Acupuncture for Knee Pain in San Francisco
A kneecap that aches on the stairs, a sharp outer knee a few miles into every run, or a stiff, arthritic knee that cuts your walks short? We treat knee pain with acupuncture, dry needling and hands-on work, and we look at the hip and foot that load it.
Sound familiar?
- An ache around or behind the kneecap on stairs, hills or squats
- Stiffness and pain after sitting a while with your knees bent
- Sharp pain on the outside of the knee that starts at the same point in every run or ride
What our patients say
5.0 on Google from 92 reviews
Gosh, I'm so happy I found Andrew! Thanks to him, I avoided going down a surgery route for my injury! In June 2022, my left knee started acting up (my best guess is overcompensation for gluteal tendonitis I was treating) but I pushed through to backpack 264 miles on the John Muir Trail. When I finished my trek, my left knee was pretty unhappy and I couldn't even get in and out of my car without feeling like a jigsaw puzzle. I tirelessly saw dozens of providers over the next year - chiropractors, physical therapists, orthopedists, massage therapists, etc. All had their own theories - soleus muscle, calf strain, chronic exertional compartment syndrome, etc. The complexity in my case was that my pain was not in my knee itself - it was on the left side in between my knee cap and calf. Despite my knee MRI showing meniscus tears, inflammation, tendonosis, etc. the doctors insisted we treat the symptoms, not the MRIs. So, I got a calf MRI, hip MRI, and an EMG, all of which were negative. Then, one doctor recommended oral Prednisone, and he told me I should see results better than Advil for pain management. It did nothing. It wasn't until I was finally referred to one doctor who noticed something in my knee MRI and caught that there is excess fluid in my proximal tibiofibular joint (PBTJ), and that area tracks with where I feel my pain. To test his suspicion diagnostically, he recommended an ultrasound-guided cortisone injection in my PBTJ to see if that reduced my pain. The pain did decrease (which was good), but it wasn't gone. The doctors informed me issues concerning the PBTJ are rare, and that they needed to refer me to one of the only specialists in the country for this. That specialist happened to be in Minnesota, and when I checked his website, he was only seeing patients for surgery. I did not want surgery. I felt completely defeated, unsure where to go next. In May, I was recommended by someone who also had a challenging journey with injuries (and was able to return to running and hiking) to try acupuncture. I was surprised, since I had not considered Eastern Medicine before for a sports injury. The person specifically recommended I search for an acupuncturist who specializes in athletes, and that led me to find "Acupuncture for Athletics." :) My first appointment with Andrew was May 30, and he patiently listened to my whole ordeal and reviewed all of the documentation I brought (MRIs, doctor's notes, etc). He assured me he treats the root cause, which I appreciated because I did not want to do a band-aid fix only for this to return again, and that he has hope I can feel better. We started off with cupping along my left leg to encourage the inflammation to dissipate, and then we did needles in my leg. Oof, I remember one session when Andrew placed a needle near my PBTJ - I screamed SO loudly lol. But once all of the needles were in, it slowly felt like a meditative experience, and I was able to relax into it. Over my 7 sessions with Andrew, I began to notice the needles felt less painful. In the beginning, I remember feeling the pain just in walking over to Andrew's office. By the 6th session, I realized I wasn't thinking about my pain anymore. I did one more session to be sure, and I was in disbelief that I actually felt pain-free! We decided to go a month testing how the pain fared without regular sessions, and so far so good! The pain flares here and there, but in a MUCH less capacity than before. Throughout this whole process, Andrew was kind, patient, and determined. He was committed to solving the underlying issue, and he was flexible and accommodating to me - whether I wanted to address my left knee or start tackling similar pain that was creeping up on my right knee. Had it not been for Andrew, I would have likely chased surgery because I was running out of ideas. I appreciate you, Andrew! If you're nearing your wits' end with a chronic injury, please go see Andrew and give it a good ~5 sessions if you can. Wishing everyone out there good luck on their chronic pain journeys! You got this!
I could not recommend Andrew enough! He has so much knowledge on the human body and can figure out quickly what areas need work. I went in with major back pain that kept me from lifting weights or running, and after a few sessions I am pain free.
