From the Guidelines
Knee pain is most commonly caused by degenerative knee disease, which affects approximately 25% of people older than 50 years. This condition is often associated with osteoarthritis, a degenerative joint disease that occurs when the protective cartilage cushioning the ends of bones wears down over time 1. Other frequent causes of knee pain include patellofemoral pain syndrome, tendinitis, bursitis, ligament injuries, and meniscus tears.
Common Causes of Knee Pain
- Osteoarthritis: a degenerative joint disease that occurs when the protective cartilage cushioning the ends of bones wears down over time
- Patellofemoral pain syndrome (runner's knee)
- Tendinitis
- Bursitis
- Ligament injuries (like ACL tears)
- Meniscus tears
Management Options
- Watchful waiting
- Weight loss if overweight
- Interventions led by physical therapists
- Exercise
- Oral or topical pain medications such as non-steroidal anti-inflammatory drugs
- Intra-articular corticosteroid and other injections
- Arthroscopic knee surgery
- Knee replacement or osteotomy
The preferred treatment for knee pain is a combination of non-operative management options, including weight loss, exercise, and oral or topical pain medications, as arthroscopic surgery has been found to be no better than exercise therapy for patients with degenerative medial meniscus tear 1. Knee replacement is the only definitive therapy, but it is reserved for patients with severe disease after non-operative management has been unsuccessful.
From the Research
Knee Pain Causes
The most common cause of knee pain is osteoarthritis (OA), a degenerative joint disease that affects the cartilage and surrounding tissues in the knee joint.
Osteoarthritis Symptoms and Treatment
- Osteoarthritis is characterized by pain, stiffness, and limited mobility in the affected joint 2.
- Treatment options for OA include pharmacological agents, such as non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, and intra-articular corticosteroids, as well as symptomatic slow-acting drugs like glucosamine sulfate and chondroitin sulfate 3.
- Intra-articular injections of corticosteroids and hyaluronic acid have been shown to reduce pain and improve function in patients with knee OA 4, 5.
- Pharmaceutical treatment recommendations for OA management include oral and topical NSAIDs, COX-2 inhibitors, duloxetine, intra-articular corticosteroids, and intra-articular hyaluronic acid 6.
Non-Operative Therapeutic Considerations
- Non-surgical treatment options, such as platelet-rich plasma, bone marrow mesenchymal stem cells, and autologous microfragmented adipose tissue, are being explored to slow down the natural course of OA and postpone or replace extensive surgeries like total knee arthroplasty 2.
- Gene therapy may potentially become an option for orthopedic patients in the future 2.