下楼梯时一步一步都要扶着扶手、蹲下去买个东西站起来「哎哟」一声、早上刚起床膝盖僵一阵才走得开、走一段路膝盖就酸胀发热——很多上了年纪的人都有这样的膝盖。医学上这多半是退化性膝关节炎（膝骨关节炎）：膝关节里那层缓冲用的软骨，随着年龄和长年使用慢慢磨损、变薄，骨头之间的摩擦增加，就出现疼痛、僵硬和响声。它跟年轻人跑步、运动扭到的膝盖痛不一样——那是劳损或急性损伤，这是长年累月的退化。好消息是：虽然磨掉的软骨长不回来，但疼痛和僵硬是可以调理、活动是可以改善的。
Gripping the rail step by step going downstairs, an "ouch" as you rise from a squat, a stiff knee for a while each morning, an ache and warmth after a short walk — many older knees feel like this. Medically it's usually knee osteoarthritis: the cushioning cartilage inside the knee thins and wears with age and years of use, so the bones grate more and you get pain, stiffness and clicking. It's different from a young runner's knee from overuse or injury — this is long-term wear and tear. The good news: while worn cartilage doesn't grow back, the pain and stiffness can be managed and movement improved.
Berpaut pada pemegang tangga langkah demi langkah, "aduh" bila bangun dari mencangkung, lutut kaku seketika setiap pagi, sakit dan panas selepas berjalan sedikit — banyak lutut warga tua begini. Dari segi perubatan ia biasanya osteoartritis lutut: rawan penampan dalam lutut menipis dan haus dengan usia, jadi tulang bergesel lebih dan timbul sakit, kekakuan dan bunyi. Ia berbeza daripada lutut pelari muda akibat kecederaan — ini kehausan jangka panjang. Berita baik: walaupun rawan yang haus tak tumbuh semula, sakit dan kekakuan boleh diuruskan dan pergerakan diperbaiki.
退化性膝关节炎，和运动扭到的膝盖痛不一样
It's Not the Same as a Sports Knee Injury
Ia Bukan Sama dengan Kecederaan Lutut Sukan
同样是膝盖痛，「为什么痛」很不一样。退化性膝关节炎是软骨磨损的结果，多见于中老年、体重偏重、长年蹲跪或走楼梯多的人；特点是上下楼、蹲起时痛，早上或久坐后僵一阵（通常几分钟内松开），活动时有摩擦感或「咔咔」声，天气变化、劳累后加重，久了膝盖可能慢慢变形（O 型腿）。而运动引起的膝盖痛，多是跑跳、扭到造成的肌腱韧带劳损或急性损伤，跟特定动作和运动量有关。方向不同，处理也不同——所以第一步是先分清你的膝盖属于哪一种。
Knee pain looks the same but the "why" differs. Osteoarthritis is the result of worn cartilage, common in the older, heavier, and those who have squatted, knelt or climbed stairs for years; it hurts on stairs and rising from a squat, is stiff for a few minutes each morning or after sitting, grates or clicks with movement, and worsens with weather changes and fatigue, sometimes bowing the leg over time. A sports knee is usually tendon-ligament overuse or an acute injury from running, jumping or twisting, tied to specific movements and load. Different roots, different care — so first sort which kind yours is.
Sakit lutut nampak sama tetapi "kenapa" berbeza. Osteoartritis ialah hasil rawan yang haus, biasa pada yang berusia, berat berlebihan, dan yang lama mencangkung atau naik tangga; ia sakit di tangga dan bila bangun, kaku beberapa minit setiap pagi, bergesel atau berbunyi, dan bertambah teruk dengan cuaca dan keletihan. Lutut sukan biasanya kecederaan urat akibat berlari atau terpusing. Akar berbeza, rawatan berbeza — jadi kenal jenis dahulu.
