Knee pain can appear in many forms. Arthritis, an injury, and gradual wear and tear as you age can all have an effect on your activities and comfort level. If you’re unable to walk or climb a stairs because of your pain (and have tried several non-invasive methods to find relief), knee replacement surgery may be the best way to get your life back. While the benefits of the procedure may significantly outweigh temporary discomfort, it’s important to have realistic expectations regarding your recovery timeline and knee replacement pain after surgery.

What does knee replacement surgery recovery look like?

During knee replacement surgery, your doctor will make an incision before moving your knee cap and cutting away any damaged bone, cartilage, and joint surfaces. Artificial joints will then be attached and tested by bending and rotating your knee before your doctor closes your incision with stitches.

Whether you’re having a total or partial knee replacement will have an effect on your pain level and recovery.

A traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. On the other hand, a partial knee replacement is much less invasive. Patients usually walk without assistance within two weeks. This is because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.

After your surgery, you’ll follow weight-bearing guidelines. How much pressure your new knee can initially support will depend on the condition of your natural bone, as well as the type of prosthesis you have.

Also note that every patient heals at a different pace. Practicing knee-strengthening exercises before surgery can help you recover more quickly, but an elderly patient, smoker, or someone who suffers from other medical conditions may take longer to heal. Talk to your doctor about your medical history to gain a better understanding of what to expect from your personal recovery journey. Always follow their directions exactly for recovery.

What causes pain after knee replacement surgery?

Researchers continue to study the many causes of pain after knee replacement surgery. Some are biological and due to conditions present before surgery, while others are due to complications that arise during surgery.

On the biological side, patients suffering from arthritis may experience increased sensitivity because of the ongoing pain that was present before surgery. As we’ll explain below, inflammatory responses and allergy-related problems can also contribute to persistent pain. Another source of pain is referred pain originating from the hip due to a change in alignment.

If you are experiencing ongoing pain after knee replacement surgery, but do not have a medical history of arthritis or the previously mentioned issues, you may be dealing with surgical complications. While your doctor will take steps to prevent problems, it’s still possible for these to rare issues to occur:

• Infection
• Nerve injury
• Prosthetic loosening
• Poor alignment or rotation
• Incorrect sizing
• Instability
• Stiffness

Remember to stay open and honest with your doctors. This will help them properly diagnose and treat the problem to get you the pain relief you’re looking for.

Where will I feel knee replacement pain?

As mentioned above, knee replacement pain can come in many different forms depending on the cause. Knee pain is to be expected due to the surgical procedure itself, with swelling, bruising, and the introduction of prosthetic parts.

Beyond that, it is possible to feel pain in parts of the body other than your knee. This is known as referred pain.

Your hips, lower back, groin area, and calves may initially hurt due to the change in your stance and the way you walk. Of course, it is also typical to feel sore due to extended amounts of time in bed during your recovery.

Knee replacement pain: The week following surgery

You should expect to stay in the hospital for several days following knee replacement surgery. This is often considered the most painful stage of the recovery process. Your doctor will prescribe medications to help you manage your pain level.

In addition to icing your knee, you may be encouraged to move your foot and ankle to increase blood flow and lower the risk of swelling and blood clots. Your doctor may also use blood thinners, support hose, and compression boots to prevent further complications.

Generally the day after surgery, a physical therapist will show you exercises that will help you recover your range of motion and continue to heal. You may even be asked to get up and take a few steps (with assistance). Patients who get up and put a safe amount of weight on their new knee typically experience a quicker recovery.

After leaving the hospital, most patients continue to take some form of pain medication for two to six weeks. Your doctor will determine the best method of pain relief for your specific needs, whether it is over-the-counter medications or something stronger.

Knee replacement pain after three months

Swelling and bruising can continue for three months or more following knee replacement surgery. However, it varies from patient to patient and depends on the condition you were in before surgery. Many patients are back to their activities without the pain they had before surgery by this stage of recovery.

If you find that any movement or activity is still exceedingly painful after three months, you may be experiencing chronic pain. Chronic pain is defined as pain persisting for three months or longer. It’s a condition that affects roughly 20% of knee replacement surgery patients. It can develop and increase in intensity in the weeks and months following surgery. This can have a huge impact on your overall quality of life. Talk to your doctor for help.

Pain after knee replacement: six months

If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again. Unfortunately, there is no easy answer.

In some cases, it may take up to a year for all of your swelling to completely go away. Your knee will continue to recover for years to come, as scar tissue forms and your muscles become stronger with continued physical therapy and light exercise.

As previously mentioned, if you are still experiencing debilitating levels of pain at this stage, you could be suffering from chronic pain. While you may be tempted to “tough it out,” it’s important to talk with your doctor. Together, you can find what is causing your persistent pain and come up with a plan to fix it.

Knee replacement pain, a year and beyond

The goal of knee replacement surgery is to help you get back to the activities you love. Your doctor will encourage you to stay fit through activities like swimming, cycling, and even golf. This type of exercise will help you stay limber and pain-free.

On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.

The good news is that studies show more than 90% of total knee replacements are still functioning properly 15 years after surgery. Staying healthy and following the advice of your doctor will help you achieve these long-term benefits.

While it’s possible for pain to persist for a year and beyond, it shouldn’t be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee, but if you’re suffering from ongoing pain after a year, always talk to your doctor.

