The Best Non-Surgical Alternatives For Chronic Knee Pain

Supplements Help Support Healthy, Pain-free Joints Your doctor may recommend that you take dietary supplements in addition to other treatments to help manage knee pain. The… Aisha Abdullah - March 8, 2023

Although chronic knee pain is commonly treated with knee replacement surgery, the operation has one of the highest regret rates of any medical procedure. Like all surgeries, it carries a risk of complications, and it isn’t a solution that works for everyone. Many patients who regret the surgery say that they wish they knew about alternative options for chronic knee pain before going under the knife. These are some of the best non-surgical alternatives to treat knee pain.


Knee Surgery Can Be Life-Changing, But Many People Regret It

Osteoarthritis is the most common type of arthritis that primarily affects the knees and hips. The disease develops when the cartilage in your joints breaks down, either from injury or overwork, causing your bones to rub against each other. Osteoarthritis in the knees causes chronic pain, swelling, and stiffness. The condition has no cure, but there are effective treatments, including knee replacement surgery.

The procedure involves replacing the damaged part of the knee with a prosthetic, reducing pain and stiffness. Although many people report that the surgery vastly improved their lives, as many as 20 percent of people who get the procedure are not satisfied with the results. The surgery can be risky and doesn’t always relieve pain. It also may not be a permanent solution. The knee prosthetic typically lasts for 15 to 20 years, so younger people who have the surgery will likely have to have their knee replacement replaced. Especially for people with less severe symptoms, knee replacement may be too extreme of a treatment.

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Anti-Inflammatory Drugs Are One of the Most Common Answers to Knee Pain

Most people are advised to take nonsteroidal anti-inflammatory drugs (NSAIDs) at the first sign of knee pain. The drugs offer fast and inexpensive relief from chronic knee pain and can be purchased at any drug or grocery store. NSAIDs can be taken orally or as a topical cream rubbed directly onto the joint. The drugs include over-the-counter medications like aspirin, ibuprofen (e.g. Advil, Motrin) and naproxen (e.g., Aleve), and prescription celecoxib.

As the name implies, NSAIDs work by blocking two enzymes, including one that causes inflammation. Although NSAIDs are an effective option for treating knee pain, they are not without risks. One of the two enzymes that NSAIDs block plays a role in protecting your stomach lining. That means that taking NSAIDs can cause stomach problems like indigestion and ulcers. Prescription NSAIDs only block the inflammation-causing enzyme and don’t harm the stomach.

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Non-NSAIDs Pain Medication Provides Safer Arthritis Relief

NSAIDs are a common, effective way to relieve knee pain. But using these drugs regularly, in high doses, or over long periods can cause damage to the heart, kidneys, and stomach. People who are at higher risk for heart disease, kidney disease, or have a history of stomach ulcers may be advised to avoid NSAIDs.

Fortunately, acetaminophen (Tylenol) provides relief from knee pain without fewer risks than NSAIDs. Also called paracetamol, the medication works by changing how your brain responds to pain. Acetaminophen is much easier on the stomach and kidneys and is safe for people with a variety of chronic health conditions, including pregnancy. However, because the drug isn’t anti-inflammatory, it may not ease the swelling and stiffness that comes with osteoarthritis. Additionally, in very high doses, it can cause liver damage.


Low Impact Exercises Relieve Aching Knees Without Pressure

Your first instinct when experiencing knee pain may be to avoid exercise to avoid making it worse. But exercise is necessary to keep your whole body, including your knees, healthy. Low-impact exercises are those that get your heart up and help you stay fit without putting pressure on sore knees. It also helps strengthen the muscles supporting the knees and reduces stiffness. Walking is one of the best and cheapest low-impact exercises.

Getting in a half-hour walk a few times a week can help you stay in shape and feel better overall. Other types of low-impact workouts include ellipticals, bike riding, yoga, and swimming. You should never push yourself to work out through serious or worsening knee pain. Finding the right low-impact exercise for you may take time, but the positive impacts on your knees and whole body are worth it.

