Knee Pain Treatment

Knee Pain Treatment: An Overview

Understanding knee pain treatment is important in healing your knee and relieving your pain. Knee pain is a common problem in people of all ages. It may occur as a result of an injury- such as in the case of a torn ligament, for example- or it may occur due to a medical condition- such as arthritis.

Whilst some more minor conditions respond to basic knee pain treatment with conservative methods, in more severe cases or complex problems, more rigorous physical therapy or even surgical repair may be required.

Knee pain can vary in its severity and location, depending on what is causing the pain. Along with the pain itself, various signs and symptoms may also be present, such as swelling, stiffness, redness and warmth, feelings of weakness or instability in the joint, the inability to full extend or straighten the knee, and sometimes little ‘popping’ or ‘crunching’, grinding noises may be heard with movement.

Knee Pain Treatment

When should a professional opinion be sought for knee pain treatment?

You should always seek the opinion of a sports podiatrist for your knee pain treatment. You should make an appointment promptly if you experience any of the follow symptoms with regard to your pain:

  • Severe knee pain related to an injury
  • Obvious knee swelling
  • Inability to bear weight on the affected knee
  • Inability to fully extend the knee
  • Have a fever in addition to swelling and redness in the knee
  • Can see an obvious deformity or problem with your knee or leg.

Diagnosis is required before knee pain treatment can commence

Before your knee pain treatment can commence, a correct diagnosis is required. Sometimes the knee pain treatment of choice for a particular condition may be completely incorrect or may actually exacerbate another condition, and for this reason, it is imperative to seek medical advice from your sports podiatrist.

During your consultation, prior to formulating a knee pain treatment plan, your sports podiatrist will conduct a thorough examination. This will include:

  • Visual inspection of the knee and leg for any deformities, swelling and bruising
  • Physically checking for warmth or tenderness in the knee
  • Assessing the range of motion in the knee joint
  • Manipulation of the knee joint to assess the integrity of the structures within the knee.

Biomechanical Assessment before Knee Pain Treatment can Commence

Your sports podiatrist will most likely wish to conduct a biomechanical assessment and gait analysis on the treadmill (if you are able) prior to commencing a plan for knee pain treatment. The assessment involves placing removable markers on certain points on the patient’s legs, and recording video footage as the patient walks / runs on the treadmill. The video is played back in slow motion and using specialized computer software, an analysis of the patient’s gait (manner of walking) can be made. This is useful in identifying abnormalities and malalignments in the patient’s body, often pointing to the root of the problem that is causing the patient’s knee pain, assisting in selecting appropriate knee pain treatment options for the patient.

Diagnostic Imaging before Knee Pain Treatment can Commence

In some circumstances, your sports podiatrist may request some diagnostic imaging prior to commencing your knee pain treatment. This can aid in their diagnosis and ensure that you are provided with the most appropriate knee pain treatment plan. Some types of diagnostic imaging that you may be asked to have include:

  • Xray: xray is useful in detecting bone fractures and degenerative joint disease, such as arthritis
  • Ultrasound: ultrasounds are useful for viewing the soft tissue structures in the body, and allow the radiographer to move the joint into different positions to view the changes in the way tissues behave with movement in real time
  • Magnetic resonance imaging (MRI): MRIs are particularly useful in detecting soft tissue injuries to tendons, ligaments muscles, meniscus and cartilage. They work by using radio waves and a powerful magnet to create three dimensional images of the inside of the body
  • Computerized tomography (CT) scan: CT scans are useful in diagnosing bone problems such as gout, and subtle fractures that may otherwise not be obvious on traditional xray. CT scans work y combining numerous xray images from different angles to create cross-sectional images of the insides of the body.

 Knee Pain Treatment Options

Knee pain treatment will vary considerably depending on what exactly the cause of the pain is. Once your sports podiatrist has determined the cause of your knee pain, an appropriate treatment plan can be devised. The results of the biomechanical assessment are also very useful here, as they can be used to identify biomechanical issues that require attention in order to prevent problems recurring in the future.