Andrew applies his knowledge of the body and expert techniques to address affected muscles both for maintenance during training and related to injury. His combination of acupuncture and massage helps to open up areas and find the place to target. I have seen Andrew in the past for recovery post concussion and most recently for routine maintenance while training at a high level for my next marathon. I highly recommend Andrew and am lucky to have him as a part of my support team to stay healthy! - Katie Hynes, competitive runner -
As an avid runner who is always training for an endurance race my body has a tendency to break down. Andrew is a legit magician. He’s able to get to the root off the problem quickly and I often don’t miss a beat with regards to my training. Marathon prep would not be possible otherwise.
There’s no one I trust more than Andrew to support my kids in their healing process if they’ve had a sports-related injury. As elite athletes, it’s so important that their knees, ankles and shoulders are well taken care of, and Andrew is our go-to for treatment of pain or injury and also guidance for best practices outside the treatment room to further help healing along. My daughter recently rolled her ankle and was ready for a painfully prolonged healing process when we took her into to see Andrew for a couple treatments before a tournament weekend. With his help, her recovery was amazing, allowing her to feel confident on her ankle. Thanks to Andrew, she was healthy enough to play without pain or exacerbating the injury. We are very grateful to have Andrew on speed dial when these types of injuries occur!
Andrew introduced me to a form of healing which, after years of competitive long distance running and many injuries, I am more than thankful to have discovered! My latest injury, a small tear in my left hamstring, sidelined me for a number of months. After trying rest, physical therapy and anti-inflammatories with little results, I finally met Andrew. His approach from the very beginning was completely methodical, precise and extremely professional. Right away the pain eased, and I felt my body finally respond to treatment. Andrew was instrumental in healing my hamstring, and I trust that his acupuncture/massage techniques will keep me healthy and, importantly, keep me running for many decades and miles.
I came to Andrew after nearly six excruciating months of not being able to run. I had a seemingly minor Achilles tendon injury that simply refused to heal, defying every modality I tried. I hoped Andrew, a specialist in sports injuries, could break the deadlock. The simple answer is that in three visits, I was running again, hardly able to believe my good fortune. The more complicated answer runs deeper. Andrew’s work doesn’t just address physical injury; he works on spiritual and emotional injury and stress too. I didn’t realize that my physical injury was bound up with emotional trauma, but he did, and he figured out how to disentangle them so the healing process could start. The process can be painful; emotional injuries that have lodged in your body have to work their way out through muscle and bone, like a physical illness. But it’s also both profound and unexpected. As another of Andrew’s clients said, he is a true healer.
Andrew’s massage and acupuncture techniques have seen me successfully through back-to-back marathons seven weeks apart, plus two active pregnancies and a record-breaking racing season in between. He is a veritable genius in his field — a true healer.
As a professional dancer, I rely heavily on Andrew throughout the performance season to literally fix me in order to get me back onstage. I have chronic problems with my knee and my shoulder, and the combination of acupuncture with electric stimulation and heat has been tremendously helpful. Andrew only needs five minutes to find exactly where he needs to work, and the results are fantastic. His acupuncture work is also gentle, and doesn’t leave me sore the next day — in fact, it’s one of the only therapies I feel comfortable receiving right before a show. Andrew does great deep tissue work as well, and he is very responsive and attentive as a therapist. I’d highly recommend him to dancers, athletes and non-dancers alike.
I was introduced to Andrew by a friend who dubbed him as nothing short of magical. After experiencing his expertise firsthand, I couldn't agree more. Andrew's mastery of the human body and its intricacies truly feels like a kind of magic. I've been to other specialists for my chronic upper back and neck pain, but Andrew is different. He focuses on treating the actual problem, not just masking the symptoms. For the first time, I walked out of an acupuncture session and went back to exercising without feeling any pain. It was a game-changer. I feel as if I've been given a brand new back. Honestly, I never thought a life without back pain was possible until now. While I was also working with Andew some other health issues came up that couldn’t be diagnosed by western medicine. His thoughtful and holistic approach immediately made me feel understood and valued. Throughout our sessions, he would patiently explain the various points he was working on or the sensations I was experiencing, shedding light on what was going on internally within my body. Thanks to him, I now have a deeper appreciation for how imbalances in one area can send ripples throughout the entire system. He was able to find the root cause, guiding me slowly but surely on the path to recovery. I feel blessed to have met Andrew, he really has changed my life and I’m grateful for that.