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Physical Therapy Strengthens Knee Muscles

The goal of physical therapy is to improve your ability to move and perform everyday tasks with an injury or illness. For people with chronic knee pain, physical therapy can help improve the health of their joints and reduce the need for knee replacement surgery. Strengthening physical therapy exercises tone and strengthen the muscles that support your knees.

They also reduce the risk of further injury to the knee by training your body to appropriately distribute pressure on the knees, back, and hips when standing or moving. This reduces wear and tear on the joint. Flexibility training exercises help increase your joint’s range of motion and improve overall joint function. Working with a physical therapist can help you not only with knee pain but also with swelling and stiffness.


Weight Loss Can Take Pressure Off Joints

One of the reasons that knee pain is so common is that our knees bear a lot of weight, literally. Your knee joints support the weight of the upper body and feel the force of that weight whenever you’re standing, walking, or running. Losing weight can help take some of that pressure off of your knees, which in turn can help reduce chronic pain. For example, one study found that 10 pounds of weight equals 40 pounds of pressure on your knees.

That means that every pound lost is like taking 4 pounds off of your knees. Another study found that patients with knee pain who lost weight reported less pain, improved joint function, and better overall quality of life. Weight loss has also been shown to reduce joint inflammation, improve osteoarthritis symptoms, and slow down the progression of the disease.

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Prescription Opioids Are Powerful Knee Pain Relievers

When over-the-counter pain relievers and other treatment options are not enough to deal with knee pain, a doctor may prescribe the prescription opioid tramadol. The medicine treats moderate to severe pain by altering how the brain processes it. In clinical trials, opioids were as effective as NSAIDs at reducing pain from osteoarthritis. Like acetaminophen, it has a lower risk of kidney, heart, or stomach problems than NSAIDs.

However, like all opioids, tramadol is a controlled substance with the potential for abuse and addiction if it is not taken appropriately. Tramadol can also cause dizziness or drowsiness that may impact your ability to drive or work. Still, the drug may be a safer option for people who do not respond to or are unable to take other painkillers.

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Steroid Can Help Knock Out Pain and Swelling in Your Knees

When our bodies are under stress, it naturally releases a hormone called cortisol. This hormone keeps our immune system in check and controls inflammation. Corticosteroids are synthetic chemicals that replicate the anti-inflammatory action of cortisol. Sometimes called steroids for short, corticosteroids are fast-acting and powerful treatments, typically reducing pain and swelling within hours. Steroids can be taken orally or applied topically as a cream.

But, for osteoarthritis, steroids are most commonly given as injections directly into the knee muscles or arteries. The effects of the treatment can last up to three months. One drawback of steroid injections is that they have a high risk of side effects, including suppressing your body’s natural ability to make cortisol and bone loss. Steroid injections are great for short-term pain relief but shouldn’t be used over long periods because of the side effect risk.


Joint Fluid Therapy Temporarily Restores Knee Function

If pain relievers and lifestyle changes don’t improve your knee pain, your doctor may suggest joint fluid therapy. Also called viscosupplementation or gel knee injections, this quick and easy procedure involves injecting a gel-like fluid called hyaluronic acid directly into the knee joint. The body naturally produces the fluid to lubricate the joint and protect it from damage. But people with osteoarthritis have less hyaluronic acid to cushion the joint, making it more vulnerable to injury.

Joint fluid therapy restores normal levels of hyaluronic acid to the joint and provides relief from chronic knee pain. Gel knee injections can provide months of pain relief and can be repeated every six months. Depending on the type of treatment you receive, you may need only one injection or several injections spaced out over a few weeks.


Genicular Artery Embolization Reduces Inflammation from Osteoarthritis

One of the first signs of inflammation is the abnormal growth of blood vessels. This process results in an increase in blood flow to the inflammation site, leading to the swelling and pain that is characteristic of osteoarthritis. Genicular artery embolization is a new approach to treating osteoarthritis-related knee pain. The treatment blocks the first stage of inflammation by preventing blocking increased blood flow to the joint.