上下楼梯、蹲下站起时痛（比走平路明显）；早上或久坐后僵，动一动几分钟就松开（不像风湿关节炎僵很久）；膝盖弯伸有摩擦感或「咔咔」声；活动多了酸胀、变天加重；年纪偏大、体重偏重、以前常蹲跪或搬重。若关节持续肿胀、长时间僵硬不缓、多个关节对称肿痛，或伴发烧，就不一定是单纯退化，要请医师鉴别（例如类风湿、痛风、感染）。
Pain on stairs and rising from a squat (more than on the flat); morning or after-sitting stiffness that eases within minutes (unlike the long stiffness of rheumatoid arthritis); grating or clicking as the knee bends; ache after activity, worse with weather; older age, extra weight, a history of squatting or heavy carrying. If a joint is persistently swollen, stiff for a long time, or several joints are symmetrically painful, or there is fever, it may not be simple wear — a practitioner should tell it apart from rheumatoid arthritis, gout or infection.
Sakit di tangga dan bila bangun dari mencangkung; kaku waktu pagi atau selepas duduk yang reda dalam beberapa minit; bergesel atau berbunyi bila lutut dibengkokkan; sakit selepas beraktiviti, teruk dengan cuaca; usia lanjut, berat berlebihan. Jika sendi bengkak berterusan, kaku lama, atau beberapa sendi bengkak simetri atau ada demam, ia mungkin bukan kehausan biasa — pengamal perlu membezakannya.
中医看退化膝盖，常见这几型
The Common Patterns Behind a Worn Knee
Corak Biasa di Sebalik Lutut Haus
中医把退化性膝关节炎归在「痹证」「骨痹」，认为「肝主筋、肾主骨」，年长之后肝肾渐亏是根本，再加上气血不足、风寒湿侵袭或血瘀阻络，膝盖就又痛又僵。对照看看你比较像哪一型——很多长辈是混合型。
TCM places knee osteoarthritis under "bi syndrome" — the liver governs the sinews and the kidney the bones, so dwindling liver-kidney essence with age is the root, joined by qi-blood deficiency, wind-cold-damp invasion or blood stasis blocking the channels. See which fits you best — many older knees are a mix.
TCM meletakkan osteoartritis lutut di bawah "sindrom bi" — hati menguasai urat dan ginjal menguasai tulang, jadi kekurangan pati hati-ginjal dengan usia adalah akarnya, ditambah kurang qi-darah, serangan angin-sejuk-lembap atau darah beku. Lihat yang mana paling sesuai — banyak yang campuran.
膝盖酸软无力、走久发软、腰膝一起酸、上了年纪逐渐加重，常伴头晕耳鸣。这是「筋骨失养」的根本型。方向是补肝肾、强筋骨。
Weak, aching knees that give way after walking, aching lower back and knees together, gradually worse with age, often with dizziness or tinnitus. The root pattern of "sinew and bone under-nourished." Nourish the liver and kidney, strengthen sinew and bone.
Lutut lemah dan lenguh yang terasa nak jatuh selepas berjalan, pinggang dan lutut lenguh bersama, makin teruk dengan usia. Corak akar. Pupuk hati-ginjal, kuatkan urat-tulang.
膝盖遇冷、变天、下雨前更痛更僵，热敷会舒服些，重胀感明显。方向是祛风散寒、除湿通络，艾灸温通特别对症。
Knees that hurt and stiffen more in the cold, with weather changes or before rain, easing with warmth, with a heavy swollen feeling. Dispel wind, scatter cold, drain damp and free the channels — warming moxibustion suits this well.
Lutut yang lebih sakit dan kaku dalam sejuk, tukar cuaca atau sebelum hujan, lega dengan haba. Halau angin, sejuk dan lembap — moksibusi amat sesuai.
膝盖固定一处刺痛、夜里更明显、按压有痛点，可能以前扭伤过或劳损久。方向是活血化瘀、通络止痛。
A fixed stabbing spot on the knee, worse at night, tender to press, often after an old sprain or long strain. Move the blood, resolve stasis, free the channels and ease pain.
