Knee Pain and Homoeopathy

Dr. Rajneesh Kumar Sharma

Homoeo Cure & Research Centre P. Ltd.

NH 74- Moradabad Raod, Kashipur

Uttaranchal – INDIA - 244713

Article outline-

Introduction- Key words- Knee anatomy- Common knee disorders and their miasmatic analysis- Homoeopathic Treatment

Introduction

Knee joint pain is a very common complaint, being not only uncomfortable but causing lot of anxiety. It is often associated with ageing process but no age is immune. To study knee pain, one must be acquainted with anatomy of knee joint.

Key words-

Osteoarthrosis-

This is the form of arthritis characterized by erosion of articular cartilage, either primary or secondary to trauma or other conditions. The articular cartilage becomes soft, frayed, and thinned with eburnation of subchondral bone and outgrowths of marginal osteophytes. It results in pain and loss of function and mainly affects weight-bearing joints. It is more common in older persons.

Rheumatoid arthritis-

It is a systemic disease, occurring more often in women, which affects connective tissue. Arthritis is the dominant clinical manifestation, involving many joints, especially those of the hands and feet, accompanied by thickening of articular soft tissue, with extension of synovial tissue over articular cartilages, which become eroded. Its course is variable but often is chronic and progressive and it often leads to deformities and disability.

Ankylosing spondylitis-

This is the arthritis of the spine, resembling rheumatoid arthritis that may progress to bony ankylosis with lipping of vertebral margins. This disease is more common in the male often with the rheumatoid factor absent and the HLA antigen present. There is a striking association with the B27 tissue type and the strong familial aggregation suggest an important genetic factor, perhaps inherited as an autosomal dominant, the mechanism, however, remains obscure.

Psoriatic arthritis-

It is the concurrence of psoriasis and polyarthritis, resembling rheumatoid arthritis but thought to be a specific disease entity, seronegative for rheumatoid factor and often involving the digits.

Rickets-

It is a disease due to vitamin-D deficiency and characterized by overproduction and deficient calcification of osteoid tissue. It is associated with skeletal deformities, disturbances in growth, hypocalcemia, and sometimes tetany. It is usually accompanied by irritability, listlessness, and generalized muscular weakness. In this disese, fractures are frequent.

Osteoporosis-

This is a condition of reduced bone mass, with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition). It results in increased fracture incidence. Osteoporosis is classified as primary (Type 1- postmenopausal osteoporosis; Type 2- age-associated osteoporosis; and idiopathic, which can affect juveniles, premenopausal women, and middle-aged men) and secondary osteoporosis (which results from an identifiable cause of bone mass loss).

Gout-

It is a disorder of purine metabolism, occurring especially in men, characterized by a raised but variable blood uric acid level and severe recurrent acute arthritis of sudden onset resulting from deposition of crystals of sodium urate in connective tissues and articular cartilage. The most cases are inherited, resulting from a variety of abnormalities of purine metabolism. The familial aggregation is for the most part galtonian with a threshold of expression determined by the solubility of uric acid. However, gout is a feature of the Lesch-Nyhan syndrome an X-linked disorder.

Osteomalacia-

It is also called as adult rickets. It is a disease characterized by gradual softening and bending of the bones with varying severity of pain. The softening occurs because the bones contain osteoid tissue which has failed to calcify due to lack of vitamin D or renal tubular dysfunction. It is more common in women than in men. Osteomalacia often begins during pregnancy.

Paget’s Disease-

It is a generalized skeletal disease, frequently familial, of older persons in which bone resorption and formation are both increased, leading to thickening and softening of bones (e.g., the skull), and bending of weight-bearing bones.

Pseudogout-

Acute episodes of synovitis caused by deposits of calcium pyrophosphate crystals rather than urate crytals as in true gout; associated with articular chondrocalcinosis is called as pseudogout.

Tibia vara or Genu varum -

It is a deformity marked by medial angulation of the leg in relation to the thigh or an outward bowing of the legs.

Genu valgum or Knock knees -

It is a deformity marked by lateral angulation of the leg in relation to the thigh.

Tumours of Knee-

These may be benign or malignant. Malignant ones may be metastatic. viz. osteosarcoma, Eving’s sarcoma etc.

Anatomy of the Knee Joint

Articular Surfaces

The articular surfaces are most incongruent.

The femoral condyles, bearing articular cartilage, are almost wholly convex.
The tibial surfaces are also cartilage-covered areas, separated by the intercondylar region. Each region is gently hollow centrally and flattened peripherally where the meniscus rests.
The lateral tibial articular surface is almost circular and smaller and the medial oval.
Patella is the largest seasamoid bone in the body. Its articular surface is adapted to the femoral surface which extends onto the anterior surfaces of both condyles like an inverted U. As the knee extends, the middle patellar facets contact the lower half of the femoral surface; in full extension only the lowest patellar facets are in contact with the femur. Ligaments of the joint are the patellar ligament (ligamentum (tendo) patellae), tibial and fibular collateral, oblique and arcuate popliteal, anterior and posterior cruciate and transverse ligaments.

Fibrous Capsule

The fibrous capsule is complex, partly deficient and partly augmented by expansions from adjacent tendons. Internally the capsule is attached to the meniscal rims, connecting them to the tibia by short coronary ligaments.

Synovial Membrane

It is the connective tissue membrane that lines the cavity of a synovial joint and produces the synovial fluid; it lines all internal surfaces of the cavity except for the articular cartilage of the bones. The synovial membrane of the knee is the most extensive and complex in the body.

Bursae

Bursae associated with the knee are numerous.

Anteriorly there are:

A large subcutaneous prepatellar bursa between the lower patella and skin.
A small deep infrapatellar bursa between the tibia and patellar ligament.
A subcutaneous infrapatellar bursa between the distal part of the tibial tuberosity and skin.
A large suprapatellar bursa between the femur and quadriceps femoris.

Laterally there are:

A bursa between the lateral head of gastrocnemius and joint capsule (sometimes continuous with the joint).
One between the fibular collateral ligament and the tendon of biceps femoris.
One also between the fibular collateral ligament and the tendon of popliteus.
One between the tendon of popliteus and the lateral femoral condyle, usually an extension from the joint.

Medially there are:

A bursa between the medial head of gastrocnemius and fibrous capsule.
A bursa between the tibial collateral ligament and the tendons of sartorius, gracilis and semitendinosus.
Variable bursae, in number and position, deep to the tibial collateral ligament between the capsule, femur, medial meniscus, tibia or tendon of semimembranosus.
A bursa between the tendon of semimembranosus and the medial tibial condyle and also the medial head of gastrocnemius (the semimembranosus bursa).
An occasional bursa between the tendons of semimembranosus and semitendinosus.

Posteriorly, bursae are variable.

The ligaments of the knee

The cruciate, collateral, posterior and capsular ligaments and the menisci form an integrated stabilising system which prevents the tibia from shifting or tilting under the femur in an abnormal fashion.

Patellar Ligament (Ligamentum Patella)

This is the central band of the tendon of quadriceps femoris, continued distally from the patella to the tibial tuberosity. It is strong, flat, about 8 cm in length, attached-

Proximally to the apex, adjoining margins and to rough areas on the anterior surface and on the depression on the distal posterior patellar surface, and
Distally to the superior smooth area of the tibial tuberosity.
The patellar ligament is separated from the synovial membrane by a large infrapatellar fat pad and from the tibia by a bursa.

Oblique Popliteal Ligament

It expands from the tendon of semimembranosus, blends partly with the capsule and ascends laterally to the lateral part of the intercondylar line and lateral femoral condyle. It is in the floor of the popliteal fossa with the popliteal artery in contact.

Arcuate Popliteal Ligament

It is Y-shaped mass of capsular fibres, having a stem attached to the head of the fibula.

Tibial Collateral Ligament

It is a broad flat band nearer the back of the joint. It extends from the medial femoral epicondyle, immediately distal to the adductor tubercle, to the medial meniscus, tibial condyle and adjacent shaft.