Like joint fluid therapy, genicular artery embolization is fast, low-risk, and minimally invasive. Between 80 to 85 percent of people who have the procedure report significant improvements in pain and joint function. Additionally, two studies found that patients reported continued alleviation of pain and stiffness a year after the procedure.

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Radio Waves That Warm Up Nerves Are a New Knee Surgery Alternative

Another relatively new alternative to knee replacement surgery is cooled radiofrequency ablation. The procedure involves using an electrode to first heat up the nerves around the knee joint and then cool them down. This process, known as cooled radiofrequency ablation, interferes with the nerves’ ability to send pain signals to the brain. The treatment was approved to treat knee pain in 2017 and is not as well studied as other knee pain treatments.

However, one study found that around three-quarters of people who received the treatment reported significant improvements in symptoms six months later. A more recent study found similar results in 80 percent of patients after a year. The procedure is outpatient and minimally invasive but can be quite expensive.

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Topical Pain Medications Can Alleviate Arthritis Pain

Treatments for chronic knee pain don’t always have to involve pills or injections. Topical pain medications can be applied directly to the joint, providing fast pain relief. Topical treatments may come in gel, cream, spray, or patch forms that deliver the drug right where it’s most needed. One major benefit of topical treatments is that they typically have fewer side effects than other pain treatments because they aren’t interacting with the rest of your body.

Topical pain treatments often contain salicylates (aspirin), which is an anti-inflammatory pain killer. Capsaicin is a chemical that naturally occurs in chili peppers. When added to topical pain treatments, capsaicin causes a heating effect that prevents nerve cells from sending pain signals to the rest of the nervous system. Other topical pain medicine active ingredients are chemicals like menthol and lidocaine, which reduce your perception of pain.


Platelet-Rich Plasma Therapy May Help Repair Damaged Knees

Our bodies have an incredible ability to heal after injury and illness. Platelets are blood cells that cause blood to clot and play an important role in tissue healing. Experimental platelet-rich plasma therapy harnesses the healing ability of these cells to repair damaged tissue, such as a torn Achilles tendon.

This type of treatment that induces the body to heal itself is called regenerative medicine. For people with osteoarthritis, the procedure involves taking a patient’s blood, extracting the platelets, and injecting them directly into the knee joint. When combined with other treatments, platelet-rich plasma reduces knee pain and stiffness from osteoarthritis. Although the results are promising, more studies are needed to determine if the therapy is an effective treatment for knee pain on its own.


Stem Cell Therapy is an Experimental Knee Pain Treatment

Like platelet-rich plasma, stem cell therapy is another experimental, regenerative knee pain treatment that uses a patient’s cells to help them heal. Stem cells can produce many different types of cells, including cells that can replace or repair damaged tissue. The bone marrow, the soft tissue inside our bones, contains billion of stem cells that will become blood cells.

Bone marrow concentrates (BMC) are stem cells that have been extracted from a patient’s bone marrow, which can then be injected into the knee joint. The goal of the treatment is to encourage the healing of damaged cartilage in the knee. Similar to platelet-rich plasma therapy, there isn’t a lot of data about the effectiveness of BMC injections in treating knee pain. However, animal studies have shown promising results, and there’s an ongoing clinical trial in humans.

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Acupuncture is an Alternative Medicine Approach to Knee Pain

Acupuncture is a practice adopted from traditional Chinese medicine that involves inserting needles into the skin to relieve pain and inflammation. There isn’t much scientific evidence to back up the effects of acupuncture, but many people swear by it. Some practitioners believe that the therapy increases blood flow or promotes the release of brain chemicals called neurotransmitters that help alleviate pain. Because there is no clear method and the technique is difficult to standardize, it’s unclear how much of the healing powers of acupuncture are simply a placebo effect.

One study found that osteoarthritis patients who received acupuncture treatments were no more effective at reducing pain than placebo. However, there is some evidence that acupuncture may help improve osteoarthritis symptoms when paired with other treatments. Some experts, including the American College of Rheumatology and Arthritis Foundation, recommend acupuncture on the condition that it may be worth trying.

