Chronic knee pain is very common and can significantly impact your quality of life. Knee pain can arise from injuries, arthritis, overuse, or other conditions. While there is no cure, there are many ways to manage chronic knee pain and improve function.
What causes chronic knee pain?
Some common causes of chronic knee pain include:
- Osteoarthritis – wear and tear damage to knee cartilage and bones
- Rheumatoid arthritis – autoimmune disease causing knee inflammation
- Post-traumatic arthritis – arthritis after knee injury
- Patellofemoral pain syndrome – pain under or around kneecap
- Tendonitis – inflammation of tendons around the knee
- Bursitis – inflammation of fluid-filled sacs (bursae) around the knee
- Chondromalacia patellae – softening and damage to underside of kneecap
- Osgood-Schlatter disease – pain below kneecap in adolescents
- Gout – uric acid crystal buildup in joints
- Plica syndrome – irritated folds of tissue in the knee joint
Knee injuries, overweight, overuse, muscle imbalance, and some medical conditions can make people more prone to developing chronic knee pain. Aging also increases risk as joint tissues become less flexible.
When to see a doctor
See your doctor if you have:
- Constant or worsening knee pain
- Significant knee swelling
- Inability to fully straighten or bend the knee
- Popping, clicking, catching, or locking of the knee
- Knee weakness, instability, or give-out
- Limping or change in gait
Early evaluation and treatment can help find the cause and prevent the pain from getting worse. Seek emergency care if knee pain is accompanied by significant trauma, sudden swelling, or inability to bear weight.
Diagnosis
To diagnose the cause of knee pain, the doctor will:
- Take a medical history
- Do a physical exam of the knee
- Order imaging tests – x-rays, MRI, CT scan
- Draw fluid or take a tissue sample (biopsy) – to check for infection, gout, or other problems
- Perform blood tests
Based on the results, the doctor can determine if the knee pain is from arthritis, injury, overuse, infection, or other causes. An accurate diagnosis is key to getting proper treatment.
Treatment options
Chronic knee pain treatment aims to relieve pain, maintain or improve mobility, and prevent disability. Options may include:
Medications
- Pain relievers – acetaminophen, NSAIDs like ibuprofen or naproxen
- Stronger prescription pain medicines for severe pain
- Corticosteroid injections to reduce inflammation
- Hyaluronic acid injections to lubricate the knee joint
- Nerve pain medications – gabapentin, pregabalin, lidocaine patches
Physical therapy
- Exercises to strengthen leg muscles, improve flexibility and balance
- Massage, heat/cold therapy, TENS (transcutaneous electrical nerve stimulation)
- Braces, knee taping, walking aids like canes or walkers
Lifestyle approaches
- Weight loss to reduce knee joint stress
- Activity modification – avoid high-impact exercise, change movement patterns
- Rest and knee elevation when pain flares up
- Heating pads, cold packs, massages
- Stress management and coping techniques
Surgery
- Arthroscopic surgery to clean out loose cartilage or smooth damaged bone
- Osteotomy to realign leg bones
- Knee cartilage grafting or regeneration procedures
- Partial or total knee replacement for severe arthritis
The right treatment depends on the individual case. A combination of non-surgical and surgical approaches is often needed for lasting relief.
Home remedies and lifestyle tips
Along with medical treatment, you can manage knee pain with self-care:
Exercise
Low-impact activity can strengthen muscles, improve flexibility, and prevent stiffening. Try:
- Walking, swimming, or water aerobics
- Low resistance muscle strengthening
- Stretching, yoga, tai chi
- Stationary biking with little or no resistance
Rest and elevate
Take breaks between activity. Elevate your leg and apply ice to help control swelling and pain.
Bracing and supports
Knee braces, sleeves, taping, or shoe orthotics can provide extra joint support and improve alignment.
Diet
Eating anti-inflammatory foods (fruits, vegetables, fish, nuts) may help reduce knee pain. Avoid foods that increase inflammation (sugary, fried, processed foods).