I would strongly (strongly!) recommend Acupuncture for Athletics for both athletes and non-athletes alike. Not only does Andrew help with injury recovery, pain management, and stress relief, but he creates a relaxing and positive environment that enhances the work that he does and leads you to feel better both physically and mentally after each visit. And beyond acupuncture and massage, Andrew goes the extra mile to provide guidance on how to address specific pain-points and injuries, or to simply ensure that you are feeling and performing your best. Again, I can't recommend Acupuncture for Athletics enough!
I had a golfers elbow and my coach referred me to Andrew. He has been an amazing acupuncturist and worked on my right elbow, shoulder and arm for a couple of weeks. I have felt so much better just after the first session and going back really helps the blood flow so much better and my right arm, elbow and shoulder feels less tense and more relaxed. Definitely recommend this place, especially for athletes!
Does this sound like you?
Knee pain tends to follow a few familiar patterns. Most people we see recognize themselves in one or two of these.
If any of these ring a bell, an assessment will show us which part of the knee is irritated and what's overloading it.
- An ache around or behind the kneecap on stairs, hills or squats
- Stiffness and pain after sitting a while with your knees bent
- Sharp pain on the outside of the knee that starts at the same point in every run or ride
- Soreness just below the kneecap when you jump, land or kneel
- Morning stiffness and a deep ache that builds as you walk
- A knee that feels weak or unsure on the way down a hill
Why knees hurt
The knee is a hinge sitting between two bigger, more mobile joints. Your hip above and your foot and ankle below decide a lot about how force reaches it, so knee pain is often a sign that something in the chain has changed: more miles, more hills, tired glutes, a stiff ankle or new shoes.
Most knee pain we see isn't a torn ligament. It's an irritated tendon, a sensitive joint surface behind the kneecap, or overworked tissue along the outer thigh. These overuse problems respond well to treatment but tend to return if the load stays the same.
Knee osteoarthritis is different: a gradual change in the joint's cartilage and bone, more common after 50, felt as stiffness, swelling and an ache with walking. It can't be reversed, but pain and function can often improve a lot.
Common contributors
- A jump in mileage, hill work or speed sessions
- Weak or fatigued hip and glute muscles
- Tight quads, calves or outer thigh
- Stiff ankles or worn-out shoes
- Lots of squatting, kneeling or stairs
- An old knee injury or surgery
- Age, genetics and extra body weight (for arthritis)
Four common causes of knee pain
Where it hurts and when it hurts tell us a lot. Sorting out which of these you have is the first job at your assessment, because each one needs a slightly different plan.
| Condition | Where it hurts | What it feels like | Where we focus |
|---|---|---|---|
| Runner's knee (patellofemoral pain) | Around or behind the kneecap | A dull ache on stairs, hills, squats and after long sitting | Quads, glutes and outer hip, plus how you load the knee |
| IT band syndrome | The outside of the knee, sometimes up the thigh | A sharp or burning pain that arrives at a predictable point in a run or ride | The hip, glutes and the tissue along the outer thigh |
| Patellar tendinopathy (jumper's knee) | Just below the kneecap | Sore when you jump, land, squat or kneel, often stiff the next morning | The quads and tendon, alongside a gradual loading plan |
| Knee osteoarthritis | Across the joint, often the inner side | Morning stiffness, swelling and an ache that builds with walking | Pain relief and the muscles that support the joint |
Why the label matters
A sore tendon needs gradual loading, not weeks of rest, while an IT band flare usually settles once we calm the outer hip and trim your training. Cleveland Clinic notes that IT band syndrome accounts for about 12% of running injuries, and that most people improve with nonsurgical care within four to eight weeks.
Who gets knee pain
Runners fill many of our knee appointments, but knees take the strain of almost everything we do on our feet.
People we see most
Related problems we treat
- Acupuncture for runners
- Hip and glute pain
- Plantar fasciitis and heel pain
- Tight hamstrings and calves
- Shin pain from running
How we treat knee pain
We treat the sore spot and the muscles that load it. Most visits combine several of these, chosen for your knee and the way you train.
- Sports acupuncturePoints around the knee and along the thigh and hip to ease pain and muscle guarding.
- Dry needlingInto trigger points in the quads, glutes and outer hip that pull on the kneecap and IT band.
- CuppingAlong the outer thigh and quads, to loosen tissue a foam roller can't reach.
