Knee pain is the most common peripheral joint to bring patients into the clinic.
The economic and social impacts of knee pain related to osteoarthritis are profound. Symptoms include pain in the knee when standing or walking, swelling, stiffness, weakness, instability, popping/crunching noises, inability to fully straighten the knee.
Many patients find that they have ‘flare-ups,’ which pass with home treatments and rest. Over time, however, these conditions may get worse and become more constant. There are many causes of pain, which can be related to old injuries, including meniscal tears, which may have required repair, chronic bursitis, and chronic tendinitis of the patella (knee cap).
There are mechanical issues that include loose bodies (pieces of bone or cartilage floating in the knee joint) or recurrent knee dislocation. Frequently, the knee joint is not the pain generator, but issues related to the hip (including the iliotibial band) or foot/ankle issues. A lack of muscle flexibility or strength and excess weight can cause trouble.
The most common cause of knee pain is osteoarthritis. This is the basic “wear and tear” damage that occurs as the cartilage deteriorates, and there is further damage to the bone. Other arthritis causes include rheumatoid, gout, and pseudogout, which can be diagnosed with blood tests.
There are a multitude of knee pain treatments that could be recommended, depending on the condition. The treatment plan may include one or more of the following:
- non-steroidal anti-inflammatories
- compound transdermal medications
- bracing, including custom bracing
- neuromodulation treatments
- vitamin supplementation
- cold therapy
- initial corticosteroid injections
- viscosupplement injection treatment (a kind of synthetic treatment injected in a series of three injections)
- growth factor injections
- cryopreserved stem cell injections
- Botox therapy
- platelet rich plasma injections.