For those with knee osteoarthritis, pain management becomes key for maintaining a healthy, active lifestyle. Although joint replacement surgery (whether it be inpatient or outpatient) may be a solution, an orthopedic surgeon will typically start with conservative pain relief measures before turning to more invasive methods.
Dr. Abraham at APEX Orthopedics & Sports Medicine has decades of experience treating knee arthritis pain. He creates personalized treatment plans based on patients’ needs, ensuring they get the best outcomes for their lifestyle.
Read on to learn more about non-surgical treatment for knee pain and the options that are available.
What is knee osteoarthritis and what does it stem from?
Before we delve further into non-surgical treatment options for knee pain, it is important to understand the basics behind knee osteoarthritis.
Knee osteoarthritis, also known as degenerative joint disease, is the wear and tear of the cartilage around the knee joint, which leads to inflammation, pain, and even joint degeneration.
The knee is a hinge joint, which allows for flexion and extension. It is also the strongest and largest joint in the body. There are three bony components to the anatomy of the knee:
(1) The end of your thigh bone (femur)
(2) The head of your shin bone (tibia)
(3) The kneecap (patella)
Joints are covered with articular cartilage that protect the connecting bones from grinding against each other. In the knee joint, the cartilage is two wedge-shaped pieces that aid in shock absorbing. These pieces are called the meniscus.
Over time, the meniscus can break down from years of wear and tear. They become thinner and thinner, leading to less protection for the joint. As the joints begin to rub, especially if there isn’t enough space between the two, it causes inflammation, discomfort, and pain.
Diagnosis for knee osteoarthritis requires an examination from a physician along with tests such as X-rays or ultrasounds. But you may have an idea on whether you have osteoarthritis based on these symptoms:
- Joint stiffness, especially after you’ve been sitting or lying down
- Pain and swelling around knee (can be a sharp pain or dull ache)
- Feeling of the joints crunching when you move
- Difficulty bending or straightening your knee
- Knee locking up while you’re moving
- More pain in rainy weather
Some people are more prone to knee osteoarthritis than others. Factors that come into play include:
- Age
- Genetics
- Work injuries
- Physical activity (especially from athletes)
- Obesity
It’s common for osteoarthritis to appear around a person’s 50s, but it can happen earlier if there’s an underlying issue. For example, someone with an injury or a significant genetic predisposition might be diagnosed with knee osteoarthritis in their 40s.
Most people can tolerate osteoarthritis in the shoulders, elbows, and ankles, but joints that affect walking (such as the knees and hips) become a larger issue.
Determining which non-surgical treatment for knee pain will work best
No two patients are the same; therefore, determining the best treatment requires a detailed evaluation from an orthopedic physician. Rather than everyone having the same pain, knee osteoarthritis is more of a spectrum. Some people may have mild, more tolerable pain while others may suffer from severe pain that hinders daily life.
For this reason, Dr. Abraham always dedicates one-on-one time with a patient to find the right treatment option. This may include asking questions such as:
- What caused your knee osteoarthritis?
- How severe is your osteoarthritis?
- Is the pain tolerable?
- What are your lifestyle goals?
- How has knee osteoarthritis affected those goals?
From there, Dr. Abraham can decide whether more conservative knee osteoarthritis treatments will suffice or if you would benefit more from surgery.
Types of conservative knee osteoarthritis treatment options
Despite what you may believe, most people do not require a knee joint replacement surgery in order to relieve pain. There are numerous options available today that can help you maintain your lifestyle and minimize pain.
Physical therapy
Dr. Abraham often prescribes physical therapy to help with pain and promote activity. Joints love to move, and motion is vital to keep fluids and nutrients flowing to the area. While some people may think exercising could make their pain worse, that is often not the case. In reality, a lack of movement can stiffen the joint to the point where pain increases and you have a hard time moving.
