Knee pain can leave you uncomfortable. and indefinitely sidelined from activities you enjoy — a fact you’re well aware of it you’ve had a recent injury or face chronic pain caused by arthritis or cartilage damage.
Garden State Pain & Orthopedics's Dr. Deepan Patel, who treats patients who suffer from various conditions that cause knee pain, offers nonsurgical options to address them.
When a new patient comes to the orthopedic surgeon seeking relief from knee pain, Dr. Patel conducts a thorough evaluation, starting with a complete history to find out how long the patient has been experiencing pain, which activities exacerbate it, and what the patient has tried to reduce the discomfort.
“Then, I'll do a physical exam to try to find the source of the pain and how the knee feels in terms of stability — is there any swelling, is there any deformity about the knee?” he said. “Then, I will finish with some sort of imaging. In my office, we will take X-rays or do an ultrasound evaluation to try to get a look inside the knee. Then, if needed, I will order more advanced imaging, like an MRI.”
Although many patients worry that seeing a surgeon means they’ll certainly need surgery, Dr. Patel explained this his initial approach to treating chronic pain is nonsurgical.
He prefers that patients start with physical therapy, chiropractic care, acupuncture or a home exercise program — a popular choice in light of the pandemic.
“Then, if needed, we’ll implement some type of medication regimen,” he said. “That can be a prescription-strength anti-inflammatory or a topical cream to help with the pain. After that, we consider braces or orthotics to help if it's a joint. So, for the knee, for example, we could give them a brace that provides support and helps with stability.”
If the pain continues, Dr. Patel and the patient may discuss injection options, which include traditional cortisone or gel as well as regenerative medicine, such as platelet rich plasma or stem cell injection. These treatments take effect in approximately two to three days and can last from six weeks to six months. In some cases, they can be curative, the orthopedic surgeon said.
“Any patient is a candidate for these types of treatments,” Dr. Patel said. “It's not limited to a certain age group or a certain type of condition, whether it's a tendon injury or meniscus or cartilage or even arthritis.”
Using these treatment options, approximately 50% of patients will experience sufficient relief, allowing them to either put off or avoid surgery, Dr. Patel noted.
When to Seek Medical Help?
While it’s not uncommon for people to try to address pain on their own with rest, ice, elevation or over-the-counter medications, often they aren’t enough. If four weeks have passed and pain persists, Dr. Patel recommended having the knee examined by a professional.
“It’s better to seek care sooner rather than later,” he said. “Just because you're seeing a surgeon doesn't necessarily mean you're going to have surgery. Sometimes coming in earlier can prevent or minimize the chance of having surgery because you're treated early.”
By delaying too long, some patients “have lost the window” to benefit from the aforementioned treatments, Dr. Patel, explained, and find themselves facing surgery.
Additionally, if patients don’t seek proper medical care, they could face the possibility of becoming dependent on pain medications. Even reliance on over-the-counter anti-inflammatories can lead to stomach issues, such as ulcers. Individuals who take prescription pain medication run the risk of other side effects, including addiction.
Dr. Patel said he encourages all patients who experience knee pain to have it checked out so they can explore their treatment options and return to a pain-free lifestyle.
“Sometimes patients feel that they have a certain problem but believe ‘I’m not a candidate for this,’ ” he said. “Or, maybe they think they’re too old or that it costs too much so they can’t have it. We always try to find a way to make sure that whatever the patient needs, they get. We try to remove as many barriers as possible to that.”