Although there is a huge gap between traditional Western medicine and alternative medicine, many practitioners now integrate both methods in their practice. The strange thing about alternative medicine is that many years ago, before the advent of high technology, it was the traditional practice. Take a look at an old Merck Manual. It contains much of what is now considered alternative medicine.

Thanks to the efforts of nutritional pioneers such as Adele Davis and Dr. Robert Atkins and the work of best-selling authors like Dr. Andrew Weil, Dr. Deepak Chopra, Dr. John Sarno, and Dr. Dean Ornish, people increasingly look to combine the benefits of Eastern medicine, homeopathy, and other alternative treatments with those of traditional medicine. This chapter discusses how alternative practices might be useful for both healing the knee and reducing pain in chronic knee problems.

ACUPRESSURE

Acupressure seeks to remedy illness by applying deep finger pressure at specific points throughout the body. It may be effective for relieving headache, muscle and joint aches, and tension and for promoting relaxation. The Japanese version of acupressure is shiatsu; tuina is a Chinese variation of the same practice.

ACUPUNCTURE

Originating in China more than five thousand years ago, acupuncture is founded on the belief that health requires a balanced flow of chi—the vital life force present in all living organisms. Acupuncture balances the body by inserting needles at points on the body specific to the problem. It works to "tonify" or sedate either yin or yang, the two opposite and complementary forces in the world, and to correct and rebalance energy flow, relieving pain and restoring health.

In terms of knee problems, acupuncture has been shown to have great benefits for those suffering from osteoarthritis and rheumatoid arthritis, knee trauma, and overuse syndromes. Studies have also shown that acupuncture stimulates the release of endorphins and enkephalins, the body's natural painkilling chemicals. Acupuncture thus literally alters your perception of pain and offers pain relief. In practice, patients commonly watch knee swelling and bruising diminish within a few hours after a session of needling.

The book Medical Acupuncture by Joseph Helms, M.D., of UCLA (the leading guru of acupuncture for medical doctors), discusses and illustrates the acupuncture points specific for healing the knee.

AYURVEDIC MEDICINE

Ayurvedic medicine is not a specific treatment but instead an East Indian medical system that has been practiced for more than two thousand years. The goal of Ayurvedic medicine is to prevent disease by balancing your dosha, or metabolic type. There are three primary dosha categories: kapha, the calm, somewhat lethargic, and overweight people who need coffee to get started and may lie in bed when depressed; pitta, the competitive, quick-tempered people; and vata, the thin, quick, energetic mentalizers who often have difficulty sleeping. These types compare somewhat to the Western categories of endomorphs, mesomorphs, and ectomorphs. Bringing these dosha into balance is done through a combination of diet, herbs, laxatives, massage, stretching, breathing exercises, and yoga.

If your knee problems are related to arthritis, you may find some relief from a plant extract formulation called RA-1 that is used in Ayurvedic medicine. A randomized trial, with results published in the Journal of Rheumatology (June 2000), found that subjects using RA-1 showed a modest improvement in pain and swelling over those using a placebo.

Dr. Arvind Chopra of the Bharati Hospital Medical College in Pune, India, reported that, in a three-year follow-up study with an increased dosage of RA-1, 40 percent of patients found significant relief from regular use of the herbal remedy. Sponsorship for comparative drug trials is currently being sought.

CHIROPRACTIC MEDICINE

Chiropractic is a branch of the healing arts that is based on the understanding that good health depends in part on a normally functioning nervous system (especially the spine and the nerves extending from the spine to all parts of the body).

Chiropractic comes from the Greek word chiropraktikos, meaning "effective treatment by hand." Chiropractors locate and adjust musculoskeletal areas of the body which function improperly and restore normal function to the muscles, joints, and nerves. Doctors of chiropractic use the time-honored methods of consultation, case history, physical examination, and X-ray examination.

Chiropractic is synergistic with all other healing modalities. It assists in realigning the body, while other modalities are taking effect.

The spine is not the only body part that chiropractors adjust. Frequently, an adjustment to the knee will stop pain and reduce inflammation. Chiropractors may also reduce knee pain by adjusting the mechanics of gait with braces and orthotics. In addition, they are experts in knee nutrition.

HERBAL MEDICINE

Although you may think of herbal remedies as an old-fashioned or "New Age" alternative, the truth is that 25 percent of all prescription drugs are based on herbs and 74 percent of those use herbs in the same way that native cultures used them as plant medicines.

Interest in herbal medicine has greatly increased in recent years. Pharmaceutical companies haven't promoted the use of herbs, because herbs can't be patented, and this greatly limits the revenue to be gained from them. However, the federal Dietary Supplement Health and Education Act of 1994 eased Federal Drug Administration restrictions on herbs and all natural, nondrug supplements. Consequently, mainstream distributors such as One A Day have created their own lines of herbal supplements, and these have stimulated public interest and awareness.

Herbs may or may not offer the same rapid relief as pharmaceutical drugs, but when properly administered they may offer a healthful, gentle way to relieve a number of conditions.

For knee problems, anti-inflammatory herbs may be an excellent alternative to drugs, particularly for treating chronic conditions, because long-term use of NSAIDs can damage the stomach, kidneys, and liver. By taking a whole-body approach, focusing not just on relief of your pain but also on the health of all your organs, you simultaneously reduce your symptoms of swelling, reduce the resultant pain, and reduce the stomach irritation and other problems related to traditional anti-inflammatories. An herbal anti-inflammatory such as Saint-John's-wort, which has mild pain-relieving and sedative properties, can also help ease the depression that accompanies chronic physical problems. Kava kava (from the plant Piper methysticum) may also be useful to reduce pain-driven anxiety.