Knee Pain Treatment Guide
As your partner in care, we are dedicated to helping you get better. We developed this guide to answer common questions about knee pain, including risk factors, symptoms and treatment options. If you have any specific questions about your care after reading this, please discuss them with your physician. We hope this is a valuable resource for you on your journey to better.
Diagnosing Knee Pain
Early diagnosis of knee pain is important, and not just in order to minimize the amount of time spent in pain. A prolonged amount of time without the proper treatment can lead to knee joint damage, the onset of arthritis or surgery that may have been avoided.
Diagnosing knee pain begins with your doctor performing a physical examination—inspecting your knee for swelling and tenderness and determining how far you can move your leg—as well as reviewing your medical history. Your doctor will ask for information, including the location and a description of the pain, when the pain began and whether it was the result of an injury, and when the pain occurs and whether anything makes it better or worse.
Your doctor may then order additional tests, including:
- X-rays
- MRI (magnetic resonance imaging) scan
- CT (computed tomography) scan
- Ultrasound
Once a diagnosis has been made, your doctor will work with you to plan your treatment and next steps.
Treatment Options
Even minor knee pain can keep you from completing your everyday tasks. When you’re searching for relief, it’s important to work with a healthcare provider who will team up with you to create a personalized treatment plan that works within your unique set of circumstances. The orthopedic specialists at Baylor Scott & White consider your diagnostic results and health history as well as your personal goals for the level of activity you wish to achieve and your inclination for certain treatment options. Ultimately, the orthopedic specialists at Baylor Scott & White will strive to provide effective pain relief with, whenever possible, minimally invasive treatment options.
Non-Surgical Treatment Options
Knee pain caused by conditions such as arthritis, bursitis and tendonitis can be relieved with conservative treatments including:
- Rest — Because inflammation often occurs with overuse, simply resting the knee joint as much as possible can relieve pain.
- Ice or heat — Applying ice packs a few times a day can reduce inflammation. Having a warm shower or bath can also relax muscle for pain-relieving stretches.
- Medications — Over-the-counter pain medications such as acetaminophen or ibuprofen can often relieve pain. Certain conditions may also be treated with prescription anti-inflammatory medications or anti-rheumatic drugs.
- Injections — For chronic inflammation, therapeutic injections such as a corticosteroid, typically cortisone, can help reduce the inflammation and relieve pain.
- Weight loss — Reducing your body mass can lessen the impact that walking and other activities can have upon your knee.
- Physical therapy — Low impact exercising of the knee joint can strengthen the area without further aggravating the condition. Focused stretching can serve to increase flexibility that will help to avoid further injuring the knee area and lessen the amount of time spent in pain. Physical therapists will demonstrate the best exercises and stretches to increase your range of motion and restore your normal function. Physical therapy requires you to be an active participant and engage in the advised activities on a daily basis.
- Braces or other forms of support — A knee brace or splint can support and stabilize a knee that has been injured or is affected by arthritis. Arch supports and shoe lifts can also reduce pressure on the knee.
Surgical Treatment Options
With knee conditions such as ligament injuries, meniscus tears and advanced arthritis, surgery may be the only option available to control pain. The goal for some surgeries may be to preserve the natural knee joint and avoid total knee replacement by slowing or stopping the progression of degenerative disease. In other cases, such as severe osteoarthritis or injury, total knee replacement may be necessary.
Surgical options available at Baylor Scott & White include:
- Arthroscopy — Knee arthroscopy is a minimally invasive surgical technique that allows surgeons to diagnose and treat certain knee problems. With arthroscopy, a surgeon makes several small incisions on your knee rather than the large incision required for open knee surgery. The surgeon is able to insert an arthroscope, which contains a small camera, and certain other small instruments into the incisions in order to view the knee joint and make repairs. As a result of the smaller incisions and less trauma to the area, surgery can be performed as an outpatient procedure under general local anesthetic and often results in less pain and shorter recovery time. Knee arthroscopy is used most often for injuries including ligament or meniscus tears and for worn cartilage.
- Total knee replacement — Total knee replacement is surgery to remove all of the parts of a knee and replace it with an artificial joint (prosthesis). During surgery, the surgeon removes cartilage and bone from your knee joint and replaces it with a prosthetic made of metal and plastic. Total knee replacement may be recommended for certain injuries or severe arthritis or other condition that has deteriorated the bone and cartilage to the point that pain is constant and mobility is extremely impaired.
- Partial knee replacement — A partial knee replacement removes and replaces only the parts of your knee that are affected by injury or disease. In a partial knee replacement, cartilage and bone is removed from the affected components and replaced with a prosthetic. Unlike total knee replacement, some of the natural bone and cartilage is preserved, which often leads to better knee function.
- Robotic-assisted knee surgery/partial knee resurfacing — Surgeons at select Baylor Scott & White locations are trained in the use of a robotic arm to assist in partial knee resurfacing surgery. Partial knee resurfacing is an innovative treatment option for those in which osteoarthritis hasn’t progressed to all three components of the knee. During the procedure, only the affected components of the knee are resurfaced or cut away, allowing the preservation of the patient’s healthy bone and tissue, and an implant is then secured in the joint. The benefits to robotic-assisted partial knee resurfacing surgery typically include better accuracy and precision leading to ideal implant positioning, quicker recovery, less scarring, more rapid pain relief, and a shorter hospital stay than traditional knee replacement surgery.