- Cold laserLow-level laser over an irritated patellar tendon or a sore joint line.
- Sports massageHands-on work for quads, hamstrings and calves, often booked as an acupuncture and massage combo.
Who performs dry needling in California?
In California, dry needling is performed by licensed acupuncturists. Physical therapists in California are not currently authorized to perform dry needling. Every practitioner at our clinic is a California-licensed acupuncturist.
What the research says
Knee osteoarthritis has the deepest research behind it. A 2004 trial of 570 people with knee arthritis found that six months of real acupuncture, added to usual care, improved pain and function more than sham acupuncture. A 2024 review of 10 trials with 3,221 people found the benefit over sham lasted roughly four and a half months after treatment ended.
That body of work is why the American College of Rheumatology guideline conditionally recommends acupuncture for knee osteoarthritis. The National Center for Complementary and Integrative Health adds that the pain relief seen in arthritis studies was comparable to anti-inflammatory drugs.
For runner's knee, most of the research is on dry needling. A 2020 review of 10 trials found dry needling eased knee pain in the short term, with the strongest effect in patellofemoral pain. A 2025 review of 466 people with patellofemoral pain also found dry needling reduced pain. Most of these studies paired needling with exercise, which is how we use it too.
For IT band syndrome and patellar tendinopathy, we use needling to settle pain and tight muscles while steady strengthening does the long-term work. New to needles? Here's what happens in an acupuncture session.
What studies have found
- Knee osteoarthritis has the strongest support, including a guideline recommendation
- Dry needling eased runner's knee pain, especially alongside exercise
- Arthritis pain relief comparable to anti-inflammatory drugs
- Results vary, and it works best as part of a plan
Your first visit and your plan
Allow about an hour for your first visit. The number of sessions you'll need varies, and we'll give you an honest estimate after your assessment.
Assess
We ask about your training, work and past injuries, then watch you squat, step down and balance, and check hip strength and ankle movement to find what's driving the pain.
Treat
You'll usually lie on your back or side while we needle points around the knee, thigh and hip, often with cupping or massage on the quads and outer thigh.
Afterwards
Many people notice the knee moves more freely on the way out. Needled muscles can feel sore for 24-48 hours, like after a hard workout. Easy walking or cycling is fine that day.
Build it back
We give you a few simple strength exercises for the hips and quads and help you adjust your training, then space visits out as the knee settles.
When to see a doctor first
Most knee pain is an overuse problem we can help with. Some signs, though, point to a torn ligament or meniscus, a fracture, an infection or a blood clot, and those need a physician before anything else.
The NHS advises getting urgent medical advice if your knee is very painful, badly swollen or has changed shape, if you can't move it or put weight on it, or if it locks, gives way or painfully clicks. If your knee is hot and red and you feel feverish, get seen the same day.
Once your doctor has ruled out anything serious, we're glad to work alongside them.
See a physician first if you have
- A pop at the moment of injury, then fast swelling
- Trouble putting weight on the leg or straightening the knee
- A knee that locks, gives way or looks misshapen
- A hot, red, swollen knee, especially with a fever
- A swollen, tender calf, which can signal a blood clot
Who'll treat you
Three California-licensed acupuncturists with Traditional Chinese Medicine training, who treat knees every week, from new marathoners to people managing arthritis. Andrew Castellanos brings more than 25 years with athletes and helps patients recover after knee surgery. We look at the hip and foot that load the knee, too.
Andrew Castellanos
L.Ac, CST · Clinic owner
Runner's knee, IT band pain and recovery after knee surgery.
- Eases swelling and stiffness after surgery
- Was on call for the Impala Racing Team
- Dry needling and cupping for tight quads and IT band
Ali Hakimi
L.Ac
Local acupuncture for knee pain, with advice to keep you active.
- Local acupuncture for injury recovery and pain reduction
- Diet and lifestyle guidance to help you stay moving
- Extensive knowledge of classical herbal medicine
Suzanne Lange
DACM, L.Ac, CMT
Orthopedic acupuncture and bodywork for aching or arthritic knees.
- Whitfield Reaves Sports Medicine Apprenticeship
- Doctorate in Acupuncture and Traditional Chinese Medicine
- Myofascial work for the muscles around the knee
Pricing and booking
Knee treatment fits into a standard session, using whatever mix of techniques your knee needs. There's no package to sign up for.
