Knee Pain Treatment in Delhi, India

Knee pain can generally be classified into two types: acute and chronic. Acute knee pain occurs suddenly, often due to an injury such as a sprain or strain, and typically lasts for a short period. Chronic knee pain, on the other hand, develops over time and can persist for weeks or months. It is usually linked to conditions such as arthritis or overuse injuries and may worsen without treatment.

Common symptoms that often accompany knee pain include:

• Swelling: Swelling is common and often occurs after an injury, such as a sprain or strain, or due to inflammation caused by conditions like arthritis. 
• Reduced Range of Motion: Knee pain can sometimes impact a person's range of motion, making it difficult for them to fully bend or straighten the knee. This symptom is commonly observed in cases of joint inflammation, injury, or degeneration of the knee's cartilage.
• Stiffness: Stiffness in the knee joint can make it difficult to bend or straighten the leg. This is commonly seen in people with osteoarthritis or after prolonged periods of immobility.
• Redness and Warmth: Inflammation caused by injuries or medical conditions such as bursitis or infections can cause the knee to appear red and feel warm to the touch. 
• Tenderness: Tenderness around the knee joint, particularly on the sides or directly on the kneecap, can indicate inflammation of the soft tissues, such as tendons or bursa. This is often seen in conditions like tendinitis or bursitis.

Max Hospitals provides treatment for a variety of conditions that cause knee pain. These include but are not limited to:

Injury

Knee injuries are a common cause of knee pain and can occur suddenly due to accidents, sports activities, or falls. Injuries such as ligament sprains, meniscus tears, or fractures can result in acute pain, swelling, and difficulty moving the knee. Depending on the severity of the injury, treatment may range from rest and physiotherapy to surgical intervention for more serious damage.

Medical Conditions

Several medical conditions contribute to knee pain, including:

• Arthritis: Both osteoarthritis and rheumatoid arthritis can cause knee pain. Osteoarthritis occurs due to wear and tear of cartilage, leading to pain, stiffness, and swelling. Rheumatoid arthritis is an autoimmune condition that causes inflammation in the joints, including the knee, resulting in joint damage.
• Gout or Pseudogout: These conditions occur due to the buildup of uric acid crystals (gout) or calcium crystals (pseudogout) in the knee joint, causing sudden, severe pain and swelling.
• Bursitis: Inflammation of the bursa (fluid-filled sacs) around the knee can cause swelling, redness, and pain, especially when kneeling or bending the knees.
• Patellar Tendinitis: This condition involves inflammation of the tendon that connects the kneecap to the shinbone, often due to repetitive activities like jumping or running, causing pain in the front of the knee.

Overuse or Strain

Repetitive use of the knee joint can lead to injuries, especially in athletes or people who engage in activities such as running, jumping, or squatting. Patellofemoral pain syndrome (also known as “runner’s knee”) and tendinitis are common overuse injuries. These injuries result from repetitive stress or improper alignment, leading to inflammation in the tendons, muscles, or soft tissues around the knee, causing discomfort and pain.

Several risk factors can increase the likelihood of developing knee pain. These include: 

• Obesity: Extra weight puts additional stress on the knees, increasing the risk of arthritis and other knee issues.
• Previous Injuries: Past knee injuries, such as ligament tears, can make the knee more vulnerable to pain and damage in the future.
• Physical Activity Level: Both inactivity and high-impact activities can increase the risk of knee pain. Lack of exercise weakens the muscles, while a repetitive strain can cause injury.
• Poor Alignment: Misalignment of the knee or improper posture can place extra stress on the joint, leading to pain.
• Occupation: Jobs that require repetitive bending, lifting, or standing for long periods can strain the knee and lead to pain.

Accurate diagnosis is crucial to understanding the cause of knee pain and determining appropriate treatment. Common diagnostic methods employed at Max Hospitals to determine the cause of knee pain include:

Physical Exam

A physical exam is often the first step in diagnosing knee pain. During this process, the doctor assesses the knee’s range of motion, stability, and overall function. Specific movements or manual tests, such as bending the knee or applying gentle pressure, help pinpoint the source of discomfort and rule out certain conditions.

