Treatment options for knee pain – making a decision


Expert reviewer, Damian McClelland, Orthopaedic Surgeon and Bupa Musculoskeletal Services Clinical Director
Next review due October 2022

Are you preparing for an appointment for your knee? Or considering your treatment options? When you need to make decisions about your health, there can be different options. Which test or treatment is best? Should you have treatment at all?

This information will help you and your healthcare team decide what’s right for you. As you read through this information, you may want to have a pen and paper to hand. This is so you can make a note of any questions you’d like to ask when you next see doctor, nurse or physiotherapist.

Doctor and patient are talking

Making a decision

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

Knee pain, and the conditions that cause it, can be long-term. 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.

GP visit

When you first visit your GP with knee pain, they will assess you to try and work out what’s causing the pain. They will examine both knees, see how your knee pain affects how you walk and how you move the affected leg.

As well as examining your knee, they’ll ask you about the history of the knee pain, any injuries you’ve sustained and your general health. They’ll also find out how the pain is affecting your life – 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. For some situations, they will refer you to a specialist urgently. If you have a long-standing injury to your cartilage or meniscus, they may refer you to an orthopaedic surgeon.

Many knee injuries can be successfully treated with rest, support for the joint, ice and physiotherapy. So if there is unlikely to be a problem needing surgery or urgent referral, they may refer you to a physiotherapist. As well as treating you, the physio will also assess you and can then refer you on to an orthopaedic surgeon if your condition doesn’t improve or they diagnose a problem that needs surgical care.

Tests

If 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:

X-ray and CT (computerised tomography) scan

These are painless and overall quite safe. However, they do involve exposure to radiation, which has 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. Find out more about CT scans and X-rays.

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. You can’t have an MRI scan if you have a pacemaker or some metal implants. Tell your doctor and radiographer if you think this may apply to you. Find out more about MRI scans.

Ultrasound scan

This is a scan using sound waves. It’s painless and medically very low risk. Find out more about ultrasound scans.

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. Find out more about knee arthroscopy.

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

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
  • 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. Your doctor may recommend resting your leg, keeping it up when you can and using ice packs. It may also help to avoid 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. We have more information about what to do when you first injure your knee and what not to do after your injury.

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 create a programme that best suits your needs.

Let them know about your usual physical activity, for example, whether you play any sports. They will be able to discuss options for helping you return to your usual routine. You’ll also need to think about how much time you can set aside for appointments.

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 surgery to solve your knee problem. This will usually be the case if you have a severe injury or if other treatments haven’t worked. However, surgery may be considered earlier depending on your personal circumstances. For example, if you have a job where your knee stability is important, or you play a lot of sport, having surgery straightaway may be the best option.

During your consultation with your doctor, you can discuss your priorities and preferences. You can work to reach a decision together about if and when surgery may be the best option for you.

Option grid: explore your treatment options

Our handy option grid can help you see what each treatment involves; including how it’s done, potential risks and recovery time.

Knee pain treatment options: Bupa's option grid PDF opens in a new window (0.2MB)

Knee pain explore your treatment options grid


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    • Assessment of knee injury. BMJ Best Practice. bestpractice.bmj.com, last reviewed April 2019
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  • Reviewed by Alice Windsor, Specialist Health Editor, Bupa Health Content Team, October 2019
    Expert reviewer, Damian McClelland, Orthopaedic Surgeon and Bupa Musculoskeletal Services Clinical Director
    Next review due October 2022



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