Non-Operative Treatment of Knee Pain

Initial Evaluation in the Office

Dr. Kelly performs a thorough clinical evaluation of each patient that includes three major parts: history, physical examination, and imaging. The history is a focused conversation about duration of symptoms, location of pain, aggravating factors, and previous injuries or surgery to the knee. Next, Dr. Kelly will examine the knee focusing on the overall alignment, range of motion, and any areas of swelling or tenderness. Finally, x-rays of the knee are reviewed which provide additional information about the health of the knee joint.

What is Dr. Kelly’s approach to care?

Dr. Kelly strongly believes that all patients should try some form of non-operative treatment below. These treatment options can provide significant improvement in symptoms without any risks associated with surgery. In fact, the vast majority of people who are treated in the office never receive surgery and respond well to the treatment options below!

Why Does My Knee Hurt?

It is important to make an accurate diagnosis of knee pain before offering treatment options. The most common causes for knee pain are reviewed below.

• Knee Arthritis: When the cartilage wears out and the knee loses its cushioning, this can cause severe pain from the nerves inside the bone. See “Knee Arthritis” page.
• Meniscus Tear: Meniscus tears can be the result of aging or can occur with an injury. Typically patients describe difficulty with squatting. Sometimes the meniscus can restrict normal range of motion and cause popping or clicking within the knee.
• Tendinitis/Bursitis: The knee is surrounded by muscular attachments as well as fluid sacs called bursa. If these get inflamed, it can be quite painful. These injuries respond well to non-operative treatment and very rarely require surgery.

Can I still exercise if my knee hurts?

Yes! As the saying goes, “motion is lotion.” We want our patients to remain active. High impact exercises like running or jogging may cause more pain in the knee compared to low impact exercises like biking or swimming. We can work with you to find a way to remain active and limit pain in your knee.

Non-operative Treatment Options

1. Ice and elevation – Many people often forget about this basic treatment method, however ice and elevation can be very helpful to decrease knee pain. This works better with flare ups of pain versus long-term treatment of chronic knee pain.
2. Weight Loss – The knee has to withstand 5x your bodyweight with certain daily activities such as climbing stairs. When listening to the patient, it is common for Dr. Kelly to hear about knee pain that developed after a period of weight gain.  He understands that it can be even more challenging to lose weight when your knee hurts. Our team often recommends focusing on diet and low impact or water-based exercise to help lose weight and reduce the stress on your knee.
3. Physical Therapy – A skilled physical therapist can evaluate a patient to understand each patient’s unique needs. He or she can then help strengthen muscles to improve mobility and reduce pain. Improving muscle control around the knee can result in less pain and less sense of “knee giving out.” Physical therapists can also offer treatment of soft tissues to reduce inflammation and swelling and improve range of motion. After a few sessions, most people are able to transition to exercises at home.
4. Anti-Inflammatory Medication – The first medication to treat knee pain is typically a non-steroidal anti-inflammatory drug, or NSAID. Common examples include ibuprofen (Advil), diclofenac (Voltaren), and meloxicam (Mobic). If patients are unable to tolerate oral pills, topical creams are also available.
5. Injections – The main purpose of injections is to reduce inflammation and symptoms. Cortisone injections reduce inflammation and can provide excellent short-term relief of pain and symptoms. Viscosupplementation Injections attempt to lubricate the joint surface with hyaluronic acid, a substance that is naturally present in your joint. Platelet Rich Plasma (PRP) injections include concentrated products from a patient’s own blood to reduce inflammation.