• Bone and Joint Health
• Health Topics
• Joint Conditions/Injuries/Treatment
• Knee Pain

Your Guide To Knee Pain Relief

Is knee pain bothering you? To the point the discomfort gets in the way of your daily activity, work, and exercise?

If so, a doctor’s appointment could help you get on the path to finding the cause of the pain – and relief.

Arthritis is the most common cause of knee pain. Knee arthritis symptoms may include a swollen, tender, or warm kneecap, and pain accompanied by fever. The joint can become stiff and difficult to move, and make daily activities difficult.

You should see your health care provider if symptoms last three days or more, or occur several times in one month, the Arthritis Foundation recommends.

Orthopedic surgeon Matthew Lawless, MD, says, “The patient should seek treatment once they become frustrated with how the knee pain interferes with their activities of daily living, with their job, with their exercise routine, or just becomes a general nuisance.”

Knee pain can also result from injuries. When untreated, joint injuries can develop into arthritis, accelerating the deterioration of cartilage, which cushions the ends of bones in joints to prevent them rubbing against each other, causing pain.

A common knee injury is a torn meniscus, one of two rubbery, wedge-shaped pieces of cartilage that absorb shock in each knee joint. Meniscus tears can result from a sudden twist of the joint, commonly in athletics. And degenerative meniscus tears occur in older adults after years of normal wear and tear that weakens the cartilage, Dr. Lawless says.

Diseases such as gout, Lyme disease, and lupus can also cause knee pain.

And knee pain can result from six types of arthritis:

• Osteoarthritis. The most common, this arthritis results when joint cartilage deteriorates, causing bones to rub against each other. Knees are commonly affected by osteoarthritis.
• Rheumatoid arthritis. This is an inflammatory disease in which the body’s immune system attacks and damages the joints.
• Infectious arthritis. Caused by an infection in the joint itself
• Juvenile arthritis. Affects those age 16 or younger
• Psoriatic arthritis. Associated with psoriasis, a skin disease
• Reactive arthritis. Results from a gastrointestinal, genital, or urinary infection

Dr. Matthew Lawless talks about causes of knee pain.

Click play to watch the video or read video transcript.

Diagnosing Knee Pain

Your doctor can diagnose the cause of your knee pain based on:

• Your medical history
• Symptoms that you’ve been encountering and how they affect your life
• Treatment that you’ve sought or received
• A physical exam of your knee
• An X-ray

Dr. Lawless says that patients over the age of 40 usually have an X-ray while standing. This helps determine the amount of cartilage remaining in the joint. Cartilage does not show up on X-rays, but the X-ray will show the amount of space between the bones in a joint, from which the doctor can determine the amount of remaining cartilage in the joint. The less space, the less cartilage, and the greater likelihood of arthritis.

Your doctor may order an MRI if unsure of the diagnosis based on the X-ray and examination, or as confirmation if the diagnosis seems unusual considering your age or the degree of knee pain you have been experiencing.

Dr. Matthew Lawless talks about how knee pain is diagnosed.

Click play to watch the video or read video transcript.

Conservative, Nonsurgical Treatment Of Knee Pain

Once your knee pain is diagnosed, your physician will likely start you on a conservative, nonsurgical treatment plan.

The following are typical nonsurgical treatments for knee osteoarthritis:

• Weight control/loss. Weight management can ease the strain on your knee joints and may help reduce the risk of other health issues such as inflammation, high blood pressure, type 2 diabetes, and cardiovascular disease.
• Exercise. This can help you manage weight, as well as build muscle strength to support your knee joints, help you maintain mobility, and reduce stress. Low-impact exercise is best for arthritic joints. For instance, cycling, walking, swimming, water aerobics, tai chi, yoga, stretching, strengthening, and balancing exercises.
• Medications. Over-the-counter (OTC) and prescription medications can help relieve pain and other osteoarthritis symptoms of the knee. These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) and naproxen (Aleve).
• Heat and cold packs for relieving pain and inflammation
• Activity modification. An occupational therapist can teach you new ways to accomplish everyday activities with less pain and strain on your knee joints.
• Physical therapy. Dr. Lawless says that physical therapy can help you reestablish knee motion lost to the stiffness of arthritis. Physical therapy also can strengthen the muscles that support your knees – and improve your balance.

“Almost everyone with knee pain can benefit from physical therapy, whether we continue on the conservative course, nonoperatively, or even progress to operative management,” Dr. Lawless says.

Dr. Matthew Lawless explains the role of physical therapy in treating knee pain. 

Click play to watch the video or read video transcript.

Your doctor may recommend injections of corticosteroid into the knee joint to manage knee pain after other conservative, nonsurgical treatment therapies have been tried without success.

Dr. Matthew Lawless talks about how often knee injections can be given.

Click play to watch the video or read video transcript.

Surgical Treatment For Knee Pain

Surgery is considered only when nonsurgical options have been tried without success or after they lose their effectiveness in relieving pain, Dr. Lawless says.

The most common surgical procedures for the knee are arthroscopy and partial or total knee joint replacement.

Knee arthroscopy is a minimally invasive surgery in which the surgeon makes small incisions for inserting a tiny camera and surgical instruments to repair an injured knee joint. Arthroscopy is typically used to repair meniscus and ligament tears and can be used to:

• Remove loose fragments of bone or cartilage
• Repair defects in cartilage to restore joint movement
• Reconstruct a torn anterior cruciate ligament (ACL)
• Remove inflamed synovial tissue from the joint
• Treat kneecap problems
• Treat infection in the joint

Research shows that knee arthroscopy is usually not effective for arthritis patients, bringing only short-lived pain relief, if any, according to the Arthritis Foundation.

Knee replacement (arthroplasty) is commonly the surgical option for treating knee pain caused by arthritis, after nonsurgical treatments no longer help. Depending on the extent of joint damage, your surgeon will perform a partial or total knee replacement. Partial knee replacement is suitable for only a small percentage of knee replacement patients.

In knee replacement surgery, the surgeon removes damaged cartilage surfaces at the ends of the thigh and shin bones, along with a small portion of underlying bone. The surgeon then replaces the removed cartilage and bone with metal and plastic components – the new joint surface. The kneecap may also be covered with an artificial surface.

Total knee replacement is considered one of the most successful surgical procedures in medicine, according to the American Academy of Orthopaedic Surgeons.

And Dr. Lawless says, “Once a patient has a total knee arthroplasty, they should expect to have much of their pain relieved. They should be able to sleep through the night. They should be able to get up and perform activities as they once were able before their knee pain became limiting.”

Revision surgery. Over time, artificial joints can wear out. Dr. Lawless says that 90 to 95 percent of knee replacements last 10 years; 80 to 85 percent, 15 years; and 70 to 75 percent 20 years.

“Once a total knee fails then we do what’s known as a revision surgery where we take the replaced knee out and put in a new knee.” The operation is more complex, takes more time, and requires larger artificial implants than a first-time total knee replacement.

Knee revision surgery is becoming more common as more people are having knee replacements at a younger age.

Dr. Matthew Lawless talks about knee replacement revision surgery.

Click play to watch the video or read video transcript.

Source: Matthew Lawless, MD, Premier Orthopedics; Arthritis Foundation; MedlinePlus; American Academy of Orthopaedic Surgeons; American Academy of Family Physicians

Matthew W. Lawless, MD

Premier Orthopedics

View Profile View Articles

Schedule An Appointment