A physical therapist will work with your orthopedic physician to ensure his or her exercise plans align with your doctor’s treatment recommendations. Exercises may include light weight lifting, stretching, and low-impact cardio to keep the joint healthy. As synovial fluid (the substance that lubricates the joint) continues flowing through the knee, it helps prevent bones from grinding and causing pain.
Physical therapy and other activities can also help with weight loss. In some instances, Dr. Abraham may recommend losing weight to alleviate pressure on the joints. Combining physical therapy exercises with a healthy diet can often help arthritis pain.
Medications
Oral medications are another non-surgical treatment for knee pain that does not require any other invasive care. For people with more mild arthritis, over-the-counter NSAIDs (anti-inflammatory medication such as Advil) or topical medications such as Voltaren gel may work just fine. However, if OTC medications do not help, your doctor may give you prescription medications to aid chronic inflammation.
Keep in mind that if you are taking NSAIDs, it is important to talk to your doctor first. Even though you can buy them on your own, you want to make sure this is the right treatment. In some cases, NSAIDs may cause stomach irritation, ulcers, or even kidney damage. Reasonable dosing and monitoring can help alleviate those side effects. If you find that you require more than the recommended daily dose, you may have to find another treatment option.
Injections
There are a few different types of injections you could get that would go indirectly into the joint. First, your doctor may prescribe cortisone injections, which help reduce arthritis-related inflammation. These steroid shots last for about 3 to 6 months before you would need to come in for another one. In many cases, people manage their arthritis with corticosteroids and do not require any further treatment. A second option is viscosupplementation, which is a hyaluronic acid gel injection into the joint. This injection can help lubricate the area to reduce pain and promote mobility.
Third, your doctor may have you consider regenerative medicine options. Natural substances found in your body, such as stem cells or platelet-rich plasma (PRP), can help repair and replace damaged tissue. Regenerative medicine is not for everyone and typically works best for people with mild-to-moderate knee arthritis. Results from severe cases are more spotty, so it is often best to seek out alternative treatments.
What happens if non-surgical treatments do not relieve knee pain?
If more conservative measures aren’t helping, then you may need a joint replacement. During a knee joint replacement procedure, your surgeon will put in an implant to replace the entire joint (in more severe cases) or simply part of the joint.
Dr. Abraham also specializes in robotic-assisted knee replacements, which allow for more accurate and effective procedures. During the surgery, Dr. Abraham puts reference points on the thigh and shin bone. This allows the computer to understand where different body structures are in space by using the triangulation and visual system.
The visualization creates fixed reference points in the bone. From there, Dr. Abraham takes a point probe with sensors and paints over the end of the bones. Sensors take that digital spatial information and convert it to a 3D picture on the computer. As a result, Dr. Abraham can determine factors such as:
- Where to make the cuts in the bone
- How to position the implant
- How the implant affects the balance of the knee replacement
Basically, this system allows for live digital mapping of the joint. In contrast, some of the other systems use a preoperative CT scan or a preoperative X-ray that uses proprietary software to transfer that information into an intraoperative plan. In other words, surgeons don’t receive live data of the knee to do the surgery.
Learn more about robotic-assisted knee replacement surgery. →
Get to know Dr. Abraham at APEX Orthopedics & Sports Medicine
Dr. Abraham is a general orthopedic surgeon with a focus on total and partial knee joint replacement procedures and hip replacements. After fine tuning his craft for over 15 years, he began using robotics as a means to create more precise and accurate outcomes for knee replacements and has been doing so since March 2018. He is now a leading physician who also trains other orthopedic surgeons on the merit of robotics and best practices.
With the help of the APEX’s private practice model, Dr. Abraham ensures each patient receives the most value that doesn’t involve hidden fees or outlandish pricing.
The core of his success lies in proper diagnosis. An appointment with Dr. Abraham includes the highest quality technology to pinpoint a patient’s underlying musculoskeletal conditions. From there, he can better understand which hip osteoarthritis treatment will work best for you.
For a thorough evaluation with Dr. Abraham, call us at 913-642-0200 or schedule an appointment today.