There are so many varied options for knee pain treatment. Listed below are just some treatment options.

Knee Pain Treatment: Shockwave Therapy

Shockwave therapy is a revolutionary knee pain treatment, which works by using a hand-held probe to mostly painless direct high-frequency sound waves into an affected area. It is a method that is scientifically proven to stimulate healing by encouraging blood flow and tissue regeneration1, whilst helping to break down scar tissue. It also offers many patients almost instantaneous pain relief.

Knee Pain Treatment: Orthotics and Braces

Under some circumstances, your sports podiatrist as part of your knee pain treatment approach may advise custom-made orthotics. These can help with knee alignment through stabilizing the foot. Orthotics can also help with shifting the pressure to ease knee pain. This approach is commonly seen in cases of osteoarthritis amongst other conditions. There are various support braces that may also be used to restrict motion and support the knee as it heals.

Knee Pain Treatment: Physical Therapy

Often based on the findings of the biomechanical assessment, your sports podiatrist may recommend some strengthening or stretching exercises for your leg muscles as part of your knee pain treatment. The types of stretches or exercises they choose will depend on what is occurring biomechanically to cause your knee pain. You may need to correct movement patterns that are affecting your knees, or if you play a particular sport, you may need to assess and correct your technique.

Knee Pain Treatment: Injections

Injecting medications or substances directly into the knee joint may be required in some cases of knee pain treatment. These injections may include:

  • Corticosteroids such as cortisone, to reduce the symptoms of inflammation and provide pain relief that may last up to a few weeks. Commonly used in patients with arthritis flares.
  • Hyaluronic acid, which may help improve mobility and ease pain by lubricating the joint
  • Platelet-rich plasma (PRP), contains a concentrated amount of growth factors with may promote healing and reduce inflammation. PRP injections tend to work best in patients with early osteoarthritis2 and tendon injuries.

Knee Pain Treatment: Surgery

In some cases, surgery is required for knee pain treatment. This may be the case with severe injuries that are unlikely to heal with other treatment approaches and is hence seen as a last resort to knee pain treatment. Surgical options may include arthroscopic approaches for examination and repair, or partial or complete knee replacements, where the damaged parts or the entire knee is replaced with artificial parts made of metal and plastic. All surgeries carry risks, so it is important to consider the pros and cons of deciding to have a surgical reconstruction as opposed to a non-surgical rehabilitation of your condition.

Other Considerations for Knee Pain Treatment:

When considering your knee pain treatment is important to keep in mind the following:

  • Try to maintain a healthy body weight. Excess body weight puts undue pressure on the knees and can make knee pain worse
  • Limit high impact exercise while your knee recovers. Activities such as swimming are a great low-impact option
  • Cold compresses and ice packs can be safely used for up to 20 minutes at a time at regular intervals throughout the day to provide pain relief
  • Ask your sports podiatrist for their recommendation on which footwear is most appropriate for your foot and for preventing knee pain
  • Over the counter medications such as anti-inflammatory drugs are not a long term solution for knee pain. They provide short-term relief in some cases, but they also can have side effects and don’t resolve the root of the problem.

The information contained in the article above, regarding knee pain treatment, is not intended to be taken as general or medical advice. If you are experiencing knee pain, you should make an appointment with a sports podiatrist who will be able to offer a correct diagnosis and individualised plan for knee pain treatment. Appointments can be made online at www.sydneypodiatrist.net.au or by calling 93883322.

Karl Lockett– sports podiatrist.

References

1 Liao, C., Xie, G., Tsauo, J., Chen, H., Liou, T., (2018), Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials, BMC Musculoskeletal Disorders, 19, 278.

2Spakova, T., Rosocha, J., Lacko, M., Harvanova, D., Gharaibeh, A., (2012), Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid, American Journal of Physical Medicine & Rehabilitation, 91, 411-417.