Heat and cold
Alternating heat (heating pad, warm shower) and cold (ice packs, gel packs) may alleviate knee pain and swelling.
Massage
Gentle massage around the knee can help relax muscles and stimulate blood flow. Use cream or oil to allow hands to glide easily over skin.
Over-the-counter creams
Creams with menthol, capsaicin, turmeric, or other herbal ingredients can temporarily relieve knee pain when applied to skin.
Weight loss
Slimming down lessens stress on knee joints. Losing just 10-15 pounds can significantly improve knee pain.
Mind-body techniques
Meditation, deep breathing, and mindfulness can help manage pain levels and stress.
When to see a doctor
See your doctor promptly if self-care fails to provide relief or if you experience:
- Increased knee swelling or bruising
- Inability to bear weight on the leg
- Knee buckling, locking, catching, or give-way
- Intense pain at rest or at night
- Signs of infection – fever, redness, warmth, drainage
Worsening pain that persists beyond a few days may signify an acute injury or progression of an underlying problem needing medical attention.
Prevention
While not always possible to prevent chronic knee problems, you can lower your risk by:
- Maintaining a healthy weight
- Choosing low-impact exercise
- Wearing supportive footwear
- Avoiding high-heeled shoes
- Quitting smoking
- Not overusing knees in repetitive motions at work or sports
- Getting sufficient vitamin D and calcium
Knee braces and taping during athletic activities can also help prevent knee injuries.
When to see an orthopedic specialist
See an orthopedic specialist promptly if:
- Knee pain persists beyond 2 weeks of self-care
- Other treatments such as physiotherapy, medications, injections have failed
- Your knee locks, buckles, or gives out
- Imaging shows damage to knee structures – cartilage, ligaments, tendons
- You have significant leg weakness, limited mobility, or difficulty walking
- Activities of daily living are impaired by knee problems
Orthopedic doctors have specialized expertise in diagnosing and treating knee conditions. Early orthopedic evaluation can lead to better outcomes in chronic knee disorders.
When to consider surgery
Knee surgery may be an option if:
- There is severe, debilitating pain or loss of knee function
- Other non-surgical treatments have failed to relieve symptoms
- Activities of daily living are significantly affected
- Imaging reveals loose cartilage, bone spurs, torn ligaments, or other fixable problems
- Knee arthritis has progressed to bone-on-bone
Common types of knee surgery include arthroscopy for minor repairs, osteotomy for realignment, and partial or total knee replacement for arthritis. Discuss risks and benefits with your orthopedic surgeon.
Coping strategies
Living with chronic knee pain presents both physical and emotional challenges. Coping strategies include:
- Learning ways to relieve pain naturally – rest, ice, massage, relaxation techniques
- Taking medications as prescribed
- Balancing activity and rest
- Using mobility aids if needed – cane, walker, wheelchair
- Joining a knee pain support group
- Talking to friends, family, or mental health professional about struggles
- Setting small, achievable goals each day
- Keeping a positive attitude and doing activities you enjoy
Patience, lifestyle modification, support, and working closely with your healthcare providers can help you successfully manage chronic knee pain.
Prognosis and long-term outlook
The prognosis for chronic knee pain depends on the cause and severity of damage. With proper, ongoing treatment you can often expect:
- Reduced or manageable pain levels
- Improved stability and function of the knee joint
- Enhanced ability to stay active and participate in daily activities
- Avoidance of disability or need for more invasive procedures
Certain conditions like osteoarthritis tend to worsen over decades and may eventually require knee joint replacement surgery. Getting orthopedic care early on can help slow progression.
Conclusion
Chronic knee pain can happen to anyone but there are many effective ways to successfully manage symptoms. A combination of medications, physical therapy, lifestyle changes, coping techniques, and sometimes surgery can help you improve mobility and quality of life. Working closely with your healthcare providers and adopting self-care measures allows most people to live full, active lives despite chronic knee pain.