29 July 2019

What are the alternatives to having surgery for severe knee pain?

Your knees have taken a beating – they've been carrying you for all your life – but is surgery really necessary or are there other options out there?

Arthritis in the knees can strike people as young as 45, with symptoms severe enough to limit activities and harm quality of life. What can be done about it?

First, know that inactivity isn't the answer. You need to move, so try low-impact exercises like walking and swimming. Researchers are also looking at possible benefits from interval training rather than continuous workouts.

Conflicting results

If you're overweight, research has shown that diet, along with exercise, can reduce pain and improve function.

Studies on the popular supplement glucosamine have yielded conflicting results over the years, but one explanation for the mixed findings has to do with the different formulas that were used. Success in Europe and other parts of the world was found with a daily 1 500-milligram dose of patented crystalline glucosamine, according to the International Journal of Rheumatic Diseases.

Acupuncture helps some people find relief, as does daily do-it-yourself acupressure – using just your fingertips on the painful areas.

Design a workout

More invasive procedures, like injections of corticosteroids or hyaluronic acid, have limited benefits and possible side effects. And knee surgery, often suggested to "wash out" debris inside the joint, does not seem to result in significant pain relief, better function or greater benefits than conservative strategies like exercise therapy.

One helpful suggestion came from an analysis of studies involving exercise among people with knee and other joint pain and published in the Cochrane Database of Systematic Reviews. Work closely with your health care team to understand how exercise can help you and to find types of activity that you'll enjoy. Your team may include not only your primary care doctor, but also an orthopaedist and a physical therapist who can design a workout based on your needs and your abilities.

Image credit: iStock


Ask the Expert

Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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