Fibular Collateral Ligament

It is a strong cord, attached to the lateral femoral epicondyle, proximal to the popliteal groove. It extends to the fibular head in front of its apex. The ligament is not attached to the lateral meniscus.

Cruciate Ligaments

They are very strong and sited a little posterior to the articular centre. They are termed cruciate because they cross, anterior and posterior from their tibial attachments. This are-

The Anterior Cruciate Ligament, attached medially to the anterior intercondylar area of the tibia partly blending with the anterior horn of the lateral meniscus.
The Posterior Cruciate Ligament, stronger, less oblique with some shorter fibres, attached to the posterior intercondylar area and posterior horn of the lateral meniscus.

Transverse Ligament

It connects the anterior convex margin of the lateral to the anterior horn of the medial meniscus; it varies in thickness and may be absent.

Menisci

The menisci (semilunar cartilages) are crescentic laminae deepening the articulation of the tibia which receives the femur. Their peripheral attached borders are thick and convex; their free borders are thin and concave. The proximal surfaces are smooth and concave, in contact with the articular cartilage on the femoral condyles, while their distal surfaces are smooth and flat, resting on the tibial articular cartilage.

Menisci probably assist lubrication, facilitate combined sliding, rolling and spinning, and may cushion extremes of flexion and extension. Menisci are-

Medial Meniscus- Broader behind, it is almost a semicircle.
Lateral Meniscus- About four-fifths of a circle and covers a larger area than the medial meniscus.

Vessels and Nerve Supply to the Joint

Arteries supplying the joint are-

the descending genicular branches of the femoral
superior, middle and inferior genicular branches of the popliteal
anterior and posterior recurrent branches of anterior tibial
the circumflex fibular artery and
the descending branch of the lateral circumflex femoral.

Nerves are from the-

Obturator
Femoral
tibial and
Common peroneal nerves.

The extensor mechanism of the knee

Extension of the knee is produced by the quadriceps muscle acting through the quadriceps ligament, patella, patellar ligament and tibial tubercle.

Weakness of extension- It leads to instability, repeated joint trauma and effusion. There is often a vicious circle of pain-

→quadriceps inhibition →quadriceps wasting →knee instability →ligament stretching and further injury →pain.

Loss of full extension- It also leads to instability, as there is failure of the screw-home mechanism. Rapid wasting of the quadriceps is seen in all painful and inflammatory conditions of the knee.

Weakness of the quadriceps is also sometimes found in lesions of the upper lumbar intervertebral discs, as a sequel to poliomyelitis, in multiple sclerosis and other neurological disorders, and in the myopathies. Quadriceps wasting may be the presenting feature of a diabetic neuropathy or secondary to femoral nerve palsy from an iliacus haematoma.

The term ‘jumper’s knee’ is used to describe a number of conditions where there is pain in the patellar ligament or its insertion: it includes the -

Sinding–Larsen–Johansson syndrome- seen in children in the 10–14 age group, where there are X-ray changes in the distal pole of the patella.

Osgood Schlatter’s disease- (often thought to be due to a partial avulsion of the tibial tuberosity) which occurs in the 10–16 age group. In it there is recurrent pain over the tibial tuberosity, which becomes tender and prominent. Radiographs may show partial detachment or fragmentation. Pain generally ceases with closure of the epiphysis. In an older age group (16–30) the patellar ligament itself may become painful and tender. This almost invariably occurs in athletes, and there may be a history of giving-way of the knee. CT scans may show changes in the patellar ligament, the centre of which becomes expanded.

Following table summarizes the main causes of knee joint pain.

Common causes of knee pain

Type of Lesion	Diagnosis	Miasm
		Psora	Sycosis	Syphilis	Pseudopsora	Cancerous
Degenerative	Osteoarthrosis	+	++	+++		+

Traumatic (Post Injury)	Knee sprain	++	+
	Meniscal Injury	++	+
	Ligament Injury	++	+
	Fracture	++	+
	Dislocations	+++		+
	Overuse Injury	++	+++			+

Rheumatological	Rheumatoid Arthritis	+	++	+		+
	Ankylosing Spondylitis	+	++++	++		++
	Psoriatic Arthritis	++	+++	+

Infections	Tuberculous	+	+	+	+++
	Bacterial	+	+	++	+

Metabolic Disorders	Rickets	+		+++	+
	Osteoporosis	+		++++	+
	Gout	++	+++			++
	Osteomalacia			+++	+	+
	Steroid induced	++	++	+		+++
	Pagets disease	+	+	+	+	++++
	Pseudogout	+	+

Haemoglobinopathies	Bleeding disorders	++		++	+
	Haemophillia	+	+	+++

Congenital anomalies	Tibia Vara (Bow-legs)	+	++	+++		+
	Genu varum (Bow-legs)	+	++	+++		+
	Genu Valgum (Knock knees)	+	+	+++		+

Tumors (Bony/Synovial)	Benign	+	+++		++
	Malignant	+	+++	++		+++
	Metastatic	++	+++	+		++++