Tempat sakit menusuk yang tetap pada lutut, teruk waktu malam, sakit bila ditekan, selalunya selepas terseliuh lama dahulu. Gerakkan darah, surai kebekuan.
膝盖隐隐酸软、走一段就累、肌肉松软没力、面色偏差，恢复慢。方向是补益气血、濡养筋肉，同时练大腿力量。
A dull weak ache, tiring after a short walk, soft weak muscles, poor complexion, slow to recover. Boost qi and blood to nourish the sinews, alongside building thigh strength.
Lenguh lemah yang halus, penat selepas berjalan sedikit, otot lembik, muka pucat. Tambah qi dan darah, sambil bina kekuatan peha.
安心中医怎么帮退化的膝盖？
How An Xin TCM Helps a Worn Knee
Bagaimana An Xin TCM Membantu Lutut Haus
中医帮退化膝盖，不是「让软骨长回来」，而是按你的类型，把疼痛、僵硬、循环处理好，同时补肝肾、强筋骨，让你走路、上下楼、蹲起更轻松。方向对了，好转是痛的程度更轻、发作次数更少、每次不适的时间更短，走得比以前远、上下楼没那么怕。
TCM helps a worn knee not by "regrowing cartilage" but by working on pain, stiffness and circulation, matched to your type, while nourishing the liver-kidney and strengthening sinew and bone so walking, stairs and squatting get easier. Get it right and improvement shows as milder pain, fewer flare-ups and a shorter time feeling unwell each time — walking further, less afraid of stairs.
TCM membantu lutut haus bukan dengan "menumbuhkan semula rawan" tetapi menangani sakit, kekakuan dan peredaran mengikut jenis anda, sambil memupuk hati-ginjal dan menguatkan urat-tulang. Arah yang betul menunjukkan sakit lebih ringan, kurang kerap dan lebih pendek — berjalan lebih jauh, kurang takut tangga.
针灸取膝周及肝肾相关穴位，帮助止痛、放松紧绷、改善循环；配合手法松解大腿和膝周僵硬的软组织；风寒湿型加艾灸温通散寒，很多长辈觉得暖暖的很舒服。规律做，能实实在在减轻疼痛和僵硬。
Acupuncture on points around the knee and liver-kidney channels helps ease pain, release tension and improve circulation; hands-on work loosens tight tissue around the thigh and knee; for the cold-damp type, warming moxibustion scatters cold — many older patients find the warmth soothing. Done regularly, it genuinely eases pain and stiffness.
Akupunktur pada titik sekitar lutut membantu meredakan sakit dan memperbaiki peredaran; kerja tangan melonggarkan tisu tegang; untuk jenis sejuk-lembap, moksibusi menghangat — ramai warga tua rasa selesa.
按辨证用科学中药（浓缩颗粒）：肝肾亏虚补肝肾、强筋骨，风寒湿祛风散寒除湿，血瘀活血通络，气血不足益气养血。冲泡方便、剂量准。目标是从体质根本帮筋骨「有得养」，减缓退化的脚步，而不只是止痛。
Matched to the pattern with concentrated herbs (granules): nourish the liver-kidney and strengthen sinew-bone for deficiency, dispel wind-cold-damp, move blood for stasis, or boost qi and blood. Easy to make, precisely dosed. The aim is to nourish the sinews and bones from the constitution and slow the wear, not just numb pain.
Dipadan dengan corak menggunakan herba tumpat: pupuk hati-ginjal dan kuatkan urat-tulang, halau angin-sejuk-lembap, gerakkan darah, atau tambah qi-darah. Matlamatnya memupuk urat dan tulang, memperlahankan kehausan.
