Can pain management help with knee pain?

From the Guidelines

Pain management can effectively help with knee pain, and the most recent and highest quality study recommends a combination of non-pharmacological and pharmacological treatment modalities, with exercise therapy being as effective as oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis. According to the study published in the British Journal of Sports Medicine in 2023 1, a network meta-analysis of randomized controlled trials found that exercise provides superior analgesia compared to NSAIDs, and its effects on knee pain are similar to the effects of analgesics.

The optimal management of knee osteoarthritis requires a combination of non-pharmacological and pharmacological treatment modalities, including regular education, exercise, appliances, and weight reduction, as well as oral analgesics such as paracetamol and NSAIDs, and intra-articular injections of corticosteroids or hyaluronic acid for flare-ups of knee pain, especially if accompanied by effusion 1.

Some key treatment options for knee pain include:

• Over-the-counter medications like acetaminophen (Tylenol) at 325-650mg every 4-6 hours or NSAIDs such as ibuprofen (Advil, Motrin) at 200-400mg every 4-6 hours or naproxen (Aleve) at 220-440mg every 8-12 hours
• Non-medication approaches like physical therapy, hot/cold therapy, activity modification, weight management, and assistive devices like knee braces or walking aids
• Injections such as corticosteroids or hyaluronic acid for temporary relief of moderate to severe knee pain

It's essential to consult a healthcare provider for proper diagnosis and a personalized treatment plan, as the best approach often combines multiple strategies tailored to the individual's specific condition, pain level, and overall health status.

From the FDA Drug Label

In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease Pain management with naproxen can help with knee pain by reducing joint pain or tenderness and increasing range of motion in knee joints, as demonstrated in clinical studies in patients with osteoarthritis 2.

• Key benefits of naproxen for knee pain include:
  • Reduction in joint pain or tenderness
  • Increase in range of motion in knee joints
  • Increased mobility
  • Improvement in capacity to perform activities of daily living impaired by the disease

From the Research

Pain Management for Knee Pain

• Pain management can help with knee pain, as various treatment options are available to address the symptoms of knee pain, including physical therapy, pharmacologic agents, interventional pain procedures, and surgical options 3.
• The most common cause of knee pain is degenerative osteoarthritis (OA), which can be diagnosed through a standard musculoskeletal and neurological examination, and medical imaging may be performed to improve specificity 4.
• Conservative treatment options for knee pain include exercise therapy, weight loss, education, and self-management programs, which are recommended as first-line management for OA 5.
• Intra-articular injections of corticosteroids and radiofrequency ablation of the genicular nerves have been shown to be effective in managing knee pain when conservative treatment fails 4.
• Pharmacologic management of acute pain, including the use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), can also be effective in managing knee pain 6.
• Multidisciplinary approaches, including psychological therapy, integrative treatments, and procedural options, may be recommended when conservative measures fail to provide satisfactory pain relief 4.

Treatment Options for Knee Pain

• Exercise therapy and weight loss are recommended as first-line treatment for knee OA 5.
• Hip and knee strengthening exercises, in combination with foot orthoses or patellar taping, are recommended for patellofemoral pain 5.
• Conservative management, including exercise therapy, is also appropriate for most meniscal tears 5.
• Surgical referral for knee joint replacement may be considered for patients with end-stage OA after using all appropriate conservative options 5.
• Intra-articular injections, radiofrequency ablation, and surgery may be considered as procedural options for managing knee pain 4.

Effectiveness of Pain Management for Knee Pain

• A systematic review found that there is a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement 7.
• A study found that a single injection of botulinum toxin A provided meaningful pain relief for about 40 days in patients with chronic postsurgical pain after knee replacement 7.
• The use of acetaminophen and NSAIDs as first-line treatment options for acute mild to moderate pain has been shown to be effective in managing knee pain 6.