Effect of Distal Needling on Knee Pain Using Acupuncture Techniques

Inclusion Criteria: * Adult patients (\> 18 years old), suffering chronic stable pain score \>40 mm on 100 mm VAS of the knee due to patellar tendonitis. * Patients have had X-rays or other tests confirming they are not candidates for surgery nor are scheduled for steroid injections or hyaluronic acid injections within 8 weeks from the beginning of the study. * Adult patients (\> 18 years old), two weeks after ACL reconstruction surgery (with or without meniscal involvement), with pain score \>40 mm on 100 mm VAS of the knee (all patients at this stage have significant ROM limitation). Exclusion Criteria: * Patient refusal * Soldiers * Pregnancy * Morbid obesity * Diabetes * Peripheral vascular disease * Lower limb neurological deficit (such as multiple sclerosis, nerve palsy), other serious co-morbidity (including severe back pain or hip pain) * A history of prolonged or current steroid use * Received hyaluronic acid injections within the previous 3 months * Have needle phobia or allergy to sticking plaster.