- Joint revision surgery — The need may arise for a previously replaced knee to undergo repair or revision. A prosthetic joint has a lifespan of 10 to 20 years. Over time, the artificial knee may loosen or break or otherwise lose effectiveness. Repair may also be needed when pain persists after knee replacement due to an issue such as infection or structural defect of the prosthetic. Revision is often more complex than the original surgery and requires expertise of the surgical team.
- Soft tissue sarcoma/bone tumor treatment — Your treatment plan will be determined by your care team of orthopedic oncologists, medical oncologists, radiation oncologists, oncology surgeons and plastic surgeons. The plan is tailored to each individual, but the goal is always the same: pain-free recoveries that restore function, salvage limbs and eliminate the underlying cause of the problem.
- One-day joint replacement discharge — Select Baylor Scott & White facilities offer eligible patients a one-day joint replacement discharge when undergoing knee replacement procedures. Advances in surgical anesthesia have made it possible for patients to wake up sooner and begin rehabilitation within hours after knee replacement surgery with minimal discomfort. They are then discharged home within 24 hours after their procedure. Eligible patients must be in overall good health, have a healthy body mass, have a support person to help at home, and have completed pre-operative training.
Understanding the Knee
The knee is a hinge joint, and the largest joint in the body. Unlike the ball-and-socket joint of the hip, which has a wide range of movement, the hinge joint of the knee flexes and extends back and forth in a single plane. The knee is comprised of a number of bones, cartilage, ligaments and tendons, all of which contribute to making the knee one of the most commonly injured joints in the body.
Causes of Knee Pain
Knee pain may be due to a variety of causes. Sports injury, excess body weight, overuse or a degenerative disease can all be sources of chronic knee pain. Sometimes injury in another part of the body—such as a foot injury—can cause pain in the knee. With so many components susceptible to injury and disease, chronic knee pain should be examined in order to discover the root of the problem and to manage it effectively.
Some of the more common causes of knee pain include:
- Ligament injury — The bones surrounding the knee are connected by four main ligaments: the anterior and posterior cruciate ligaments (ACL and PCL) found inside your knee joint, and the medial and lateral collateral ligaments (MCL and LCL) found on the sides of your knee. Injury to these ligaments can be caused by moving too quickly, twisting or hyperextending the knee, or colliding with someone or something. At the time of injury you may hear a popping sound, pain and swelling may occur, and your knee may no longer be able to hold weight.
- Meniscus tear — The meniscus is made up of cartilage that serves as a cushion between your shin bone and thigh bone. A sudden twist to the knee can tear the meniscus. This may cause pain, swelling and the inability to straighten your knee.
- Arthritis — Arthritis is a disease that causes inflammation and swelling in and around the joints. There are a number of types of arthritis, but the most common to affect the knee are osteoarthritis and rheumatoid arthritis. Arthritis breaks down the cartilage that allows the joints to move smoothly, which leads to pain, stiffness and reduced range of motion. It can also lead to the development of bone spurs or excess fluid in the knee. Arthritis is a degenerative disease that will get worse over time. Arthritis occurs in people as they age or may be caused by injury or overuse, excess body weight putting stress on the joints, or hereditary factors that could cause certain joint defects.
- Bursitis — Joints are protected and cushioned by fluid-filled sacs called bursae. Bursae can get inflamed from injury or overuse from repetitive activities. Inflammation of bursae in the knee joint can cause painful bursitis.
- Baker’s cyst — A Baker’s cyst occurs when fluid builds up behind your knee, causing swelling. While it may not cause pain, it’s important to determine the underlying cause of the accumulation of fluid, which may be attributed to arthritis or a meniscus tear. A Baker’s cyst may go away on its own, or your doctor may drain the fluid with a needle in order to relieve the swelling.
- Tendonitis — Repetitive activities or overuse can cause tendons—the tissues that attach muscles to bones—to become irritated and inflamed. Patellar tendonitis is inflammation of the tendon that connects the kneecap to the shinbone. It is most common with athletes, particularly with jumping activities.
- Patellofemoral pain syndrome (PFPS) — Patellofemoral pain syndrome, also known as chondromalacia, is inflammation of the kneecap. This is associated with pain when bending the knee, such as with walking up and down stairs. It’s typically caused by overuse and athletic activities including running, gymnastics and swimming.
Why Baylor Scott & White Health
For over 100 years, Baylor Scott & White has been helping patients heal with quality care, advanced medical techniques, and innovative research. Our multidisciplinary approach to healthcare means that every patient has access to an expert team of physicians and medical professionals across a range of specialties that provides effective, comprehensive, and individualized treatment plans.
The orthopedic specialists at Baylor Scott & White have a proven track record in the successful diagnosis and treatment of knee disorders. We are committed to providing you with effective relief from knee pain with treatment plans that are as minimally invasive as possible.
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