Making a decision about treatment


The term ‘shared decision-making’ refers to health professionals involving patients fully in decisions about their care. This is mainly to do with choosing treatments, but can also cover tests and investigations, support packages, and self-care options.

Knee pain, and the conditions that cause it, can be long-term situations. This means shared decision-making is important to ensure the condition is being managed in a way that’s effective, but also reflects your needs and preferences.

Doctor and patient are talking

GP assessment

When you first visit your GP with knee pain, they will assess you to try and work out what may be causing the pain. As well as examining your knee, they’ll ask you several questions about the history of the knee pain, any injuries you might have sustained, and your general health. They’ll also find out what effect the pain is having on your life: whether it’s affecting your ability to work, sleep or pursue hobbies.

They will then refer you on to another service, depending on what they suspect the problem may be. If the GP thinks the problem is serious, they will refer you to a specialist urgently. However, if they think you may have a less serious problem, such as a long-standing injury to your cartilage or meniscus, they may refer you according to your personal circumstances. For example, if the injury is affecting your ability to work, the GP may refer you to an orthopaedic surgeon.

Investigations

Once you have been referred to a specialist to investigate your knee pain, there are various procedures you could have to look into this further. Your doctor should consider your preferences, as well as the medical risks and benefits, and involve you in decisions about investigations. Some examples of things to consider are outlined here:

  • MRI (magnetic resonance imaging) scan – If this test is suitable for you, there are very few medical risks. However, it can be a claustrophobic and lengthy experience which some people find distressing.
  • X-ray / CT (computerised tomography) scan – These are painless and overall quite safe. However, they do involve exposure to radiation, which causes very small health risks. For one-off scans, the benefit of the investigation will often outweigh this risk. However, if you have long-term problems with your knee, it may be best to avoid repeated scans.
  • Ultrasound scan – This is medically very low risk and generally painless.
  • Invasive investigations – These include procedures like aspiration and arthroscopy. They’re generally safe, but there are very small risks of infection and damage to the area.

Your doctor can explain the risks and benefits of these investigations in more depth, answer any questions you have, and – if appropriate – involve you in any decisions about investigations.

Treatment and management

There are a large number of conditions that can cause knee problems. The exact treatment and management options that are most suitable for you will depend on what condition you have. The options can broadly be divided into: self-help, physiotherapy, medicines and surgery. Your overall management may involve more than one of these options. Some of the things you’ll need to think about are outlined here:

Self-help

If you have a minor injury, you may be able to manage it at home. This may include avoiding activities that cause the pain to come back or get worse. It will help to have a discussion with your doctor about what this will mean for your daily life, including work and hobbies.

Physiotherapy

This is an important treatment for many knee injuries. The aim is to reduce pain and help your knee recover strength, stability and range of movement. Your physiotherapist will work closely with you to devise a programme that best suits your needs. Let them know about your physical activity habits, for example whether you play any sports. They will be able to discuss options for helping you return to your usual routine. How much time you can set aside for appointments may also need to be considered.

Medicines

The main groups of medicines you can take for your knee condition are painkillers and anti-inflammatories. There are side-effects that you will need to take into consideration. Your doctor will be able to explain these to you in more detail when you’re discussing your treatment. How willing and able you are to cope with these side-effects will be weighed up against the benefits the medicines will provide, to help you reach decisions about your treatment.

Surgery

You may need a surgical procedure to solve your knee problem. This will usually be the case if you have a severe injury, or if other treatments have not worked. However, surgery may be considered earlier depending on your life circumstances. For example, if you have a job where your knee stability is important, or you play a lot of sport, surgery may be the best option. During your consultation with your doctor, you can discuss your priorities and preferences, and reach a decision together about if and when surgery may be the best option for you.


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    • Knee pain - assessment. NICE Clinical Knowledge Summaries. http://cks.nice.org.uk, revised March 2011
    • Magnetic Resonance Imaging. PatientPlus. http://patient.info/patientplus, reviewed January 2013/li>
    • Computerised Tomography (CT) Scans. PatientPlus. http://patient.info/patientplus, reviewed July 2015/li>
    • Ultrasound Scanning - Non-obstetric. PatientPlus. http://patient.info/patientplus, reviewed December 2015/li>
    • Arthroscopy and Arthroscopic Surgery. PatientPlus. http://patient.info/patientplus, reviewed August 2013/li>
    • Joint Injection and Aspiration. PatientPlus. http://patient.info/patientplus, reviewed February 2016/li>
    • Assessment of knee injury. BMJ Best Practice. http://bestpractice.bmj.com, last reviewed July 2016/li>
    • Soft Tissue Knee Injury. Medscape. http://emedicine.medscape.com, updated February 2016/li>
    • Anterior Knee Pain. PatientPlus. http://patient.info/patientplus, last reviewed June 2015/li>
    • Medial collateral ligament injury. BMJ Best Practice. http://bestpractice.bmj.com, updated April 2016/li>
    • Physical medicine and rehabilitation for iliotibial band syndrome. Medscape. http://emedicine.medscape.com, published 4 September 2014/li>
    • Anterior cruciate ligament injury. BMJ Best Practice. http://bestpractice.bmj.com, updated August 2015/li>
    • Iliotibial band syndrome. BMJ Best Practice. http://bestpractice.bmj.com, updated July 2015/li>
    • Meniscal tear. BMJ Best Practice. http://bestpractice.bmj.com, updated May 2016/li>
    • Patellofemoral pain syndrome. http://bestpractice.bmj.com, updated July 2016/li>
    • NSAIDs and adverse effects. Bandlolier. www.medicine.ox.ac.uk, accessed 28 July 2016/li>
    • Knee Ligament Injuries. PatientPlus. http://patient.info/patientplus, last reviewed February 2014/li>
    • Knee Cartilage Injuries (including Meniscal Tears). PatientPlus. http://patient.info/patientplus, last reviewed February 2014
  • Produced by Nick Ridgman, Lead Health Editor, Bupa Health Content Team, July 2016
    Expert reviewer Damian McClelland, Orthopaedic Surgeon and Bupa Musculoskeletal Services Clinical Director
    Next review due July 2019



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