Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Chinese Tuina Therapy for Treatment of Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          1. Diagnosis of KOA;

          2. Age 40-75 years;

          3. KL (Kellgren-Lawrence) grade Ⅱ or Ⅲ in recent 3 months;

          4. NRS score of pain at least more than 4 points;

          5. Single/bilateral knee pain, duration of more than 6 month; If the patient has KOA on
             both legs, the heavier leg is selected for study.

        Exclusion Criteria:

          1. Surgery history of knee or waiting for surgery (knee replacement or knee arthroscopy);

          2. Knee pain caused by other diseases (such as joint bodies, severe effusion of joint
             cavity, infection, malignant tumors, autoimmune diseases, trauma, etc.);

          3. Oral administration of hormones within 3 month, intra-articular injection within 6
             months, knee injuries or open injuries within 6 months, or knee arthroscopy within 1
             year.

          4. Severe acute/chronic organic or mental diseases;

          5. Pregnant women, pregnant and lactating women;

          6. Coagulation disorders (such as hemophilia, etc.), or the skin diseases at the site of
             operation;

          7. Device support treatment after knee osteoarthritis disability;

          8. Participation in another clinical study in the past 3 months;

          9. History of receiving acupuncture, massage, manipulation, or any medical plaster
             treatment within 3 months

         10. Breaks for treatment longer than 3-4 weeks depending on each circumstance or merit may
             be construed as non-compliance and may be excluded.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 40 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Entailment