这一步和治疗一样重要：体重偏重的减一点，膝盖负担立刻轻很多；练大腿前侧（股四头肌）力量（如坐姿伸膝、靠墙半蹲到不痛的角度）帮膝盖分担压力；选走平路、游泳、骑固定脚踏车这类低冲击运动，避免深蹲、久蹲跪、频繁爬楼梯、提重物；上下楼扶扶手、必要时用护膝或手杖。规律动比不敢动好——但要「聪明地动」。
This matters as much as treatment: lose a little weight and the load on the knee drops at once; build front-thigh (quadriceps) strength (seated knee extensions, wall half-squats to a pain-free depth) to share the load; choose flat walking, swimming or a stationary bike — low-impact — and avoid deep or prolonged squatting and kneeling, frequent stairs and heavy lifting; use the handrail, and a knee support or cane when needed. Moving regularly beats not daring to move — but move smart.
Ini sama penting dengan rawatan: turunkan sedikit berat dan beban lutut terus berkurang; bina kekuatan peha depan (kuadrisep) untuk berkongsi beban; pilih berjalan rata, berenang atau basikal pegun — kesan rendah — dan elak mencangkung dalam/lama, tangga kerap dan mengangkat berat; guna pemegang tangga dan penyokong lutut bila perlu.
诚实说：已经磨损的软骨，中医（或任何疗法）都无法让它重新长回来。我们能做的，是减轻疼痛与僵硬、改善循环与活动、延缓退化的速度、帮你维持生活质量——很多长辈调理后能走得更远、上下楼没那么苦、少靠止痛药。但以下情况请看西医评估、别硬拖：关节明显肿胀积液、严重变形、痛到影响走路和睡眠、保守处理一段时间仍持续恶化——可能需要药物、关节注射，甚至人工关节置换。而关节红、肿、热加上发烧（要排除感染），突然剧痛完全不能负重，或明显外伤后的膝痛——请尽快就医、不要等。中医调理与这些检查、治疗从不冲突，可以一起进行。
Honestly: worn cartilage cannot be regrown, by TCM or any therapy. What we can do is ease pain and stiffness, improve circulation and movement, slow the wear and help you keep your quality of life — many older patients walk further, dread stairs less and lean on painkillers less after care. But see a doctor, don't just push on, if: the joint is markedly swollen with fluid, badly deformed, painful enough to affect walking and sleep, or keeps worsening despite conservative care — medication, a joint injection or even a knee replacement may be needed. And a red, hot, swollen joint with fever (rule out infection), sudden severe pain with no ability to bear weight, or knee pain after a clear injury — seek care promptly, don't wait. TCM care never conflicts with these checks and can run alongside them.
Jujurnya: rawan yang haus tidak boleh ditumbuhkan semula, oleh TCM atau mana-mana terapi. Apa yang boleh kami buat ialah meredakan sakit dan kekakuan, memperbaiki pergerakan, memperlahankan kehausan dan membantu anda kekalkan kualiti hidup. Tetapi jumpa doktor jika: sendi bengkak dengan cecair, berubah bentuk teruk, sakit menjejaskan berjalan dan tidur, atau terus memburuk walau rawatan konservatif — ubat, suntikan atau penggantian lutut mungkin diperlukan. Dan sendi merah, panas, bengkak dengan demam, sakit mengejut tak boleh berdiri, atau sakit selepas kecederaan — dapatkan rawatan segera. Rawatan TCM tidak bercanggah dengan pemeriksaan ini.