Homoeopathic Treatment-

The symptoms with Knee Pain in various repertories-

1	Clarke J. H., Clinical Repertory (English) - Clinical - K - knee - pain in	4
2	LOWER EXTREMITIES - Breaking, brittle; pain as if - joints - knee	4
3	LOWER EXTREMITIES - Bruised - pain - joints - knee	24
4	LOWER EXTREMITIES - Burrowing or rooting pain - knee joints	3
5	LOWER EXTREMITIES - Fatigue, pain as from - joints - knee	15
6	LOWER EXTREMITIES - Fatigue, pain as from - sense of - joints - knee	22
7	LOWER EXTREMITIES - Gout-like pain - joints - knee	2
8	LOWER EXTREMITIES - Laming pain - joints - knee	20
9	LOWER EXTREMITIES - Pain, simple - joints - knee	16
10	LOWER EXTREMITIES - Rheumatic pain - knee joints	2
11	LOWER EXTREMITIES - Sprained or dislocative pain, as if - joints - knee	27
12	LOWER EXTREMITIES - Thrusting pain - knee joint	4
13	SENSATIONS AND COMPLAINTS IN GENERAL - Sprains and dislocations - pain - in joints - knee	1
14	SLEEP - Falling to sleep, late - prevented by - knee, pain in	1
15	CHILL - Chill, etc. - concomitants - lower extremities - knee, pain in	8
16	HEAT AND FEVER IN GENERAL - Concomitants - lower extremities - lower extremities - knees - pain in	11
17	SWEAT - Concomitants - lower extremities - knees - pain in	21
18	K - Knees - itching - pain, with	1
19	Pathogenetic - Knees painful	1
20	Pathogenetic - Pains knee	1
21	ABDOMEN - Colic pain - amelioration - from - lying with knees drawn up	1
22	LOCOMOTOR SYSTEM - Knees - Pains - Digging, in left knee	6
23	LOCOMOTOR SYSTEM - Knees - Popliteal space - Pain	4
24	FEVER - Chill - Concomitants - Pain in - knees, ankles, wrists, hypogastrium	1
25	HEAD - PAIN - Temples - right - alternating with - Knee; pain in right	2
26	HEAD - PAIN - Temples - left - alternating with - Knee; pain in right	1
27	THROAT - PAIN - swallowing - head forward and lift up knee; has to bend	1
28	ABDOMEN - PAIN - bending - forward - amel. - knees drawn up; with	1
29	ABDOMEN - PAIN - lying - back; on - amel. - knees drawn up; with	3
30	ABDOMEN - PAIN - Iliac region - extending to - Knee	1
31	ABDOMEN - PAIN - Ilium - Crest of ileum - extending to - Knee	1
32	ABDOMEN - PAIN - Inguinal region - extending to - Knee	5
33	ABDOMEN - PAIN - Inguinal region - extending to - Knee - drawing pain	1
34	ABDOMEN - PAIN - extending to - Knee	1
35	KIDNEYS - PAIN - swelling of right knee, with	1
36	KIDNEYS - PAIN - extending to - Knee	3
37	KIDNEYS - PAIN - extending to - Knee - stitching pain	3
38	MALE GENITALIA/SEX - PAIN - Testes - lying - back; on - amel. - knees drawn up; with	1
39	MALE GENITALIA/SEX - PAIN - Testes - lying - back; on - amel. - knees drawn up; with - drawing pain	1
40	FEMALE GENITALIA/SEX - PAIN - labor pains - extending to - Knees and up to sacrum	1
41	FEMALE GENITALIA/SEX - PAIN - lying - back; on - agg. - separating knees as far as possible; and	1
42	FEMALE GENITALIA/SEX - PAIN - Ovaries - extending to - Knees	2
43	FEMALE GENITALIA/SEX - PAIN - Ovaries - extending to - Knees - stitching pain	2
44	FEMALE GENITALIA/SEX - PAIN - Ovaries - extending to - Thighs - Inner surface - Down knee; and	1
45	FEMALE GENITALIA/SEX - PAIN - Uterus - extending to - Knees	1
46	FEMALE GENITALIA/SEX - PAIN - Uterus - extending to - Knees - stitching pain	1
47	BACK - PAIN - extending to - Knees	3
48	BACK - PAIN - extending to - Knees - stitching pain	1
49	BACK - PAIN - Lumbar region - drawing up knees - amel. - pressing pain	1
50	BACK - PAIN - Lumbar region - elbows and knees amel.; on	1
51	BACK - PAIN - Lumbar region - extending to - Knee	9
52	BACK - PAIN - Lumbar region - extending to - Knee - stitching pain	2
53	EXTREMITIES - ERUPTIONS - Knees - painful	1
54	EXTREMITIES - GIVE WAY - Knees - accompanied by - Head pain	1
55	EXTREMITIES - ITCHING - Knees - painful after scratching	1
56	EXTREMITIES - LIMPING - pain in knee; from	1
57	EXTREMITIES - PAIN - Ankles - extending to - Knee	5
58	EXTREMITIES - PAIN - Ankles - extending to - Knee - drawing pain	1
59	EXTREMITIES - PAIN - Ankles - extending to - Knee - shooting pain	1
60	EXTREMITIES - PAIN - Ankles - extending to - Knee - stitching pain	1
61	EXTREMITIES - PAIN - Ankles - extending to - Knee - tearing pain	4
62	EXTREMITIES - PAIN - Elbows - aching - alternating with - Knees; pain in	1
63	EXTREMITIES - PAIN - Elbows - alternating with - Knees; pain in	1
64	EXTREMITIES - PAIN - Feet - jumping to knee	1
65	EXTREMITIES - PAIN - Feet - jumping to knee - pressing pain	1
66	EXTREMITIES - PAIN - Feet - extending to - Knee	9
67	EXTREMITIES - PAIN - Feet - extending to - Knee - drawing pain	2
68	EXTREMITIES - PAIN - Feet - extending to - Knee - shooting pain	1
69	EXTREMITIES - PAIN - Feet - extending to - Knee - stitching pain	2
70	EXTREMITIES - PAIN - Feet - extending to - Knee - tearing pain	2
71	EXTREMITIES - PAIN - Feet - Soles - extending to - Knees	2
72	EXTREMITIES - PAIN - Feet - Soles - extending to - Knees; above	2
73	EXTREMITIES - PAIN - Feet - Soles - extending to - Knees; above - tearing pain	2
74	EXTREMITIES - PAIN - Forearms - right - and left knee	1
75	EXTREMITIES - PAIN - Hips - left - extending to - Knee	1
76	EXTREMITIES - PAIN - Hips - left - extending to - Knee - cutting pain	1
77	EXTREMITIES - PAIN - Hips - extending to - Knee	34
78	EXTREMITIES - PAIN - Hips - extending to - Knee - cough agg.; during - tearing pain	1
79	EXTREMITIES - PAIN - Hips - extending to - Knee - cutting pain	1
80	EXTREMITIES - PAIN - Hips - extending to - Knee - drawing pain	2
81	EXTREMITIES - PAIN - Hips - extending to - Knee - shooting pain	2
82	EXTREMITIES - PAIN - Hips - extending to - Knee - stitching pain	9
83	EXTREMITIES - PAIN - Hips - extending to - Knee - tearing pain	11
84	EXTREMITIES - PAIN - Hips - extending to - Knee - Hollow of knee	1
85	EXTREMITIES - PAIN - Hips - Trochanter - extending to - Knee; hollow of	1
86	EXTREMITIES - PAIN - Hips - Trochanter - extending to - Knee; hollow of - shooting pain	1
87	EXTREMITIES - PAIN - Knees	379
88	EXTREMITIES - PAIN - Knees - alternating sides - drawing pain	3
89	EXTREMITIES - PAIN - Knees - alternating sides - tearing pain	3
90	EXTREMITIES - PAIN - Knees - right - accompanied by - left hand; pain in	1
91	EXTREMITIES - PAIN - Knees - right - boring pain	1
92	EXTREMITIES - PAIN - Knees - right - dull pain	1
93	EXTREMITIES - PAIN - Knees - right - followed by - left knee	3
94	EXTREMITIES - PAIN - Knees - right - stitching pain	1
95	EXTREMITIES - PAIN - Knees - right - tearing pain	8
96	EXTREMITIES - PAIN - Knees - left - boring pain	7
97	EXTREMITIES - PAIN - Knees - left - cutting pain	2
98	EXTREMITIES - PAIN - Knees - left - drawing pain	7
99	EXTREMITIES - PAIN - Knees - left - dull pain	2
100	EXTREMITIES - PAIN - Knees - left - pressing pain	1
101	EXTREMITIES - PAIN - Knees - left - shooting pain	1
102	EXTREMITIES - PAIN - Knees - left - stitching pain	10
103	EXTREMITIES - PAIN - Knees - left - tearing pain	7
104	EXTREMITIES - PAIN - Knees - morning - 4-8 h - stitching pain	1
105	EXTREMITIES - PAIN - Knees - morning - bed agg.; in - drawing pain	1
106	EXTREMITIES - PAIN - Knees - morning - bed agg.; in - tearing pain	1
107	EXTREMITIES - PAIN - Knees - morning - drawing pain	4
108	EXTREMITIES - PAIN - Knees - morning - motion agg. - stitching pain	1
109	EXTREMITIES - PAIN - Knees - morning - rising - after - agg. - drawing pain	1
110	EXTREMITIES - PAIN - Knees - morning - rising - after - agg. - stitching pain	4
111	EXTREMITIES - PAIN - Knees - morning - rising - agg. - tearing pain	1
112	EXTREMITIES - PAIN - Knees - morning - sitting agg. - stitching pain	1
113	EXTREMITIES - PAIN - Knees - morning - stitching pain	9
114	EXTREMITIES - PAIN - Knees - morning - tearing pain	3
