When your knee hurts, it can derail everything from exercise to everyday life. You might think that surgery is the only option for long term relief but there are other alternatives. Non surgical treatments have been shown to decrease pain, increase function, and help you stay active. Here at Alpha Sports Performance Medicine, we want to identify WHY your knee hurts and create an individualized plan to restore your movement while avoiding unnecessary procedures.
The most effective treatment plans involve rehab exercises specific to your diagnosis, controlling inflammation, managing weight, and fixing biomechanical errors. Let’s take a closer look at your options.
Physical Therapy & Conservative Care
One of the most common and effective ways to treat painful knees without surgery is structured physical therapy. A physical therapist will create an exercise program that builds up the muscles around your knee, teaches proper movement patterns, and corrects joint mechanics.
Strengthening the muscles around your knee joint takes pressure off of the knee itself. This includes the quadriceps muscles on top of your thigh, your hamstring muscles in the back of your thigh, and even your gluteal muscles in your buttocks. Step downs, straight leg squats, bridges, and resistance band work are all great examples of low impact exercises that improve stability. As these muscles strengthen with exercise, daily activities like walking up and downstairs or sitting down and standing up will feel easier and less painful.
Flexibility and mobility work is also extremely important. If your hamstrings, calves, and hip flexors are tight on the front of your thigh and back of your leg, it can place more compression on your knee joint and cause you to compensate while you walk. Regular stretching exercises 2-3 times per week can help restore normal mobility.
Part of conservative treatment may also include modifying your activities to limit high impact exercise while continuing to participate in low impact exercises. Cutting back on running or jumping while still biking or swimming can be an effective way to stay active while you heal.
Weight Loss & Reduced Loading Through Your Knee
Bodyweight has been shown to have a huge impact on knee pain, especially in the knees. Every pound of bodyweight is equal to about four pounds of pressure through your knee joint every time you take a step. Losing just one pound of bodyweight can significantly decrease the load through your knee as you walk or run.
Weight loss is most effective when you combine a mild calorie restriction with low impact exercise. By continuing to exercise you will maintain your muscle mass and strength while slowly decreasing weight. This leads to more sustainable habits and better results than going “all in” and trying to lose weight as quickly as possible.
Anti Inflammatory Meds & Topical Treatment
Medication can help control both pain and swelling, especially if your knee hurts most during periods of increased activity. Over the counter and prescription non steroidal anti inflammatory medications are an option when used under the supervision of a medical professional. Topical medications may also offer localized pain relief for those who wish to minimize their oral medication use.
Injections
Along those same lines, injections can help improve inflammation in your knee to allow you to participate in more physical therapy. In some cases, corticosteroid injections can be used to help with sudden flares of inflammatory knee pain. These injections provide weeks to months of relief.
Hyaluronic acid injections are another option used to help improve the joint’s lubrication. Your response to hyaluronic acid may vary, but some people notice gradual improvement over the course of several weeks. Hyaluronic acid is most commonly used for patients with mild to moderate osteoarthritis.
There are also regenerative medicine options that are used for select patients, such as platelet rich plasma (PRP). This is a substance collected from your blood that is concentrated into growth factors that help promote healing of your tissues and decrease inflammation. Response to PRP can vary depending on your diagnosis, activity level, and overall joint health. Imaging studies, physical examination, and your history will help determine if this is an option that would be beneficial for you.
Minimally Invasive Procedures to Decrease Knee Pain
If physical therapy, bracing, and medications are not providing you with relief, there are procedural options available that do not require incisions. Genicular nerve radiofrequency ablation is a procedure that utilizes heat to block pain signals from specific nerves that supply the knee. This can provide patients with relief for months to years.
Genicular artery embolization is a minimally-invasive procedure that can also help decrease inflammation by cutting off blood supply to irritated tissues within the joint. Patients who are not quite ready for surgery, but have found that conservative measures are not helping their pain may benefit from these options.
Braces and Orthotics
Sometimes fixing biomechanical issues can help alleviate pressure on the knee. Certain braces can help unload either the inner or outer knee. Additionally, custom orthotics can be used to help correct foot positioning that may be contributing to excessive stress on the knee.
Our providers will perform a gait analysis to determine if braces or inserts are needed. We will also work with you to adjust the fit as your symptoms improve.
Surgery
If your knee pain persists for several months despite an exhaustive attempt at conservative therapy, we may need to discuss surgery. Diagnostic testing, x-rays, and a physical exam can help us figure out if surgery is the next best step.
Our goal is always to try everything we can think of to help you avoid surgery before we even consider it as an option.
Frequently Asked Questions
What are the best non surgical knee pain treatments close to me?
There are many effective non surgical treatments for knee pain relief, specifically physical therapy, strength training, weight management, icing your knee when necessary, taking anti inflammatory medications, bracing your knee, and injections.
Can physical therapy help me avoid knee surgery?
Yes! If you are suffering from knee pain from osteoarthritis or overuse type injuries physical therapy can be very beneficial. Strengthening the muscles around your knee and losing weight can decrease your pain and increase your function.
How long will it take before my knee stops hurting without surgery?
Every patients experience with non surgical treatment is different. Some people begin to feel better within a few weeks of starting therapy, but it can take up six weeks to twelve weeks to see maximum improvement.
Are injections safe?
Yes! Certain injections can help relieve your pain depending on the cause. It’s important to talk with your doctor to decide what injections, if any, can help you.
Do knee braces or orthotics work?
Orthotics and bracing can help many people who suffer from knee pain. They can help to reduce stress through the knee and make walking around more comfortable. Be sure to combine orthotics with knee strengthening exercises and weight loss to see maximal improvement.
Surgery is not the only option when you have knee pain. Our providers will work with you to come up with a personalized plan to help decrease your pain and increase your activity level.