The knee is a complex joint made up of four bones — the femur, the tibia, the fibula and the patella. A complex system of muscles, tendons and ligaments help support the joint and allow your leg to flex and extend. Cartilage and synovial fluid produced within the joint allow for ease of motion and cushioning.
This joint is prone to wearing and tearing (osteoarthritis) as is any other joint in the body, and is particularly painful as the joint is used while walking, running, standing and sitting. Osteoarthritis is a result of chronic degeneration of the joint, usually in the elderly, but may be brought on sooner by previous sports injuries, excessive weight, or past history of trauma to the joint.
Osteoarthritic knee pain can be felt anywhere around the knee joint. The patient may feel a cracking or popping feeling with movement of the knee in flexion and extension, decrease in the range of motion of the knee, and pain with activity. Patients typically describe the pain as achy, sharp, stiff, and gnawing, with pain increasing with increase in activity.
Osteoarthritis is a degenerative disease of the joint. It can occur in any joint, and the knee is particularly susceptible. Chronic wear and tear is the culprit, and as listed above, certain risk factors may hasten the occurrence and severity.
Treatment for knee osteoarthritis may include a referral to a pain management specialist. At the Center for Pain Management, you and your physician will design a treatment plan tailored to you. The plan of care will depend on your symptoms and examination. On the initial visit, a thorough history and physical exam will be performed. Early treatment focuses on confirmation of the diagnosis and the initiation of a treatment plan to alleviate pain. Your doctor may also order imaging such as x-rays and MRIs may be ordered.
Your treatment plan may involve some lifestyle modifications, physical therapy to strengthen the muscles around the joint, non-steroidal anti-inflammatories if your medical history allows, and topical creams and patches.
If pain is not improved with some of these modifications, you and your pain management physician may discuss injection therapy. This usually consists of injecting local anesthetic and steroids directly into the joint under x-ray guidance. The injection assists with diagnosing the cause of your pain and can also provide sustained relief.
Injection of viscosupplementation or Synvisc is also an option. If the pain relief experienced from injection of medication directly into the joint is short-lived and knee replacement surgery is not the right option for you at this time, cooled radiofrequency denervation may be another option. Referral to an orthopedic surgeon may also be an option.