Fascia, cartilage, acupuncture: the real role of joint degeneration and acupuncture from the structural medicine 筋膜 、軟骨 、 針灸：從結構醫學看關節退化與針灸的真正角色

• Cartilage has no blood vessels and no nerves. It relies on diffusion and joint movement for nutrition.
  軟骨無血管、無神經，營養高度依賴擴散與關節活動。
• Fascia and joint mechanics shape cartilage stress. Tension imbalance can concentrate pressure.
  筋膜與關節力學會改變軟骨受力，張力失衡容易造成壓力集中。
• Acupuncture does not “regrow cartilage” directly—it may help by improving tension, pain modulation, and movement quality.
  針灸不是直接「長回軟骨」，而是透過改善張力、疼痛調節與活動品質來支持整體環境。

1) Cartilage isn’t an isolated tissue
軟骨不是孤立存在

Many people hear “cartilage wear” and assume pain is only about cartilage. Clinically, pain severity and imaging findings don’t always match. That’s because cartilage itself has no nerves, and it is avascular (no blood vessels), so it depends heavily on its surrounding environment. Pain often comes from the joint capsule, ligaments, fascia, and protective muscle tension—more than cartilage itself.

很多人聽到「軟骨磨損」就以為疼痛完全等於軟骨問題；但臨床上常見「影像不嚴重卻很痛」或「影像看起來很糟卻還能走」。 其中一個原因是：軟骨本身沒有神經，而且無血管，它的代謝與狀態高度仰賴周圍環境。疼痛更常來自關節囊、韌帶、筋膜與保護性肌肉緊繃，而不一定是軟骨本身。

2) Fascia shapes joint mechanics
筋膜會改變關節力學

Fascia is a continuous tension network connecting muscles, tendons, ligaments, joint capsules, and periosteum. When fascia is stiff, adhered, or imbalanced left-to-right, it can change how a joint tracks and loads.

筋膜是一個連續的張力網絡，連結肌肉、肌腱、韌帶、關節囊與骨膜。當筋膜僵硬、沾黏、或左右張力失衡時， 關節的「走向與受力方式」也會改變。

• Less movement → less fluid exchange
  活動變少 → 滑液與營養交換下降
• Pressure concentrates in specific zones
  壓力集中在特定區域
• Protective tension increases joint compression
  保護性緊繃增加關節壓縮力

3) Movement “feeds” cartilage
關節活動其實在「餵養」軟骨

Because cartilage has no direct blood supply, joint motion helps drive nutrient diffusion through cyclical compression and release. Think of it like a sponge: gentle loading and unloading helps exchange fluids.

由於軟骨沒有直接血液供應，關節活動透過「壓縮—釋放」的節律，促進營養的擴散交換。 可以把它想成海綿：溫和的擠壓與回彈，有助於液體交換。

4) What acupuncture can (and can’t) do
針灸能做什麼、不能做什麼

In many cases, acupuncture is most helpful when combined with appropriate loading, mobility work, and strength/stabilization training. It supports the environment around the joint—so the joint can move more efficiently with less irritation.

多數情況下，針灸若能配合適當的負重策略、活動度訓練、肌力與穩定度訓練，效果更佳。 針灸較常扮演的是「改善關節周邊環境」的角色，讓關節在較少刺激下更有效率地運作。

5) Views of traditional Chinese medicine TCM
中醫觀點

From a Traditional Chinese Medicine perspective, fascia tension and joint stiffness can be viewed through the lens of channel sinews (經筋), qi-blood circulation (氣血運行), and painful obstruction patterns (痺證). The clinical goal is often to improve flow and reduce persistent guarding.

從中醫角度看，筋膜張力與關節僵硬可用「經筋」、「氣血運行」與「痺證」來理解。 臨床目標多著重於：改善運行、減少長期保護性緊繃，並提升活動功能。

FAQ
常見問題

Can acupuncture repair or regrow cartilage?
針灸能修復或再生軟骨嗎？

Cartilage is avascular and has limited self-repair capacity. Acupuncture should not be marketed as “regrowing cartilage.” Instead, it may help by improving surrounding soft-tissue tension, pain modulation, and movement quality—factors that influence joint loading.

軟骨無血管、修復能力有限，針灸不應被宣稱為「長回軟骨」。 針灸較可能透過改善周邊軟組織張力、疼痛調節、活動品質等面向，間接影響關節受力與症狀。

How soon can I feel improvement?
治療多久會有改善的感覺？

It varies by condition, chronicity, and activity level. Some people notice changes in pain or mobility within a few sessions, while longer-standing issues often require a consistent plan plus home exercises. Progress is usually measured by better movement tolerance, less flare-ups, and improved function rather than “a perfect joint.”

這會依問題類型、病程長短與活動習慣而不同。有些人可能在幾次內感到疼痛或活動度改善； 若是長期問題，通常需要較一致的療程與居家訓練配合。進步常以活動耐受度提高、反覆發作減少與功能提升來衡量， 而不是追求「關節變得完全完美」。

Do I need to stop exercise if I have “cartilage wear”?
有軟骨磨損就要停止運動嗎？

Not necessarily. In many cases, appropriately dosed movement helps joint fluid exchange and supports function. The key is right type, right dose, and right progression—often focusing on mobility, strength, and load management.

不一定。很多時候，適度的活動反而有助於滑液循環與功能維持。重點在於：運動種類、運動量與循序漸進是否合適， 常會以活動度、肌力與負重管理為核心。

What can I do at home to support results?
在家可以做什麼來加強效果？

Consider gentle daily mobility (pain-free range), strength/stability work 2–3 times per week, and activity pacing. If swelling or sharp pain occurs, adjust load and consult your clinician.

可考慮每天做溫和活動度練習（在不誘發疼痛的範圍內）、每週 2–3 次肌力／穩定度訓練，並注意活動量分配。 若出現明顯腫脹或尖銳痛，請調整負重並與臨床人員討論。

Is acupuncture appropriate for everyone with joint pain?
關節痛的人都適合針灸嗎？

Most people can consider acupuncture, but suitability depends on diagnosis and red flags. Seek medical assessment if you have fever, unexplained severe swelling, sudden inability to bear weight, or recent major trauma.

多數人可考慮針灸，但仍需視診斷與警訊而定。若有發燒、不明原因劇烈腫脹、突然無法承重、或近期重大外傷， 建議先就醫評估。

If you’re dealing with joint stiffness, flare-ups, or degenerative changes, it may help to zoom out: cartilage health is influenced by movement, fascia tension, and how the joint is loaded day to day.

若你正面對關節僵硬、反覆發作或退化相關問題，建議把視角放大：軟骨的狀態常與活動方式、筋膜張力、 以及日常受力策略息息相關。

This article is for general education and does not replace medical diagnosis or individualized care. If symptoms are severe, worsening, or associated with red flags, please seek medical evaluation.
本文為一般衛教資訊，不能取代醫療診斷或個別化治療。若症狀嚴重、惡化或伴隨警訊，請先就醫評估。