常见问题
Frequently Asked Questions
Soalan Lazim
退化性膝关节炎看中医有用吗？Can TCM help with knee osteoarthritis?Bolehkah TCM membantu osteoartritis lutut?+
有帮助，但要说清楚目标。退化性膝关节炎（膝骨关节炎）是膝关节软骨随年龄磨损退化，中老年很常见。中医不能让磨掉的软骨重新长回来，但可以从肝肾亏虚、气血不足、风寒湿等辨证入手，用针灸、手法、艾灸温通、中药调理，来减轻疼痛与僵硬、改善关节活动、延缓退化速度，让你上下楼、走路、蹲起更轻松。配合减重、股四头肌肌力训练、避免深蹲久蹲爬楼过度，效果更稳。马六甲安心中医由 KKM 注册医师辨证调理，与西医的评估、必要时的注射或置换手术并不冲突。
Yes, but be clear about the goal. Knee osteoarthritis is age-related wear of the knee cartilage, very common in middle and older age. TCM cannot regrow worn cartilage, but working from patterns like liver-kidney deficiency, qi-blood deficiency and wind-cold-damp, it uses acupuncture, manual therapy, warming moxibustion and herbs to ease pain and stiffness, improve movement and slow the decline, so stairs, walking and standing up are easier. With weight loss, quadriceps strengthening and avoiding deep or prolonged squatting and excess stair-climbing, results are steadier. At An Xin TCM Melaka, KKM-registered practitioners treat by pattern, alongside — not instead of — medical assessment and, where needed, injections or joint replacement.
Boleh, tetapi jelas tentang matlamat. Osteoartritis lutut ialah kehausan rawan lutut berkaitan usia, amat biasa pada pertengahan dan tua. TCM tidak boleh menumbuhkan semula rawan yang haus, tetapi dari corak seperti kurang hati-ginjal dan angin-sejuk-lembap, ia guna akupunktur, terapi manual, moksibusi dan herba untuk meredakan sakit dan kekakuan, memperbaiki pergerakan dan melambatkan kemerosotan. Dengan menurunkan berat, menguatkan otot peha dan mengelak mencangkung dalam, hasil lebih stabil. Di An Xin TCM Melaka, pengamal berdaftar KKM merawat mengikut corak, seiring penilaian perubatan dan, jika perlu, suntikan atau pembedahan gantian sendi.
退化性膝关节炎和运动引起的膝盖痛有什么不同？How is knee osteoarthritis different from sports-related knee pain?Apa beza osteoartritis lutut dengan sakit lutut akibat sukan?+
两者原因和人群不同。退化性膝关节炎多见于中老年，是软骨长期磨损退化，特点是上下楼梯、蹲下站起时痛，早上或久坐后关节僵一阵（通常几分钟内缓解），活动时有摩擦感或响声，久了膝盖可能变形；天气变化、劳累后会加重。运动引起的膝盖痛（如跑步、跳跃）多是肌腱、韧带、髌骨周围的劳损或急性损伤，跟特定动作和运动量有关，年轻人也常见。方向不同，调理也不同，所以要先分清。若你更偏向运动损伤，可参考我们另一篇谈跑步膝盖痛的文章。
The cause and who gets it differ. Knee osteoarthritis is mostly in middle-aged and older people, from long-term cartilage wear — pain on stairs and on standing up from squatting, a spell of stiffness in the morning or after sitting (usually easing within minutes), a grinding feeling or sound on movement, and possible deformity over time; it worsens with weather changes and overexertion. Sports-related knee pain (running, jumping) is mostly strain or acute injury to tendons, ligaments or around the kneecap, tied to specific movements and training load, and common in the young too. The directions of care differ, so sort it out first. If yours is more of a sports injury, see our separate article on running-related knee pain.
Puncanya berbeza. Osteoartritis lutut kebanyakannya pada warga pertengahan dan tua, akibat kehausan rawan — sakit naik tangga dan bangun dari mencangkung, kaku seketika pada waktu pagi (reda dalam beberapa minit), rasa geseran atau bunyi, dan mungkin herot lama-lama; memburuk dengan cuaca dan keletihan. Sakit lutut sukan (berlari, melompat) kebanyakannya ketegangan atau kecederaan urat, ligamen atau sekitar tempurung, berkait pergerakan tertentu, biasa pada yang muda. Arah rawatan berbeza, jadi kenal dahulu.
