiz to discover what you should eat. 

External Sources of Knee Pain

Knee Pain

Dr. Alissa Kuizinas, a Holistic Podiatrist, tells us about another factor that contributes to POS.

Dr. Kuizinas notes that, “One of the common but often overlooked reasons for knee pain is footwear. The shoes that we wear throughout our lives have a direct impact on the health of our knees.

Since most shoes have a heel, this increases the incidence of knee pain and arthritis. This is not just limited to high heels, but virtually all types of shoes including athletic sneakers.”

She suggests that “A great step in preventing knee pain is to take a look at the shoes that you currently wear, and consider switching to zero drop, or barefoot style shoes.

These types of shoes will decrease the pressure on your knees and will improve overall body alignment. In addition, getting in touch with your feet, improving your foot strength, and strengthening your hips and pelvis are great ways to protect your knees and prevent pain.

Our knee joints are mainly controlled by our feet and hips, so make sure you have optimum strength and mobility there.”

Strong hips, pelvis, and feet can help

Qigong exercises, such as 18 Essential Daily Movements, help you increase awareness of how to step on your feet. Throughout the flow, you work on strengthening and aligning your hips, pelvis, and spine. You also do balancing postures that support Dr. Kuizinas’ recommendations to improve foot strength.

Moving the body incorrectly also causes problems

Agreeing with Dr. Kuizina, Brian Rossiter, creator of the Posture Exercise Method, notes that the pelvis and hips can contribute to knee pain.

According to Rossiter, “As with most chronic pain conditions, people's knees hurt because of the position of their eight load-bearing joints—the shoulders, hips, knees, and ankles—as well as overall posture.

With most people, it isn't the knees necessarily that is the problem. With most people, the position of the pelvis and position and relationship of the hip joints are the first to go off-kilter, and this results in femurs (thighbones) that turn inward or outward. With rotated femurs come knees that point inward (knock-kneed) or outward.

These cascading changes affect people up, down and across their bodies.”

Garrico echoes the idea that improper movement of the body can lead to knee pain. He notes that, “Indulging in unsupervised high intensity workouts can also be one of the causes of knee pain across ages.”

As a reminder, Dr. Goldstein advises that you make sure to rule out deeper internal causes first. If unattended, these root problems of knee pain can lead to long-term illness and disease.

Once internal health problems are ruled out, Rossiter’s method can help you address the POS sources of pain.

Bringing the Body into Alignment

Rossiter shares a sample of his method for realigning the body.

“One gentle exercise people can do to help position their bodies better is to lie on their backs, with their arms positioned palms up at the ceiling and 45 degrees out from their sides. The hips and knees should be bent at 90 degrees, with the entire legs—including knees, ankles and feet—at hip width apart (about one-and-a-half fists). The bottom half of the legs should rest on a chair or storage box at a height to allow for the ankles to be directly in line with the knees and parallel with the floor.

This position, which I call Floor Seat, helps enable the body to get into a neutral position, realigning the pelvis and hips while retraining the body to learn its natural position.

Most people have pelvises that are tilted too far forward or backward and one hip joint that is higher than and rotated in front of the other. This produces rotation throughout the legs, leading to extremely wide or too-narrow stances.

This also leads to issues in the back, shoulders, and neck, with many suffering from back strain and/or pain as well as necks that jut forward and shoulders that slump forward, with one shoulder often positioned higher than the other.”

If you enjoy this exercise, you can explore Rossiter’s method further. 

Summary of Why You have Knee Pain

The first step to stop knee pain is to determine if an internal sub-health state contributes to your knees hurting. If it does, you should work with a licensed acupuncturist to bring the body back to a healthy condition. Nutrition and exercise will also contribute to regaining optimal health.

As you eliminate the internal root causes of knee pain, you should also address external factors.

Look at your shoes, your posture and alignment, as well as overall level of movement and activity. Getting everything back into balance will help you stop knee pain and deterioration of your knees.

Juli Kramer

Dr. Juli Kramer is a certified qigong instructor. She also holds a diploma in Chinese Medicine Nutritional Therapy and multiple certificates in Chinese medicine. As a qigong and meditation teacher, Dr. Kramer understands the important role movement and meditation have on developing a healthy body and mind. Juli also has a Ph.D. in Curriculum and Counseling Psychology.

What's something new you learned?

{"email":"Email address invalid","url":"Website address invalid","required":"Required field missing"}