115	EXTREMITIES - PAIN - Knees - morning - walking agg. - stitching pain	1
116	EXTREMITIES - PAIN - Knees - forenoon - drawing pain	2
117	EXTREMITIES - PAIN - Knees - forenoon - stitching pain	4
118	EXTREMITIES - PAIN - Knees - noon - riding agg. - stitching pain	1
119	EXTREMITIES - PAIN - Knees - noon - tearing pain	1
120	EXTREMITIES - PAIN - Knees - afternoon - 13 h - tearing pain	1
121	EXTREMITIES - PAIN - Knees - afternoon - 14 h - tearing pain	1
122	EXTREMITIES - PAIN - Knees - afternoon - 15 h - tearing pain	1
123	EXTREMITIES - PAIN - Knees - afternoon - 16 h - tearing pain	1
124	EXTREMITIES - PAIN - Knees - afternoon - 16 h - walking agg. - stitching pain	1
125	EXTREMITIES - PAIN - Knees - afternoon - 17 h - tearing pain	1
126	EXTREMITIES - PAIN - Knees - afternoon - drawing pain	11
127	EXTREMITIES - PAIN - Knees - afternoon - sleep agg.; after - drawing pain	1
128	EXTREMITIES - PAIN - Knees - afternoon - tearing pain	4
129	EXTREMITIES - PAIN - Knees - evening - 19 h - drawing pain	1
130	EXTREMITIES - PAIN - Knees - evening - 21 h - drawing pain	1
131	EXTREMITIES - PAIN - Knees - evening - 21 h - stitching pain	1
132	EXTREMITIES - PAIN - Knees - evening - bed agg.; in - stitching pain	1
133	EXTREMITIES - PAIN - Knees - evening - boring pain	2
134	EXTREMITIES - PAIN - Knees - evening - drawing pain	8
135	EXTREMITIES - PAIN - Knees - evening - lying - after - agg. - tearing pain	2
136	EXTREMITIES - PAIN - Knees - evening - lying - agg. - stitching pain	2
137	EXTREMITIES - PAIN - Knees - evening - pressing pain	4
138	EXTREMITIES - PAIN - Knees - evening - sitting agg. - pressing pain	2
139	EXTREMITIES - PAIN - Knees - evening - stitching pain	12
140	EXTREMITIES - PAIN - Knees - evening - tearing pain	15
141	EXTREMITIES - PAIN - Knees - evening - walking - amel. - tearing pain	1
142	EXTREMITIES - PAIN - Knees - night - 22 h - stitching pain	1
143	EXTREMITIES - PAIN - Knees - night - midnight - tearing pain	1
144	EXTREMITIES - PAIN - Knees - night - bed agg.; in - tearing pain	8
145	EXTREMITIES - PAIN - Knees - night - boring pain	2
146	EXTREMITIES - PAIN - Knees - night - cutting pain	1
147	EXTREMITIES - PAIN - Knees - night - drawing pain	5
148	EXTREMITIES - PAIN - Knees - night - gnawing pain	2
149	EXTREMITIES - PAIN - Knees - night - shooting pain	2
150	EXTREMITIES - PAIN - Knees - night - stitching pain	8
151	EXTREMITIES - PAIN - Knees - night - stretching agg. - boring pain	1
152	EXTREMITIES - PAIN - Knees - night - tearing pain	4
153	EXTREMITIES - PAIN - Knees - night - waking; on - pressing pain	1
154	EXTREMITIES - PAIN - Knees - aching - wandering pain	1
155	EXTREMITIES - PAIN - Knees - air; in open - agg. - drawing pain	1
156	EXTREMITIES - PAIN - Knees - air; in open - agg. - tearing pain	2
157	EXTREMITIES - PAIN - Knees - alternating with - Elbow; pain in	1
158	EXTREMITIES - PAIN - Knees - appearing suddenly - disappearing suddenly; and - stitching pain	1
159	EXTREMITIES - PAIN - Knees - appearing suddenly - stitching pain	3
160	EXTREMITIES - PAIN - Knees - arthritic - drawing pain	1
161	EXTREMITIES - PAIN - Knees - ascending - agg. - drawing pain	1
162	EXTREMITIES - PAIN - Knees - ascending - stairs - agg. - cutting pain	1
163	EXTREMITIES - PAIN - Knees - ascending - stairs - agg. - shooting pain	1
164	EXTREMITIES - PAIN - Knees - ascending - stairs - agg. - stitching pain	5
165	EXTREMITIES - PAIN - Knees - bed - going to bed - before - tearing pain	1
166	EXTREMITIES - PAIN - Knees - bed - in bed - agg. - drawing pain	1
167	EXTREMITIES - PAIN - Knees - bed - in bed - agg. - stitching pain	1
168	EXTREMITIES - PAIN - Knees - bed - in bed - agg. - tearing pain	1
169	EXTREMITIES - PAIN - Knees - bending - agg. - drawing pain	2
170	EXTREMITIES - PAIN - Knees - bending - agg. - pressing pain	2
171	EXTREMITIES - PAIN - Knees - bending - agg. - stitching pain	4
172	EXTREMITIES - PAIN - Knees - blow; pain as from a	4
173	EXTREMITIES - PAIN - Knees - boring pain	27
174	EXTREMITIES - PAIN - Knees - boring pain - wandering pain	1
175	EXTREMITIES - PAIN - Knees - chill - during - stitching pain	2
176	EXTREMITIES - PAIN - Knees - cold agg.; becoming - tearing pain	8
177	EXTREMITIES - PAIN - Knees - cough agg.; during - shooting pain	1
178	EXTREMITIES - PAIN - Knees - cough agg.; during - stitching pain	1
179	EXTREMITIES - PAIN - Knees - crossing legs agg. - drawing pain	2
180	EXTREMITIES - PAIN - Knees - crossing legs agg. - tearing pain	1
181	EXTREMITIES - PAIN - Knees - cutting pain	28
182	EXTREMITIES - PAIN - Knees - descending stairs agg. - cutting pain	1
183	EXTREMITIES - PAIN - Knees - descending stairs agg. - shooting pain	1
184	EXTREMITIES - PAIN - Knees - descending stairs agg. - stitching pain	1
185	EXTREMITIES - PAIN - Knees - dinner - after - agg. - tearing pain	3
186	EXTREMITIES - PAIN - Knees - dinner - amel. - tearing pain	1
187	EXTREMITIES - PAIN - Knees - drawing pain	141
188	EXTREMITIES - PAIN - Knees - drawing pain - boring pain	1
189	EXTREMITIES - PAIN - Knees - drawing pain - jerking pain	1
190	EXTREMITIES - PAIN - Knees - drawing pain - stitching pain	4
191	EXTREMITIES - PAIN - Knees - drawing pain - tearing pain	3
192	EXTREMITIES - PAIN - Knees - dull pain	4
193	EXTREMITIES - PAIN - Knees - eating; after - tearing pain	1
194	EXTREMITIES - PAIN - Knees - gnawing pain	8
195	EXTREMITIES - PAIN - Knees - gouty - drawing pain	3
196	EXTREMITIES - PAIN - Knees - grasping pain	2
197	EXTREMITIES - PAIN - Knees - jerking pain	13
198	EXTREMITIES - PAIN - Knees - kneeling agg. - shooting pain	1
199	EXTREMITIES - PAIN - Knees - kneeling agg. - stitching pain	3
200	EXTREMITIES - PAIN - Knees - lying - agg. - boring pain	1
201	EXTREMITIES - PAIN - Knees - lying - agg. - drawing pain	2
202	EXTREMITIES - PAIN - Knees - lying - agg. - tearing pain	1
203	EXTREMITIES - PAIN - Knees - lying down - after - amel. - tearing pain	2
204	EXTREMITIES - PAIN - Knees - menses; during - drawing pain	1
205	EXTREMITIES - PAIN - Knees - motion - agg. - boring pain	1
206	EXTREMITIES - PAIN - Knees - motion - agg. - cutting pain	1
207	EXTREMITIES - PAIN - Knees - motion - agg. - drawing pain	3
208	EXTREMITIES - PAIN - Knees - motion - agg. - pressing pain	5
209	EXTREMITIES - PAIN - Knees - motion - agg. - shooting pain	3
210	EXTREMITIES - PAIN - Knees - motion - agg. - stitching pain	13
211	EXTREMITIES - PAIN - Knees - motion - agg. - tearing pain	8
212	EXTREMITIES - PAIN - Knees - motion - amel. - boring pain	2
213	EXTREMITIES - PAIN - Knees - motion - amel. - drawing pain	5
214	EXTREMITIES - PAIN - Knees - motion - amel. - pressing pain	8
215	EXTREMITIES - PAIN - Knees - motion - amel. - stitching pain	11
216	EXTREMITIES - PAIN - Knees - motion - amel. - tearing pain	9
217	EXTREMITIES - PAIN - Knees - motion - backward and forward - amel. - stitching pain	1
218	EXTREMITIES - PAIN - Knees - periodical - drawing pain	1
219	EXTREMITIES - PAIN - Knees - pinching pain	6
220	EXTREMITIES - PAIN - Knees - pressing pain	73
221	EXTREMITIES - PAIN - Knees - pressing pain - constricting pain	4
222	EXTREMITIES - PAIN - Knees - pressing pain - drawing pain	2
223	EXTREMITIES - PAIN - Knees - pressing pain - tearing pain	1
224	EXTREMITIES - PAIN - Knees - pressure - agg. - cutting pain	1
225	EXTREMITIES - PAIN - Knees - pressure - agg. - shooting pain	1
226	EXTREMITIES - PAIN - Knees - pressure - agg. - tearing pain	2
227	EXTREMITIES - PAIN - Knees - pressure - amel. - pressing pain	1
228	EXTREMITIES - PAIN - Knees - pressure - amel. - tearing pain	1
229	EXTREMITIES - PAIN - Knees - pulsating pain	4
230	EXTREMITIES - PAIN - Knees - putting foot upon the floor - drawing pain	1
231	EXTREMITIES - PAIN - Knees - rheumatic - drawing pain	4
