You notice a sharp twinge in your knee every time you stand up. Or perhaps climbing stairs has become uncomfortable, so you start avoiding them as much as possible. At first, it is easy to chalk it up to age, slather on some pain-relief ointment and carry on. But when knee pain keeps returning or begins to change how you move, sleep or spend your day, it is worth finding out what is causing it.
Knee pain may be more common as we get older, but when it is severe, persistent, or recurrent, it should not be ignored. While osteoarthritis is the most common reason for knee pain, particularly in older adults, it is not the only one. Injuries to the joint, ligaments, or meniscus; inflammation due to arthritis or sudden trauma; weakness of the supporting muscles; and repetitive overuse can also lead to pain. An accurate diagnosis is important because the right treatment depends on the underlying problem.
Meet an orthopedician if the pain lasts for several weeks, keeps returning or affects daily activities. Swelling, stiffness, difficulty bending or straightening the knee, or a feeling that it may give way are other reasons to meet a specialist. Seek immediate treatment if the pain becomes severe suddenly, the knee becomes hot and red, you cannot stand, or an injury causes significant swelling, a popping sound or a visible change in the knee’s shape.
Meeting a specialist is what most people put off because they are worried that surgery will be recommended. However, there are many patients who may benefit from non-surgical treatments. Lifestyle changes, muscle strengthening, physiotherapy, prescribed medication for pain relief and inflammation, and assistive devices like braces, orthotics, and mobility aids can play a role. For overweight individuals, even a 5–10% reduction in weight can significantly reduce stress on the knees. Low-impact activities like swimming, cycling and walking can help, although the type and intensity of exercise should be individualized.
For some patients, injections to the knee may provide symptom relief. Corticosteroid injections may help reduce inflammation and pain, while hyaluronic acid injections may improve lubrication and cushioning within the knee. Newer treatments such as platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), called orthobiologic therapies, may also provide relief in carefully selected cases. A thorough assessment will help decide which option may benefit an individual.
Knee replacement surgery is usually considered when arthritis is advanced, pain remains severe despite treatment and daily life has become seriously restricted. Even then, the same surgery is not right for everyone. If the damage is limited to one part of the knee, a partial knee replacement may be possible in a bid to preserve more of the natural joint. Some patients may also be suitable for a minimally invasive approach, which may limit damage to the surrounding tissues.
Robotic-assisted surgery is one of the newer advances in knee replacement, offering personalized planning and precision in implant positioning. This approach may minimize damage to surrounding tissue and likely support a smoother recovery. However, recovery varies from person to person, based on the person’s health, their condition and their commitment to rehabilitation.
The most important point is not to write off knee pain as ageing or to assume that surgery is inevitable. Getting assessed early can open the door to a multitude of treatment options, symptom relief, and better mobility. Ultimately, the right approach is chosen based on the condition of the patient’s joints and their individual.
Dr. Arun Kannan,
Consultant Orthopedic Surgeon,
Apollo Hospitals,
Chennai