膝盖已经退化了，还能调理吗？会不会越走越坏？My knee is already worn — can it still be helped? Will walking wear it out faster?Lutut sudah haus — masih boleh dibantu? Berjalan akan merosakkan lagi?+
能调理，而且适度活动通常比完全不动更好。膝关节需要活动来维持润滑和周围肌肉力量，长期不敢动反而让肌肉萎缩、关节更不稳。关键是「聪明地动」：避免深蹲、久蹲、频繁爬楼梯、提重物这类加重膝盖负担的动作，改成走平路、游泳、骑固定脚踏车，并加强大腿前侧（股四头肌）力量来分担膝盖压力。体重偏重的减一点，对膝盖帮助很大。中医的针灸、手法、艾灸和中药可以帮忙减轻疼痛、放松紧绷、改善循环，让你更有条件规律活动，形成良性循环。
It can be helped, and moderate activity is usually better than not moving at all. The knee needs movement to keep it lubricated and the surrounding muscles strong; long avoidance actually wastes the muscle and makes the joint less stable. The key is moving smartly: avoid deep or long squats, frequent stair-climbing and heavy lifting, and switch to level walking, swimming or a stationary bike, while building the front-thigh (quadriceps) strength that shares the load. Losing a little weight helps the knee a lot. TCM acupuncture, manual therapy, moxa and herbs can ease pain, release tightness and improve circulation, so you're more able to stay regularly active — a virtuous circle.
Boleh dibantu, dan aktiviti sederhana biasanya lebih baik daripada langsung tak bergerak. Lutut perlu bergerak untuk kekal berpelincir dan otot sekeliling kuat; lama mengelak menyebabkan otot susut dan sendi kurang stabil. Kuncinya bergerak bijak: elak mencangkung dalam, naik tangga kerap dan angkat berat, tukar kepada berjalan rata, berenang atau basikal pegun, dan kuatkan otot peha depan. Menurunkan sedikit berat banyak membantu. Akupunktur, terapi manual, moksa dan herba TCM meredakan sakit dan memperbaiki peredaran.
退化性膝关节炎什么情况要看西医、甚至考虑手术？When should knee osteoarthritis be seen by a doctor, or even considered for surgery?Bila osteoartritis lutut perlu dirujuk doktor, malah pembedahan?+
大部分退化性膝关节炎可以先用保守方式处理，但以下情况要看西医评估：关节明显肿胀积液、严重变形、疼痛严重到影响走路和睡眠、保守处理一段时间仍持续恶化——这时可能需要药物、关节注射，甚至人工关节置换。另外，出现关节红、肿、热加上发烧（要排除感染性关节炎）、突然剧痛完全不能负重、或明显外伤之后的膝痛，请尽快就医、不要拖。中医调理与这些西医检查、治疗从不冲突，该转诊就转诊、可以一起进行。
Most knee osteoarthritis can be managed conservatively first, but see a doctor for assessment if: the joint is markedly swollen with fluid, severely deformed, pain is bad enough to affect walking and sleep, or it keeps worsening despite a period of conservative care — medication, joint injections, or even a joint replacement may then be needed. Also, a red, hot, swollen joint with fever (to rule out septic arthritis), sudden severe pain with total inability to bear weight, or knee pain after a clear injury need prompt care — don't delay. TCM care and these medical checks and treatments never conflict; refer on when needed and run together.
Kebanyakan osteoartritis lutut boleh diuruskan secara konservatif dahulu, tetapi jumpa doktor jika: sendi bengkak ketara berair, herot teruk, sakit sehingga menjejaskan berjalan dan tidur, atau terus memburuk walaupun dirawat — ubat, suntikan sendi, malah gantian sendi mungkin diperlukan. Juga, sendi merah, panas, bengkak dengan demam (singkir artritis septik), sakit teruk mengejut tak boleh berdiri, atau sakit selepas kecederaan perlu rawatan segera. Rawatan TCM dan pemeriksaan ini tidak bercanggah.