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Prolotherapy Uses a Sugar Solution to Trigger the Immune System

Prolotherapy is an alternative therapy that claims to relieve pain by injecting a dextrose sugar solution into the joint. The solution causes irritation in the joint, which triggers your body’s immune response to start healing the damaged area. Like many alternative medical approaches, there is some evidence of a slight benefit of prolotherapy but not enough for most doctors to recommend it.

Some small studies have shown slight, short-term improvements in knee pain following the treatment. But the lack of long-term data or controlled studies makes it difficult to determine how much of the benefit is a placebo effect. Although the effectiveness of prolotherapy is debatable, the treatment is inexpensive and has few safety concerns. Some doctors say that as long as patients are continuing other, more proven treatments, there’s no harm in trying prolotherapy.


Many People Use Walking Aids Like Canes to Manage Knee Pain

Taking pressure off your knee can go a long way toward reducing knee pain. Walking aids are designed to help you do just that by allowing you to transfer your weight away from your knees. There are many different types of walking aids; it’s just a matter of finding the right one for you. Canes are probably the most common mobility aid, for a good reason. They are affordable, can be purchased in most pharmacies, and don’t require a learning curve to use.

Canes come in many different styles and may have additional feet for added stability. A crutch may be helpful when you’re dealing with a flare-up of knee pain. The devices prevent you from putting too much weight on your knee but can be uncomfortable to use long-term. Walkers provide the most support and stability of any walking aid. You can even buy walkers with seats so you can rest if you’ve been on your feet too long.

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Braces and Orthotics Take Pressure Off Your Knees

Supporting your knees with braces or orthotics (shoe inserts) can help reduce pain and stiffness. Braces wrap around the knee and keep your knee steady and aligned without putting too much pressure on the joint. Braces may be inexpensive compression sleeves that also help reduce swelling or a more expensive unloader brace that allow you to shift weight to the healthier side of your knee.

Orthotics are shoes or shoe inserts that help take pressure off of your joints. They can provide relief if you’re experiencing milder knee pain or want to avoid further damage. Just switching to shoes with better support can do wonders for your knees.


Supplements Help Support Healthy, Pain-free Joints

Your doctor may recommend that you take dietary supplements in addition to other treatments to help manage knee pain. The most common supplement for osteoarthritis is glucosamine and chondroitin, which are two components of cartilage. A large study found that glucosamine supplements slightly improved knee pain and mobility compared to placebo. Another study found that the combination of glucosamine and chondroitin was effective at alleviating knee pain, inflammation, and stiffness, at least as effective as the prescription NSAID celecoxib.

The anti-inflammation supplement SAM-e has also been found to be as effective as over-the-counter NSAIDs at reducing pain from osteoarthritis. Although supplements typically have fewer supplements than other treatments, it’s important to speak to your doctor before starting any supplement plan.

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Diet Changes Can Help Reduce Knee Inflammation

Your diet impacts every aspect of your health, including the health of your joints. Because knee pain is often caused by inflammation, eating a diet rich in anti-inflammatory foods can help you manage your symptoms. The best foods for reducing inflammation are fatty fish, like salmon, tuna, and sardines, that are packed with omega-3 fatty acids.

Nuts and seeds are also good sources of fat. Fresh fruit and vegetables, especially leafy greens, lean protein, healthy oils, and whole grains are important parts of an anti-inflammatory diet. Foods to avoid processed junk foods like potato chips, foods high in added sugar and cholesterol, and red meat.

Where Do We Find This Stuff? Here Are Our Sources:

Knee Replacement Alternatives to Consider | Johns Hopkins Medicine

Alternatives to Knee Replacement Surgery – Are They Really Effective?

5 options for knee arthritis pain – Mayo Clinic Health System

Knee Replacement Alternative Relieves Pain, Retains Mobility.

6 alternatives to knee replacement surgery | TRIA blog

Alternatives to Knee Replacement Surgery

Non-surgical Treatment Options for Knee Pain | Phelps Health