Common culprits of knee pain include overuse, injuries, arthritis, biomechanical imbalances, and age-related wear and tear.
IN our everyday routines – getting out of bed, commuting, cooking – we rarely think about the strain we place on our knees.
These hardworking joints absorb the impact of nearly every lower-body movement, making them especially vulnerable to wear and tear over time, as well as injuries from sports and exercise.
It’s no surprise, then, that knee pain is one of the most common joint complaints. So what exactly causes it – and how can we manage or prevent it? Let’s take a closer look.
What causes knee pain?
Knee pain can stem from injuries, overuse, arthritis, biomechanical issues, or age-related changes, depending on your age, activity level and injury history.
What are the different types of knee pain diagnoses?
Common types of knee pain diagnoses are ligaments injuries, meniscal tears, patellar issues, arthritis, bursitis, tendonitis, knee infections, fractures, cartilage damage, osteonecrosis and genu varum/valgus.
How do you diagnose knee pain?
The process starts with a detailed history and physical exam to assess pain. Imaging tests like X-rays, ultrasound, or MRI may confirm the diagnosis. If necessary, lab tests can guide treatment. When non-invasive tests aren’t enough, arthroscopy – a minimally invasive procedure with a small camera – can diagnose and treat issues like cartilage tears, ligament damage or inflammation.
What are the best non-surgical treatments for knee pain?
Commonly recommended options include physical therapy, medications, corticosteroids/hyaluronic acid intra-articular injection, knee bracing, ice therapy, weight reduction and lifestyle modifications.
When is surgery considered for knee pain?
Surgery is usually considered when non-surgical treatments fail to relieve pain and the condition affects daily life, mobility or quality of life. It may also be needed if there’s significant damage to the knee joint.
Dr Syed says there are many benefits to robotic-assisted TKR surgery.
Common scenarios include:
> severe osteoarthritis: when the knee joint is severely damaged by osteoarthritis and the cartilage is worn down, causing pain, stiffness, and loss of function that doesn’t improve with non-surgical treatments, a knee replacement is usually recommended
>anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) tears: if the ligaments are severely torn and there is instability in the knee, surgery for ligaments reconstruction may be necessary, particularly for athletes or individuals with high physical demands
> meniscus tears: if the meniscus (the cartilage cushion in the knee) is torn and causing locking, catching, or persistent pain, surgery may be required. The type of surgery (meniscectomy or meniscus repair) depends on the location and extent of the tear
> if the knee is misaligned due to conditions like bow-leggedness (varus deformity) or knock knees (valgus deformity), surgery to correct the alignment, such as an osteotomy, may be required to alleviate pain and improve function
> if chronic inflammation (like patellar tendonitis or bursitis) causes persistent pain and swelling despite conservative treatments, a surgical procedure to clean out the affected area (debridement) may be needed
> if there is a severe infection in the knee joint (such as septic arthritis) – an emergency surgery such as wound debridement and joint washout is necessary to clear out the infection
> if an inflammatory condition like rheumatoid arthritis causes irreversible joint damage, surgery (such as a joint replacement or synovectomy) may be necessary to improve function and alleviate pain
> If there is significant cartilage damage that cannot be repaired with non-invasive treatments (such as microfracture, osteochondral grafting, or autologous chondrocyte implantation), a knee replacement or other joint-preserving surgeries might be necessary.
How long will it take to recover from knee pain or surgery?
It can vary significantly depending on the severity and underlying cause of the pain, the type of treatment and individual factors such as age, overall health, and adherence to rehabilitation. A general recovery milestone for most knee surgery is:
> First week: Focus on reducing swelling and managing pain. Early range-of-motion exercises may begin.
> Two to four weeks: Gradual increase in mobility. If it’s a knee replacement, you may be able to walk short distances with assistance.
> One to three months: More intensive physical therapy begins. You should be able to walk without crutches and engage in light activities, such as driving or using the stationary bike.
> Three to six months: Most patients are back to moderate activities. Full range of motion and strength should be nearly restored.
> Six-12 months: Full recovery, with the ability to return to more strenuous activities.
Should I make lifestyle changes to improve knee health?
Yes – key changes include maintaining a healthy weight, exercising regularly, avoiding high-impact activities, and modifying movements like deep squats or kneeling. Using knee braces can also help.
Can knee pain be prevented from getting worse?
Yes. Medications can help manage pain, inflammation, and swelling from conditions like arthritis or injury. Common options include NSAIDs, COX-2 inhibitors, and topical creams.
Intra-articular steroid injections may offer short-term relief, but repeated use is not recommended.
Hyaluronic acid injections can improve joint lubrication and mobility, though results vary. Joint supplements like glucosamine may also help reduce pain and slow progression.
What alternative therapies can help?
Several alternative treatments may ease knee pain from arthritis, injuries, or tendonitis by reducing inflammation and improving mobility.
Common options include acupuncture and massage therapy for pain relief, herbal remedies like turmeric and ginger to reduce inflammation, or cold and heat therapy for symptom management.
Additionally there is radiofrequency ablation (RFA), a minimally invasive procedure that uses heat to interrupt pain signals from the nerves around the knee.
It’s an option for chronic pain when other treatments haven’t worked and may delay or reduce the need for surgery.
Are there any new robotic treatments for knee pain?
Total knee arthroplasty (TKA), where the weight-bearing parts of the knee are replaced with prosthetics, has become a common treatment for knee degeneration, relieving pain and disability.
Most TKAs are conventional, meaning that surgeons perform them by hand, judging how much bone to remove based on their expertise. However, advancements in robotic-assisted surgery offer more precise treatments.
These surgeries are performed using surgical robots that rely on preoperative imaging or finding anatomical landmarks during surgery to determine precisely the alignment of the bones and integrity of the soft tissues.
Using the robot improves accuracy and safety over conventional techniques.
These procedures offer personalised and precise interventions, leading to improved patient outcomes. It has become a popular option worldwide.
Benefits of robotic-assisted total knee replacement (TKR) include:
> enhanced precision in implant placement for better joint function and a more natural-feeling knee
> personalised surgical planning based on the patient’s unique knee structure and bone shape
> minimally invasive surgery with smaller incisions, reducing trauma, blood loss, pain, and speeding up recovery
> improved alignment and stability, promoting long-term stability and better function
> faster recovery and shorter hospital stays
> better long-term outcomes with reduced likelihood of revision surgery
> real-time feedback during surgery to ensure optimal results
> improved patient satisfaction.
Dr Syed Addi is the consultant orthopaedic surgeon
in Gleneagles Hospital Penang.
KKLIU 1770 / EXP 31.12.2027
