Explore treatment options before undergoing knee surgery

By Ryan Szepiela, M.D., ProMedica HealthConnect

        Joint pain, especially knee pain, is extremely common. When the pain worsens and starts to affect your everyday activities, people start to pay attention to it and seek medical advice for treatment.
        The question is: What treatments are available for knee pain and where do you start?
        Whether you have had joint pain for a long period of time or just started experiencing joint pain in everyday activities, there are several things that you can do even before seeing a physician. You can first evaluate when your knee pain starts to come on, note if there are certain activities or positions that cause pain, and then change up your daily routine to see if you can alleviate the pain.
        Weight loss and exercise are other conservative options that can improve joint pain. Weight loss can help to decrease extra weight and stress on your knees, helping your symptoms and pain. Appropriate diet and exercise to assist with weight loss can be found on trusted websites (such as ProMedica HealthConnect’s Wellness section). Ask your physician if you are unsure of what is appropriate and how to proceed.
        A physical therapist is also often utilized in order to help with joint range of motion, function, strengthening, and pain control. I see a lot of joint pain in my office that is successfully treated with the appropriate physical therapy. Next steps in treatment need to be taken when pain persists or you are unable to work out or lose weight secondary to the pain.
        For joint pain that is not responsive to conservative management, a full evaluation and further treatment is needed from your physician or joint specialist. At your appointment, a full physical exam and evaluation will be done. Most likely, further imaging in the form of an x-ray or, in certain cases, an MRI may be needed to get a detailed picture of your bones, joints and soft tissues.  In most cases, medications are not a primary treatment. As a physician, I like to evaluate and treat your joint pain and improve your function. Light medications such as Tylenol or NSAIDS (e.g., Ibuprofen, Mobic, Celebrex) may also be used during your treatment.
        Injections for knee joints can help with pain and function, and allow further advancement with physical therapy and a home exercise program. This process usually starts with a corticosteroid injection, which can help with inflammation, pain and swelling of the joint. Corticosteroid injections can be effective and long lasting. If cortisone does not work, then a hyaluronic acid injection may be used. Hyaluronic acid is a gel substance that is used to lubricate the knee, improve mobility, and reduce pain.
        If conservative treatments fail and you are not quite ready for surgery, regenerative treatments may be a possibility. These new treatments consist of stem cell treatments and platelet rich plasma (PRP). Significant research is ongoing with these treatments, and for the appropriate people they can help to delay or avoid surgery. I would recommend that you do appropriate research on these treatments if you are considering one of these procedures, and that you see a physician who specializes in this treatment. You should receive a full evaluation and imaging prior to making a decision.
        Knee surgery can be a great option for individuals with advanced knee degeneration. Talk with your doctor to learn more about your knee pain and for a treatment plan that is right for you.
        Dr. Szepiela is board certified in physical medicine and rehabilitation, sports medicine and has a specialized interest in spinal intervention. Learn more health and wellness tips at https://promedicahealthconnect.org/.


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