Knee Pain Treatment Options

Knee Pain Treatment Options

  • knee pain Treatment

Knee Pain Treatment Options

The treatment strategy of knee pain revolves around the causative factor.

Laboratory investigations will help to rule out joint disease e.g. septic arthritis.

Some of the investigations along with diseases are:

Lab Tests for pain in the knee

Laboratory Investigations

  • Gram staining and culture for septic arthritis.
  • Uric acid levels for gout.
  • ESR, CRP, RF, and ANA for rheumatoid arthritis.
  • CBC, IgG, IgM, and viral markers for polyarthritis.

X-ray of knee joint

It will help to rule out a fracture, dislocation, or osteoarthritis.

CT scan

It helps to understand the degenerative joint changes.

MRI of knee joint

It helps to visualize the tendons, ligaments, and menisci of the knee joint.

Knee pain management can be divided into the following categories:

Elevation of knee joint

Knee Pain General Management

  • Rest
  • Application of ice around the joint
  • Elevation of knee joint
  • Simple stretching exercise
  • Wearing knee pads
NSAIDs for knee pain

Medical Management of Knee Pain

Your healthcare provider may prescribe NSAIDs (nonsteroidal anti-inflammatory drugs), DMARDs (disease-modifying antirheumatic drugs), or uricosuric drugs depending upon your disease-causing knee pain.

Injections for pain in the knee

Knee Pain Injections

Directing the administration of certain injections to the knee joint would reduce the pain by relieving inflammation or decreasing disease severity. Some of the routinely used joint injections are:

Steroid injection

Steroids injections

Corticosteroid injections directly injected into your knee joint may reduce the inflammation, relieve pain. These injections are typically rehearsed after a few months as their effect weans off slowly. People with rheumatoid arthritis or osteoarthritis are candidates to get steroid injections if their joints are painful.

Depending upon the pain and inflammation, your doctor may inject steroids into the joint directly sensitive tissues around joints or muscles around.

Usually, there are no major side effects except a mild sensation of discomfort at the injection site. If aseptic measures are not observed then, infection of the knee joint may occur.

Viscosupplementation, an injection of hyaluronic acid into the knee joint

Viscosupplementation

Under normal instances, the cartilage of your knee joint has a coating of glistening fluid to lubricate the opposing surface. This glistening fluid is nothing but hyaluronic acid. In osteoarthritis, this cartilage breaks down and results in pain upon movement.

Injection of hyaluronic acid into the knee joint to reduce lubrication is called viscosupplementation. Hyaluronic acid resembles the synovial fluid thereby reducing the friction between joint spaces.

It naturally lubricates the joint and eases the movements at the knee joint, reducing the pain in return.

Examples of viscosupplementation are Hyalgan, Synvisc, and Supartz among many others.

Knee Genicular nerve block

Genicular nerve block

A genicular nerve block is selected as a treatment option when the knee pain of a patient fails to respond to traditional treatment. It relieves knee joint pain by blocking the nerve supply of the joint. The nerves of the knee joint are “blocked” by local anesthetic by your healthcare provider. This procedure is performed under the x-ray guidance to ensure the proper administration of a local pain-blocking agent.

Its complications are rare if performed by a pain management specialist under aseptic measures.

Platelet-rich plasma Knee

Platelet-rich plasma

The growth factors contain substances that promote the curing process. Platelet-rich plasma contains numerous growth factors necessary for healing from injury and decreasing inflammation. Your doctor may inject the platelet-rich plasma into your knee joint to relieve the pain from the inflammation process.

More studies are required to confirm PRP as a joint pain reducer.

Radiofrequency Ablation

Radiofrequency Ablation

In this method, radio waves are used to destroy nerves of the knee joint that cause pain and send pain signals to the brain. The procedure is similar to the genicular nerve block except that instead of just injecting local anesthetics, heat from radio waves is utilized to stun the nerves, thus relieving your knee pain.

knee surgery

Surgery for Knee Pain

Some injuries of the joint require surgical intervention for rapid recovery and an excellent prognosis but you must know the pros and cons of all treatment options. Your doctor may perform the following surgeries depending on the nature of the injury to your knee joint:

  •  Arthroscopy
  •  Osteotomy
  •  Partial knee replacement surgery
  •  Total knee replacement surgery

References-

2019 Mar 12;25:1857-1863. doi: 10.12659/MSM.915359. https://pubmed.ncbi.nlm.nih.gov/30858350/
2015 Nov 15;92(10):875-83. https://pubmed.ncbi.nlm.nih.gov/26554281/
2020 Mar;20(3):238-246. doi: 10.1111/papr.12844. Epub 2019 Nov 14. https://pubmed.ncbi.nlm.nih.gov/31605667/
2020 Sep 19;2020:2537075. doi: 10.1155/2020/2537075. eCollection 2020. https://pubmed.ncbi.nlm.nih.gov/33014212/
2018 Jul 23;20(9):54. doi: 10.1007/s11926-018-0765-x. https://pubmed.ncbi.nlm.nih.gov/30033492/

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