We're out-of-network and don't bill insurance, but we'll give you a superbill to submit for possible reimbursement. HSA and FSA cards and all credit cards are welcome. The clinic is on Webster Street, not far from the Marina Green running paths, if you're looking for acupuncture near the Marina.
Appointments
- 60-min initial acupuncture & assessment
- $225
- 45-min acupuncture follow-up
- $195
- 60-min acupuncture/massage combo
- $225
- 75-min acupuncture/massage combo
- $265
- 90-min acupuncture/massage combo
- $300
Knee pain FAQ
Can acupuncture help knee pain?
It can help many kinds of knee pain. Studies have found it eases osteoarthritis pain and improves function, and dry needling combined with exercise has eased runner's knee pain. Results vary from person to person, and we'll estimate how many sessions you'll need after your assessment.
Does acupuncture help knee arthritis?
Large trials have found that acupuncture eases arthritis pain and improves function more than sham treatment, and the American College of Rheumatology conditionally recommends it. It won't rebuild cartilage, but it can make walking and sleep easier, especially alongside strengthening and staying active.
Can acupuncture help IT band syndrome?
We often use acupuncture, dry needling and cupping for IT band pain to release the glutes, outer hip and thigh. We pair it with hip strengthening and a short-term change in your training, which is what gets most runners back.
How many sessions will I need?
It varies with the cause and how long you've had it. A recent flare often settles faster than a knee that has bothered you for a year. Visits usually start closer together and spread out as the knee improves, and we'll give you an estimate after your first assessment.
Can I keep running?
Usually, with changes. Many runners keep going at lower volume, swap hills and speed work for flat easy miles, or cross-train on a bike for a while. We'll help you decide what to keep and what to drop for now.
Does needling around the knee hurt?
The needles are very thin and most people feel little more than a dull ache or tingle. Dry needling a tight quad or glute can cause a quick muscle twitch and a deep ache that passes in seconds. Mild soreness for a day or two afterwards is normal.
Can you treat my knee after surgery?
Yes. Andrew Castellanos has years of experience with post-surgical recovery, and acupuncture can help with pain, swelling and tight muscles around a repaired knee. Please check with your surgeon before you start, and tell us what procedure you had when you book.
Do I need a referral or an MRI?
No referral is needed to book with us, and most overuse knee problems don't need imaging to start treatment. If your symptoms suggest a tear or another structural problem, we'll refer you to a physician for an exam and imaging.
Where can I get acupuncture for knee pain in San Francisco?
Andrew Castellanos treats runner's knee, IT band pain, patellar tendon pain and knee arthritis at our clinic at 2920 Webster Street in Cow Hollow. We're a short walk from the Marina, Pacific Heights and the Presidio. As well as treating the knee itself, he looks at the hip and foot that load it.
Is there parking nearby? I'd rather not walk far on my knee.
There's metered parking on Union Street, one block away, and the Union Laguna Garage at 1910 Union Street. Nearby residential streets have time limits for visitors, so check the signs before you leave the car. There's more on getting here on our directions and parking page.
References
- Berman BM, et al. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004.
- Chen H, et al. Durable Effects of Acupuncture for Knee Osteoarthritis: A Systematic Review and Meta-analysis. Current Pain and Headache Reports. 2024.
- Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research. 2020.
- Rahou-El-Bachiri Y, et al. Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020.
- Rashnavadi H, et al. The Effectiveness of Dry Needling in Patellofemoral Pain Syndrome Patients: A Systematic Review and Meta-Analysis. Journal of Bodywork and Movement Therapies. 2025.
- National Center for Complementary and Integrative Health. Acupuncture: Effectiveness and Safety.
- Cleveland Clinic. Iliotibial Band Syndrome (ITBS): Causes, Symptoms and Treatment.
- NHS. Knee Pain.
Ready to take the stairs without thinking about it?
Book an assessment at our Cow Hollow clinic, or call to talk through your knee first.
Visit us in Cow Hollow
2920 Webster Street, between Union and Filbert. A short walk from the Marina, Pacific Heights and the Presidio.
Address
Acupuncture for Athletics2920 Webster Street
San Francisco, CA 94123 Gate code: in your booking confirmation email
Hours
- Every day
- 7:30am – 9:00pm