232	EXTREMITIES - PAIN - Knees - rheumatic - stitching pain	5
233	EXTREMITIES - PAIN - Knees - rheumatic - tearing pain	5
234	EXTREMITIES - PAIN - Knees - riding a bicycle - cutting pain	1
235	EXTREMITIES - PAIN - Knees - rising - after - agg. - drawing pain	1
236	EXTREMITIES - PAIN - Knees - rising - sitting; from - agg. - drawing pain	3
237	EXTREMITIES - PAIN - Knees - rising - sitting; from - agg. - stitching pain	3
238	EXTREMITIES - PAIN - Knees - rising - sitting; from - agg. - tearing pain	3
239	EXTREMITIES - PAIN - Knees - rising - sitting; from - amel. - tearing pain	1
240	EXTREMITIES - PAIN - Knees - rubbing - amel. - stitching pain	1
241	EXTREMITIES - PAIN - Knees - rubbing - amel. - tearing pain	7
242	EXTREMITIES - PAIN - Knees - scraping pain	2
243	EXTREMITIES - PAIN - Knees - shooting pain	21
244	EXTREMITIES - PAIN - Knees - sitting - agg. - boring pain	6
245	EXTREMITIES - PAIN - Knees - sitting - agg. - drawing pain	16
246	EXTREMITIES - PAIN - Knees - sitting - agg. - pressing pain	16
247	EXTREMITIES - PAIN - Knees - sitting - agg. - stitching pain	11
248	EXTREMITIES - PAIN - Knees - sitting - agg. - tearing pain	16
249	EXTREMITIES - PAIN - Knees - sitting - amel. - drawing pain	2
250	EXTREMITIES - PAIN - Knees - sitting - amel. - shooting pain	1
251	EXTREMITIES - PAIN - Knees - sitting - amel. - stitching pain	3
252	EXTREMITIES - PAIN - Knees - sitting - amel. - tearing pain	1
253	EXTREMITIES - PAIN - Knees - sleep; preventing - tearing pain	2
254	EXTREMITIES - PAIN - Knees - standing - agg. - drawing pain	8
255	EXTREMITIES - PAIN - Knees - standing - agg. - pressing pain	1
256	EXTREMITIES - PAIN - Knees - standing - agg. - shooting pain	2
257	EXTREMITIES - PAIN - Knees - standing - agg. - stitching pain	9
258	EXTREMITIES - PAIN - Knees - standing - agg. - tearing pain	6
259	EXTREMITIES - PAIN - Knees - standing - amel. - drawing pain	1
260	EXTREMITIES - PAIN - Knees - standing - amel. - tearing pain	1
261	EXTREMITIES - PAIN - Knees - standing - sitting agg.; after - stitching pain	1
262	EXTREMITIES - PAIN - Knees - starting on falling asleep, from stitches - stitching pain	1
263	EXTREMITIES - PAIN - Knees - stepping - agg. - drawing pain	1
264	EXTREMITIES - PAIN - Knees - stepping - agg. - stitching pain	1
265	EXTREMITIES - PAIN - Knees - stepping - agg. - tearing pain	2
266	EXTREMITIES - PAIN - Knees - stitching pain	175
267	EXTREMITIES - PAIN - Knees - stitching pain - boring pain	1
268	EXTREMITIES - PAIN - Knees - stitching pain - shooting pain	1
269	EXTREMITIES - PAIN - Knees - stitching pain - tearing pain	5
270	EXTREMITIES - PAIN - Knees - stretching - agg. - boring pain	1
271	EXTREMITIES - PAIN - Knees - stretching - agg. - drawing pain	2
272	EXTREMITIES - PAIN - Knees - stretching - agg. - stitching pain	4
273	EXTREMITIES - PAIN - Knees - stretching - amel. - drawing pain	3
274	EXTREMITIES - PAIN - Knees - stretching - amel. - stitching pain	1
275	EXTREMITIES - PAIN - Knees - stretching out - tearing pain	1
276	EXTREMITIES - PAIN - Knees - sudden - pressing pain	1
277	EXTREMITIES - PAIN - Knees - sudden - tearing pain	2
278	EXTREMITIES - PAIN - Knees - supper agg.; after - tearing pain	1
279	EXTREMITIES - PAIN - Knees - supporting body with knee	1
280	EXTREMITIES - PAIN - Knees - supporting body with knee - drawing pain	1
281	EXTREMITIES - PAIN - Knees - swelling - drawing pain	1
282	EXTREMITIES - PAIN - Knees - tearing pain	126
283	EXTREMITIES - PAIN - Knees - tearing pain - boring pain	2
284	EXTREMITIES - PAIN - Knees - tearing pain - drawing pain	6
285	EXTREMITIES - PAIN - Knees - tearing pain - jerking pain	1
286	EXTREMITIES - PAIN - Knees - tearing pain - wandering pain	1
287	EXTREMITIES - PAIN - Knees - thunderstorm; during - stitching pain	1
288	EXTREMITIES - PAIN - Knees - touch agg. - pressing pain	1
289	EXTREMITIES - PAIN - Knees - touch agg. - stitching pain	4
290	EXTREMITIES - PAIN - Knees - touch agg. - tearing pain	1
291	EXTREMITIES - PAIN - Knees - ulcerative pain	2
292	EXTREMITIES - PAIN - Knees - waking; on - drawing pain	1
293	EXTREMITIES - PAIN - Knees - walking - after - agg. - pressing pain	1
294	EXTREMITIES - PAIN - Knees - walking - after - agg. - tearing pain	2
295	EXTREMITIES - PAIN - Knees - walking - after - amel. - drawing pain	2
296	EXTREMITIES - PAIN - Knees - walking - agg. - boring pain	1
297	EXTREMITIES - PAIN - Knees - walking - agg. - cutting pain	4
298	EXTREMITIES - PAIN - Knees - walking - agg. - drawing pain	19
299	EXTREMITIES - PAIN - Knees - walking - agg. - pressing pain	8
300	EXTREMITIES - PAIN - Knees - walking - agg. - shooting pain	3
301	EXTREMITIES - PAIN - Knees - walking - agg. - stitching pain	28
302	EXTREMITIES - PAIN - Knees - walking - agg. - tearing pain	15
303	EXTREMITIES - PAIN - Knees - walking - air; in open - agg. - shooting pain	1
304	EXTREMITIES - PAIN - Knees - walking - air; in open - agg. - stitching pain	3
305	EXTREMITIES - PAIN - Knees - walking - air; in open - agg. - tearing pain	1
306	EXTREMITIES - PAIN - Knees - walking - air; in open - amel. - stitching pain	1
307	EXTREMITIES - PAIN - Knees - walking - amel. - boring pain	1
308	EXTREMITIES - PAIN - Knees - walking - amel. - drawing pain	6
309	EXTREMITIES - PAIN - Knees - walking - amel. - stitching pain	5
310	EXTREMITIES - PAIN - Knees - walking - amel. - tearing pain	12
311	EXTREMITIES - PAIN - Knees - wandering, shifting pain	13
312	EXTREMITIES - PAIN - Knees - warm bed agg. - drawing pain	2
313	EXTREMITIES - PAIN - Knees - warm bed agg. - tearing pain	3
314	EXTREMITIES - PAIN - Knees - warm covering, from - stitching pain	2
315	EXTREMITIES - PAIN - Knees - warmth - amel. - tearing pain	1
316	EXTREMITIES - PAIN - Knees - weather - change of weather - stitching pain	1
317	EXTREMITIES - PAIN - Knees - weather - change of weather - tearing pain	1
318	EXTREMITIES - PAIN - Knees - wine agg. - drawing pain	2
319	EXTREMITIES - PAIN - Knees - wrapping warm amel. - tearing pain	1
320	EXTREMITIES - PAIN - Knees - yawning agg. - tearing pain	1
321	EXTREMITIES - PAIN - Knees - extending to - Ankle - drawing pain	2
322	EXTREMITIES - PAIN - Knees - extending to - Ankle - tearing pain	5
323	EXTREMITIES - PAIN - Knees - extending to - Body; all - tearing pain	1
324	EXTREMITIES - PAIN - Knees - extending to - Crest of ilium - tearing pain	1
325	EXTREMITIES - PAIN - Knees - extending to - Foot - drawing pain	3
326	EXTREMITIES - PAIN - Knees - extending to - Foot - tearing pain	3
327	EXTREMITIES - PAIN - Knees - extending to - Foot - Sole of - stitching pain	1
328	EXTREMITIES - PAIN - Knees - extending to - Hip - stitching pain	3
329	EXTREMITIES - PAIN - Knees - extending to - Hip - tearing pain	4
330	EXTREMITIES - PAIN - Knees - extending to - Leg - stitching pain	2
331	EXTREMITIES - PAIN - Knees - extending to - Leg - tearing pain	1
332	EXTREMITIES - PAIN - Knees - extending to - Lumbar region - tearing pain	2
333	EXTREMITIES - PAIN - Knees - extending to - Soles - drawing pain	1
334	EXTREMITIES - PAIN - Knees - extending to - Thigh - tearing pain	3
335	EXTREMITIES - PAIN - Knees - extending to - Toes - stitching pain	1
336	EXTREMITIES - PAIN - Knees - extending to - Toes - tearing pain	3
337	EXTREMITIES - PAIN - Knees - Above - right - stitching pain	1
338	EXTREMITIES - PAIN - Knees - Bends of knees	1
339	EXTREMITIES - PAIN - Knees - Bends of knees - left - stitching pain	1
340	EXTREMITIES - PAIN - Knees - Bends of knees - stitching pain	1
341	EXTREMITIES - PAIN - Knees - Front - ascending stairs agg. - cutting pain	1
342	EXTREMITIES - PAIN - Knees - Front - bending agg. - cutting pain	1
343	EXTREMITIES - PAIN - Knees - Front - pressure agg. - cutting pain	1