X-Ray

X-ray is a widely used imaging technique to evaluate the bones of the knee. It helps detect fractures, dislocations, or signs of arthritis, such as joint space narrowing or bone spurs. This imaging test is particularly effective for identifying structural abnormalities and assessing the overall health of the knee joint.

MRI

Magnetic resonance imaging (MRI) is a more detailed imaging technique that focuses on the soft tissues surrounding the knee. Unlike X-rays, which primarily provide images of the bones, MRIs can detect injuries in the ligaments, tendons, menisci, and cartilage. Conditions such as anterior cruciate ligament (ACL) tears or meniscus damage are best identified through MRI.

Blood Tests

Blood tests are performed when an underlying medical condition is suspected to be the cause of knee pain. For instance, elevated levels of uric acid can indicate gout, while specific markers might point to rheumatoid arthritis or an infection. Blood tests provide valuable information about systemic issues that could contribute to knee pain.

At Max Hospitals, knee pain treatment is decided based on the underlying cause, the severity of the condition, and the patient’s overall health. The two primary approaches to treating knee pain include:

Non-Surgical Treatment

Non-surgical treatments are often the first line of action, especially for conditions that can improve with rest and medication. Common non-surgical treatment options include:

• Physical Therapy: Physical therapy aims to strengthen the muscles surrounding the knee, improve flexibility, and restore function. It also teaches techniques to avoid further injury and reduce strain on the knee joint.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections are commonly used to reduce inflammation and pain.
• Rest and Ice: Resting the knee and applying ice can help reduce swelling and provide immediate pain relief, especially after an injury or strenuous activity.
• Bracing or Support: A knee brace or wrap can help stabilise the knee joint and prevent further injury, particularly in cases of ligament or cartilage damage.
• Lifestyle Modifications: Weight management, low-impact exercise, and adjustments in posture and movement can reduce stress on the knee joint, improving long-term function and reducing pain.

Surgical Treatment

In cases where non-surgical treatments fail to provide relief or if the knee damage is severe, surgical intervention may be necessary. Some common surgical options include:

• Arthroscopy: A minimally invasive procedure where a small camera is inserted into the knee joint to repair or remove damaged tissues, such as torn cartilage or ligaments.
• Knee Replacement Surgery (Arthroplasty): In severe cases of osteoarthritis or knee degeneration, knee replacement surgery may be required to remove the damaged joint and replace it with an artificial one.
• Ligament or Tendon Repair: Surgical repair of torn ligaments or tendons may be necessary in cases of significant injury, such as an ACL tear.
• Meniscus Surgery: In cases of torn cartilage, the surgeon may perform a meniscectomy (removal of damaged meniscus portion) or a meniscus repair to restore knee function.

If knee pain is left untreated or inadequately managed, it can lead to several complications that can affect mobility and overall quality of life:

• Reduced Mobility: Chronic knee pain can limit basic movements like walking, climbing stairs, or even standing for long periods, making everyday tasks more challenging. Over time, this may lead to a more sedentary lifestyle, which can contribute to weight gain and joint strain.
• Joint Deformities: Persistent knee pain caused by untreated arthritis or injuries can lead to joint misalignment and deformities. This can worsen pain and lead to abnormal wear and tear on the knee, potentially resulting in permanent damage.
• Muscle Weakness: Reduced movement due to knee pain can cause the muscles around the knee to weaken. This can lead to instability in the knee joint and increase the risk of falls or additional injuries.
• Osteoarthritis: Untreated knee injuries, such as cartilage damage, can increase the risk of developing osteoarthritis. This degenerative condition leads to the wearing away of cartilage, causing bone-on-bone contact, which results in pain, swelling, and stiffness.
• Tendon or Ligament Damage: Persistent knee pain, especially from injuries like ligament tears (e.g., ACL), can worsen over time if not addressed. This can cause additional stress on the knee joint, leading to further damage and the need for more extensive treatments or surgery.
• Chronic Inflammation: Conditions like rheumatoid arthritis or bursitis can cause inflammation in the knee joint, which may spread to surrounding tissues. If left untreated, chronic inflammation can lead to long-term damage and further complications.