344	EXTREMITIES - PAIN - Knees - Front - riding a bicycle - cutting pain	1
345	EXTREMITIES - PAIN - Knees - Front - walking agg. - cutting pain	1
346	EXTREMITIES - PAIN - Knees - Hollow of knees	126
347	EXTREMITIES - PAIN - Knees - Hollow of knees - right - drawing pain	1
348	EXTREMITIES - PAIN - Knees - Hollow of knees - right - pressing pain	1
349	EXTREMITIES - PAIN - Knees - Hollow of knees - right - stitching pain	1
350	EXTREMITIES - PAIN - Knees - Hollow of knees - morning - tearing pain	1
351	EXTREMITIES - PAIN - Knees - Hollow of knees - afternoon - walking agg. - stitching pain	1
352	EXTREMITIES - PAIN - Knees - Hollow of knees - evening - bed agg.; in - drawing pain	2
353	EXTREMITIES - PAIN - Knees - Hollow of knees - evening - drawing pain	1
354	EXTREMITIES - PAIN - Knees - Hollow of knees - evening - tearing pain	1
355	EXTREMITIES - PAIN - Knees - Hollow of knees - night - stitching pain	2
356	EXTREMITIES - PAIN - Knees - Hollow of knees - night - tearing pain	2
357	EXTREMITIES - PAIN - Knees - Hollow of knees - ascending agg. - drawing pain	1
358	EXTREMITIES - PAIN - Knees - Hollow of knees - bending knee agg.	5
359	EXTREMITIES - PAIN - Knees - Hollow of knees - bending knee agg. - drawing pain	2
360	EXTREMITIES - PAIN - Knees - Hollow of knees - bending knee agg. - pressing pain	1
361	EXTREMITIES - PAIN - Knees - Hollow of knees - chill; during - stitching pain	1
362	EXTREMITIES - PAIN - Knees - Hollow of knees - cutting pain	2
363	EXTREMITIES - PAIN - Knees - Hollow of knees - drawing pain	42
364	EXTREMITIES - PAIN - Knees - Hollow of knees - drawing pain - jerking pain	1
365	EXTREMITIES - PAIN - Knees - Hollow of knees - drawing pain - tearing pain	1
366	EXTREMITIES - PAIN - Knees - Hollow of knees - hot - stitching pain	1
367	EXTREMITIES - PAIN - Knees - Hollow of knees - lying down agg. - drawing pain	2
368	EXTREMITIES - PAIN - Knees - Hollow of knees - motion - agg. - pressing pain	1
369	EXTREMITIES - PAIN - Knees - Hollow of knees - motion - agg. - stitching pain	2
370	EXTREMITIES - PAIN - Knees - Hollow of knees - motion - amel. - drawing pain	2
371	EXTREMITIES - PAIN - Knees - Hollow of knees - pinching pain	2
372	EXTREMITIES - PAIN - Knees - Hollow of knees - pressing pain	9
373	EXTREMITIES - PAIN - Knees - Hollow of knees - pressing pain - drawing pain	1
374	EXTREMITIES - PAIN - Knees - Hollow of knees - pressing pain - jerking pain	1
375	EXTREMITIES - PAIN - Knees - Hollow of knees - pressure - amel. - drawing pain	1
376	EXTREMITIES - PAIN - Knees - Hollow of knees - pulsating pain	2
377	EXTREMITIES - PAIN - Knees - Hollow of knees - rising from sitting agg. - drawing pain	2
378	EXTREMITIES - PAIN - Knees - Hollow of knees - rising from sitting agg. - stitching pain	1
379	EXTREMITIES - PAIN - Knees - Hollow of knees - rising from sitting agg. - tearing pain	1
380	EXTREMITIES - PAIN - Knees - Hollow of knees - shooting pain	5
381	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - agg. - drawing pain	3
382	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - agg. - pressing pain	2
383	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - agg. - shooting pain	2
384	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - agg. - stitching pain	3
385	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - agg. - tearing pain	2
386	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - amel. - tearing pain	2
387	EXTREMITIES - PAIN - Knees - Hollow of knees - sitting - crossed legs; with - agg. - drawing pain	1
388	EXTREMITIES - PAIN - Knees - Hollow of knees - standing agg. - drawing pain	5
389	EXTREMITIES - PAIN - Knees - Hollow of knees - standing agg. - shooting pain	1
390	EXTREMITIES - PAIN - Knees - Hollow of knees - standing agg. - stitching pain	2
391	EXTREMITIES - PAIN - Knees - Hollow of knees - stitching pain	26
392	EXTREMITIES - PAIN - Knees - Hollow of knees - synchronous with pulse - drawing pain	1
393	EXTREMITIES - PAIN - Knees - Hollow of knees - tearing pain	22
394	EXTREMITIES - PAIN - Knees - Hollow of knees - tearing pain - drawing pain	1
395	EXTREMITIES - PAIN - Knees - Hollow of knees - walking - agg. - drawing pain	10
396	EXTREMITIES - PAIN - Knees - Hollow of knees - walking - agg. - pressing pain	2
397	EXTREMITIES - PAIN - Knees - Hollow of knees - walking - agg. - stitching pain	4
398	EXTREMITIES - PAIN - Knees - Hollow of knees - walking - agg. - tearing pain	3
399	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Calf - drawing pain	2
400	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Calf - tearing pain	1
401	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Hip - tearing pain	1
402	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Thigh - drawing pain	2
403	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Thigh - tearing pain	3
404	EXTREMITIES - PAIN - Knees - Hollow of knees - extending to - Toes - drawing pain	1
405	EXTREMITIES - PAIN - Knees - Hollow of knees - Outer side - drawing pain	2
406	EXTREMITIES - PAIN - Knees - Hollow of knees - Outer side - pressing pain	2
407	EXTREMITIES - PAIN - Knees - Hollow of knees - Tendons - drawing pain	2
408	EXTREMITIES - PAIN - Knees - Hollow of knees - Tendons - Outer - pressing pain	1
409	EXTREMITIES - PAIN - Knees - Joints - pulsating pain	1
410	EXTREMITIES - PAIN - Knees - Patella - right - stitching pain	2
411	EXTREMITIES - PAIN - Knees - Patella - right - tearing pain	1
412	EXTREMITIES - PAIN - Knees - Patella - left - stitching pain	1
413	EXTREMITIES - PAIN - Knees - Patella - forenoon - boring pain	1
414	EXTREMITIES - PAIN - Knees - Patella - afternoon - stitching pain	1
415	EXTREMITIES - PAIN - Knees - Patella - night - stitching pain	1
416	EXTREMITIES - PAIN - Knees - Patella - night - tearing pain	1
417	EXTREMITIES - PAIN - Knees - Patella - ascending stairs agg. - stitching pain	1
418	EXTREMITIES - PAIN - Knees - Patella - bending knee agg.	3
419	EXTREMITIES - PAIN - Knees - Patella - boring pain	4
420	EXTREMITIES - PAIN - Knees - Patella - dinner; after - tearing pain	1
421	EXTREMITIES - PAIN - Knees - Patella - drawing pain	7
422	EXTREMITIES - PAIN - Knees - Patella - gouty - drawing pain	1
423	EXTREMITIES - PAIN - Knees - Patella - jerking pain	1
424	EXTREMITIES - PAIN - Knees - Patella - kneeling agg. - stitching pain	2
425	EXTREMITIES - PAIN - Knees - Patella - motion - agg. - stitching pain	2
426	EXTREMITIES - PAIN - Knees - Patella - motion - agg. - tearing pain	1
427	EXTREMITIES - PAIN - Knees - Patella - motion - amel. - stitching pain	1
428	EXTREMITIES - PAIN - Knees - Patella - motion - amel. - tearing pain	1
429	EXTREMITIES - PAIN - Knees - Patella - pressing pain	9
430	EXTREMITIES - PAIN - Knees - Patella - rising - sitting; from - after - agg. - stitching pain	2
431	EXTREMITIES - PAIN - Knees - Patella - rubbing - amel. - stitching pain	1
432	EXTREMITIES - PAIN - Knees - Patella - rubbing - amel. - tearing pain	1
433	EXTREMITIES - PAIN - Knees - Patella - scraping pain	1
434	EXTREMITIES - PAIN - Knees - Patella - shooting pain	3
435	EXTREMITIES - PAIN - Knees - Patella - sitting - agg. - stitching pain	3
436	EXTREMITIES - PAIN - Knees - Patella - sitting - agg. - tearing pain	2
437	EXTREMITIES - PAIN - Knees - Patella - stitching pain	23
438	EXTREMITIES - PAIN - Knees - Patella - stitching pain - drawing pain	1
439	EXTREMITIES - PAIN - Knees - Patella - stitching pain - tearing pain	1
440	EXTREMITIES - PAIN - Knees - Patella - tearing pain	19
441	EXTREMITIES - PAIN - Knees - Patella - tearing pain - drawing pain	2
442	EXTREMITIES - PAIN - Knees - Patella - tearing pain - jerking pain	1
443	EXTREMITIES - PAIN - Knees - Patella - ulcerative pain	1