Preventing knee pain involves taking proactive steps to reduce the risk of injury, manage existing conditions, and maintain overall knee health. Here are some key strategies:

• Maintain a Healthy Weight: Excess weight puts additional strain on the knee joints, increasing the risk of pain and damage over time. A balanced diet and regular exercise can help manage weight and reduce stress on the knees.
• Stay Active: Regular, low-impact exercises like swimming, cycling, or walking help keep the muscles around the knee strong, providing better support for the joint. 
• Warm-Up and Stretch: Before engaging in physical activities, proper warm-up and stretching helps prepare the muscles and joints, reducing the risk of strains or sprains. 
• Use Proper Footwear: Wearing shoes that provide adequate support and cushioning can reduce the impact on the knees, particularly during high-impact activities. Avoid shoes that are worn out or don't fit properly.
• Correct Posture and Technique: Pay attention to posture and movement patterns during physical activities. Incorrect posture or poor technique can lead to uneven stress on the knees, increasing the risk of injury or strain.
• Avoid Overuse: Repetitive activities can cause stress on the knee joint. It's important to take regular breaks and avoid overworking the knees during sports or physical labour.
• Strengthen Muscles: Focus on strengthening the quadriceps, hamstrings, and calf muscles, as strong muscles provide better support to the knee joint and can help prevent injuries.

1. Can knee pain be caused by sitting too much?

Yes, prolonged sitting can lead to stiffness and weakness in the muscles around the knee. This can cause knee pain, especially when standing or moving after being seated for extended periods.

2. Is knee pain normal as we age?

Knee pain is not a normal part of aging, but can happen due to wear and tear of the joint. However, persistent or severe pain is not normal. It could indicate an underlying issue that may require medical attention.

3. What can I do if I have knee pain but don’t want to take medication?

Non-pharmacological options like rest, ice packs, elevation, physical therapy, and using supportive knee braces or orthotics may help manage knee pain without medication. It’s important to consult a healthcare professional before trying alternative treatments.

4. How can I prevent knee pain during exercise?

To prevent knee pain during exercise, focus on proper technique, use appropriate footwear, warm up before activities, and avoid overdoing exercises that put excessive strain on the knees. Low-impact exercises are often recommended for people with knee pain.

5. Can knee pain be a sign of something more serious?

Knee pain may sometimes indicate more serious conditions such as fractures, infections, or autoimmune diseases like rheumatoid arthritis. It’s important to seek medical advice if knee pain persists or worsens.

6. Is it safe to continue exercising with knee pain?

It depends on the severity and cause of the knee pain. Low-impact activities like swimming or cycling may be safe, but high-impact exercises should be avoided until pain subsides. Consulting a healthcare provider is crucial before continuing any exercise routine.

7. How do I know if I need knee surgery?

If knee pain is severe, chronic, or not improving with non-surgical treatments, surgery may be considered. A healthcare provider can assess the condition and recommend surgery only if necessary, based on the extent of damage.

8. Can knee pain be related to issues in other parts of the body?

Yes, knee pain can sometimes be linked to problems in the hips, lower back, or feet. Misalignment or issues in other parts of the body can cause strain on the knee joint, leading to pain or discomfort.

9. Can wearing a knee brace help with knee pain?

A knee brace can provide support, reduce swelling, and help stabilise the knee joint, especially after an injury or surgery. It can also be helpful during physical activities that put a strain on the knees.

Reviewed By Dr. Ramneek Mahajan, Senior Director (Orthopaedics) & Head Joint Replacement (Hip & Knee) Unit- Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury, Robotic Surgery on 05 February 2025.

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