444	EXTREMITIES - PAIN - Knees - Patella - waking; on - tearing pain	1
445	EXTREMITIES - PAIN - Knees - Patella - walking - agg. - drawing pain	1
446	EXTREMITIES - PAIN - Knees - Patella - walking - agg. - stitching pain	2
447	EXTREMITIES - PAIN - Knees - Patella - walking - amel. - tearing pain	1
448	EXTREMITIES - PAIN - Knees - Patella - walking - continued - amel. - stitching pain	1
449	EXTREMITIES - PAIN - Knees - Patella - wandering pain	1
450	EXTREMITIES - PAIN - Knees - Patella - extending to - Hip - stitching pain	1
451	EXTREMITIES - PAIN - Knees - Patella - extending to - Leg; into - drawing pain	1
452	EXTREMITIES - PAIN - Knees - Patella - Below - boring pain	1
453	EXTREMITIES - PAIN - Knees - Sides - Inner - morning - stitching pain	1
454	EXTREMITIES - PAIN - Knees - Sides - Inner - dinner; after - stitching pain	1
455	EXTREMITIES - PAIN - Knees - Sides - Inner - motion - amel. - stitching pain	1
456	EXTREMITIES - PAIN - Knees - Sides - Inner - sitting agg. - stitching pain	2
457	EXTREMITIES - PAIN - Knees - Sides - Inner - standing agg. - stitching pain	1
458	EXTREMITIES - PAIN - Knees - Sides - Inner - stepping - every step; at - stitching pain	1
459	EXTREMITIES - PAIN - Knees - Sides - Inner - stitching pain	14
460	EXTREMITIES - PAIN - Knees - Sides - Inner - tearing pain	6
461	EXTREMITIES - PAIN - Knees - Sides - Inner - walking - agg. - stitching pain	1
462	EXTREMITIES - PAIN - Knees - Sides - Inner - walking - agg. - tearing pain	1
463	EXTREMITIES - PAIN - Knees - Sides - Inner - walking - amel. - tearing pain	1
464	EXTREMITIES - PAIN - Knees - Sides - Inner - extending to - Toes - First - stitching pain	1
465	EXTREMITIES - PAIN - Knees - Sides - Outer - ascending stairs agg. - cutting pain	1
466	EXTREMITIES - PAIN - Knees - Sides - Outer - cutting pain	1
467	EXTREMITIES - PAIN - Knees - Sides - Outer - extension; extreme - cutting pain	1
468	EXTREMITIES - PAIN - Knees - Sides - Outer - flexion; extreme - cutting pain	1
469	EXTREMITIES - PAIN - Knees - Sides - Outer - pressure agg. - cutting pain	1
470	EXTREMITIES - PAIN - Knees - Sides - Outer - riding a bicycle - cutting pain	1
471	EXTREMITIES - PAIN - Knees - Sides - Outer - sitting agg. - stitching pain	1
472	EXTREMITIES - PAIN - Knees - Sides - Outer - sitting agg. - tearing pain	1
473	EXTREMITIES - PAIN - Knees - Sides - Outer - standing agg. - stitching pain	2
474	EXTREMITIES - PAIN - Knees - Sides - Outer - stitching pain	9
475	EXTREMITIES - PAIN - Knees - Sides - Outer - tearing pain	8
476	EXTREMITIES - PAIN - Knees - Sides - Outer - touch agg. - stitching pain	1
477	EXTREMITIES - PAIN - Knees - Sides - Outer - walking agg. - cutting pain	1
478	EXTREMITIES - PAIN - Knees - Sides - Outer - walking agg. - stitching pain	4
479	EXTREMITIES - PAIN - Knees - Tendons - evening - stitching pain	1
480	EXTREMITIES - PAIN - Knees - Tendons - motion agg. - stitching pain	2
481	EXTREMITIES - PAIN - Knees - Tendons - rising from sitting agg. - stitching pain	1
482	EXTREMITIES - PAIN - Knees - Tendons - standing agg. - stitching pain	1
483	EXTREMITIES - PAIN - Knees - Tendons - stitching pain	11
484	EXTREMITIES - PAIN - Knees - Tendons - touch agg. - stitching pain	1
485	EXTREMITIES - PAIN - Knees - Tendons - walking - agg. - stitching pain	3
486	EXTREMITIES - PAIN - Knees - Tendons - walking - air agg.; in open - stitching pain	1
487	EXTREMITIES - PAIN - Legs - extending to - Knee	1
488	EXTREMITIES - PAIN - Legs - extending to - Knee - drawing pain	1
489	EXTREMITIES - PAIN - Legs - Bones - Tibia - bending knee agg.	1
490	EXTREMITIES - PAIN - Legs - Bones - Tibia - bending knee agg. - pressing pain	1
491	EXTREMITIES - PAIN - Legs - Calves - evening - sitting with knees bent	1
492	EXTREMITIES - PAIN - Legs - Calves - extending to - Knees	1
493	EXTREMITIES - PAIN - Legs - Calves - extending to - Knees - drawing pain	1
494	EXTREMITIES - PAIN - Legs - Calves - extending to - Knees - Hollow of knees	2
495	EXTREMITIES - PAIN - Legs - Calves - extending to - Knees - Hollow of knees - drawing pain	1
496	EXTREMITIES - PAIN - Legs - Calves - extending to - Knees - Hollow of knees - tearing pain	1
497	EXTREMITIES - PAIN - Legs - Knees; below	4
498	EXTREMITIES - PAIN - Legs - Knees; below - pressing pain	3
499	EXTREMITIES - PAIN - Legs - Knees; below - stitching pain	1
500	EXTREMITIES - PAIN - Legs - Knees; below - tearing pain	1
501	EXTREMITIES - PAIN - Lower limbs - Sciatic nerve - extending to - Knee	7
502	EXTREMITIES - PAIN - Lower limbs - Sciatic nerve - extending to - Knee - Hip to knee; from	4
503	EXTREMITIES - PAIN - Nates - extending to - Knee	2
504	EXTREMITIES - PAIN - Shoulders - right - accompanied by - Knee; pain in left	1
505	EXTREMITIES - PAIN - Thighs - right - extending to - Knee	1
506	EXTREMITIES - PAIN - Thighs - bent; when knees are	1
507	EXTREMITIES - PAIN - Thighs - bent; when knees are - tearing pain	1
508	EXTREMITIES - PAIN - Thighs - cough agg.; during - extending to - Knee	1
509	EXTREMITIES - PAIN - Thighs - extending to - Knee	14
510	EXTREMITIES - PAIN - Thighs - extending to - Knee - cough agg.; during - pressing pain	1
511	EXTREMITIES - PAIN - Thighs - extending to - Knee - drawing pain	5
512	EXTREMITIES - PAIN - Thighs - extending to - Knee - tearing pain	5
513	EXTREMITIES - PAIN - Thighs - Anterior part - extending to - Knee	2
514	EXTREMITIES - PAIN - Thighs - Anterior part - extending to - Knee - drawing pain	2
515	EXTREMITIES - PAIN - Thighs - Inner side - Knees; above	13
516	EXTREMITIES - PAIN - Thighs - Knees; above	54
517	EXTREMITIES - PAIN - Thighs - Knees; above - right - stitching pain	3
518	EXTREMITIES - PAIN - Thighs - Knees; above - morning - bed agg.; in - tearing pain	2
519	EXTREMITIES - PAIN - Thighs - Knees; above - evening - bed agg.; in - tearing pain	2
520	EXTREMITIES - PAIN - Thighs - Knees; above - evening - stitching pain	2
521	EXTREMITIES - PAIN - Thighs - Knees; above - evening - tearing pain	3
522	EXTREMITIES - PAIN - Thighs - Knees; above - night - tearing pain	3
523	EXTREMITIES - PAIN - Thighs - Knees; above - drawing pain	11
524	EXTREMITIES - PAIN - Thighs - Knees; above - drawing pain - jerking pain	1
525	EXTREMITIES - PAIN - Thighs - Knees; above - jerking pain	1
526	EXTREMITIES - PAIN - Thighs - Knees; above - shooting pain	1
527	EXTREMITIES - PAIN - Thighs - Knees; above - sitting agg. - drawing pain	2
528	EXTREMITIES - PAIN - Thighs - Knees; above - sitting agg. - stitching pain	3
529	EXTREMITIES - PAIN - Thighs - Knees; above - standing agg. - tearing pain	1
530	EXTREMITIES - PAIN - Thighs - Knees; above - stitching pain	20
531	EXTREMITIES - PAIN - Thighs - Knees; above - stitching pain - pulsating pain	1
532	EXTREMITIES - PAIN - Thighs - Knees; above - tearing pain	23
533	EXTREMITIES - PAIN - Thighs - Knees; above - tearing pain - drawing pain	2
534	EXTREMITIES - PAIN - Thighs - Knees; above - walking - agg. - tearing pain	1
535	EXTREMITIES - PAIN - Thighs - Knees; above - walking - air agg.; in open - stitching pain	1
536	EXTREMITIES - PAIN - Thighs - Knees; above - extending to - Ankles - tearing pain	1
537	EXTREMITIES - PAIN - Toes - extending to - Knee	1
538	EXTREMITIES - PAIN - Toes - First - extending to - Knee	1
539	EXTREMITIES - PAIN - Toes - First - extending to - Knee - tearing pain	1
540	EXTREMITIES - PAIN - Upper limbs - right - and - left knee	1
541	EXTREMITIES - STIFFNESS - Knees - painful	3
542	EXTREMITIES - SWELLING - Knees - painful	15
543	EXTREMITIES - SWELLING - Knees - Hollow of knees - painful	2
544	EXTREMITIES - WEAKNESS - Lower limbs - accompanied by - Knees; pain in	1
545	SLEEP - SLEEPLESSNESS - pain; from - Knee	2
546	DREAMS - KNEE - pain in	1

Frequently indicated remedies for Knee Pain in decreasing prominence according to above rubrics in general-


rhus-t.	sulph.	caust.	lyc.	coloc.	kali-c.	led.	agar.	calc.	zinc.
9170
7235	6680	5820	5300	5010	4740	4175	4155	4079

Miasmatic analysis of disorders with Knee pain –


Psora	Sycosis	Syphilis	Pseudopsora	Cancerous
83 %
75 %	62 %	65 %	64 %

Top ten antimiasmatic remedies-


Remedy	nit-ac.	lyc.	sil.	thuj.	sulph.	kali-i.	merc.	phos.	ars.	aur.
Miasm
730	669	619	619	610	600	589	589	580	580
Psora
2	4	2	1	4	1	2	1	1	1
Sycosis
4	4	2	4	2	1	1	1	2	1
Syphilis
4	2	3	2	2	4	4	2	2	4
Pseudopsora
2	3	4	2	1	2	1	4	3	1
Cancerous
4	3	3	2	2	2	2	3	3	2

Bibliography

A Comparison of the Chronic Miasms, Phillis Speight
An Introduction to the Symptoms and Signs of Surgical Diseases, Norman L. Browse
Clinical Repertory, J. H. Clarke
Current Medical Diagnosis & Treatment, Lawrence M. Tierney, Stephen J. McPhee
Davidson’s Principles And Practice of Medicine
Grant’s anatomy
Gray’s anatomy
Handbook of Human Physiology, Dr. Vidyaratan
Homoeopathy, Introductory Lectures, M. L. Taylor
Human Physiology, Dr. Chandi Charan Chaterjee
Lectures on Homoeopathic Materia Medica, Lames Tyler Kent
Maggi’s Text Book of Physiotherapy
Organon Expositor, Dr. S. D. Sircar
Organon Of Medicine, At A Glance, Part I & II, Dr. A. C. Gupta
Organon of Medicine, Samuel Hahnemann
Pathology, Virginia A. LiVolsi, Maria J. Merino, John S. J. Brooks, Scott H. Saul, John E.
Practice of Medicine, Dr. K. Chaudhury
Principles of Internal Medicine Vol. I, II, Harrison
Repertory Of Homoeopathic Materia Medica, J. T. Kent
Synthetic Repertory, Vols. I, II & III
Taber’s Cyclopedic Medical Dictionary
Text Book Of Medical Physiology, Guyton
Text Book of Preventive & Social Medicine, J. E. Park & K Park
The Genius of Homoeopathy, Stuart Clause
The Principles & Art of Cure By Homoeopathy, Herberts A. Roberts
Therapeutic Pointers, E. A. Farrington
Tidy’s Text Book of Physiotherapy
Trauma & Healing Process

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