How to treat knee replacement pain

If you’re frustrated with the pain you feel on a daily basis, you have options for relief. Consider the following treatment options and talk with your doctor about which route is best for your specific needs.

Non-invasive remedies

If you’re suffering from knee replacement pain, you’ll by exploring simple at-home remedies, such as applying ice packs or hot compresses.

Knee braces are also popular for many patients. If your pain is associated with repetitive movements or specific stresses, a brace may help. It can restrict or stabilize joint movement to reduce your discomfort. Some patients wear a brace during certain activities or times of day. This can help keep their knee in a better position.

Physical therapy can also correct the effects of repetitive stress. A physical therapist uses a regimen of specific exercises and stretches to condition your muscles, tendons, and ligaments. Range of motion exercises and weight bearing activity are also important for maintaining muscle strength. In addition, physically fit people tend to have less pain and better recoveries, both short-term and long-term.

Medications

A daily regimen of commonly available medications could help you manage your pain. Your doctor may recommend aspirin, naproxen, or ibuprofen to inhibit the production of inflammatory molecules in the body, thus reducing the associated pain.

For more severe forms of pain, talk to your doctor about other knee pain medications.

Knee injections

Injections for knee pain have proven to be effective for patients who have tried several other treatments, but aren’t quite ready to consider more interventional procedures.

Corticosteroid injections are a great option for treating flare-up pain and swelling in your knee caused by fluid buildup. If this type of injection fails, your doctor may consider using a hyaluronic acid injection. Hyaluronic acid provides lubrication and acts as a shock absorber to provide padding for the knee.

Unfortunately, injections are a short-term solution. Most procedures will alleviate the pain for about four weeks to six months. Doctors don’t recommend receiving more than two or three shots per year. They’re best used in conjunction with other pain-relieving methods, like physical therapy.

Genicular nerve block with radiofrequency ablation

Instead of more invasive surgical options, many patients turn to a genicular nerve block to treat and diagnose persistent knee pain. A genicular nerve block uses anesthetic injected into one or more of the genicular nerves to interrupt pain signals being sent to the brain.

Unfortunately, a genicular nerve block’s effects only last eight to 24 hours. Doctors use genicular nerve blocks to test the effectiveness of the procedure on a person’s knee pain. Many patients who experience relief with genicular nerve blocks will then get radiofrequency ablation. When combined, these two procedures can offer pain relief that lasts anywhere from six months to a year.

Revision surgery

In rare, but serious cases, you may need knee replacement revision surgery to ease or cure your chronic pain.

Most doctors agree that unless the cause of pain is clearly identified as implant-related, revision surgery has been shown to result in poor outcomes. Your doctor will be able to determine if this is the best option for you based on your medical history and pain level. The majority of patients do not have to undergo an additional surgery.

If you’re in Arizona and are experiencing persistent knee replacement pain, contact our pain specialists today. Our team of experts at Arizona Pain are highly skilled in all areas of pain management. We are committed to finding treatment options that are compatible with your medical history and lifestyle. You don’t have to suffer alone. Get help today.

Chronic knee pain can have a dramatic effect on our daily lives. As a weight-bearing joint, your knee takes a lot of pressure across a lifetime, sometimes with debilitating results. If you suffer from chronic knee pain, a genicular nerve block might be a good treatment option for you. Here’s what you should know.

What is a genicular nerve block? 

Nerves wind through all of the joints in our bodies, and the knee is no different.

Your knee is a large, complex joint made up of four bones: the femur, the tibia, the fibula, and the patella. These bones are stabilized by the muscles of the quadriceps, hamstrings, and calves.

Ligaments and cartilage provide further connection and support. They include:

• The anterior cruciate ligament (ACL): Connects the femur to the tibia and stabilizes the knee joint
• The posterior cruciate ligament (PCL): Prevents the femur from moving forward of the tibia

Two collateral ligaments, medial and lateral, keep the knee aligned with the femur and the tibia from top to bottom.

Meniscus tissue (lateral and medial) provides easy movement between the femur and the tibia. Additional cartilage cushions the patella from behind. And for comfortable movement, fluid-filled sacs called bursae cushion the knee joint and prevent bones from rubbing against one another.

Pain relief

Woven throughout this entire joint is a complex network of nerves and arteries, collectively referred to as the genicular nerves. A genicular nerve block uses an anesthetic injected into the sides of the knee to relieve knee pain from a variety of causes. This knee pain might be sporadic, only occurring at night, or it might be constant and interfere with every step you take.

Additionally, a genicular nerve block for knee surgery can provide lasting pain relief as you recover and rehabilitate this joint. This type of pain control delivers targeted relief directly where it’s needed—without the potential side effects of oral pain medications.

Diagnosis

Genicular nerve blocks are used for knee pain, but they have other uses, too. When the cause of your pain is unclear, this type of joint injection can also be used as a diagnostic tool. For example, if a genicular nerve block relieves at least 50% of your knee pain, it indicates that you may be a candidate for a more permanent pain solution like radiofrequency ablation.

Radiofrequency ablation (RFA) for knee pain is a procedure that uses a weak electrical current to damage pain-signaling nerves in the knee. Many patients have experienced long-term pain relief and increased mobility with RFA.

How does a genicular nerve block work?

A genicular nerve block for knee pain is placed in several different locations in your knee. The anesthetic blocks the pain-signaling nerves in the knee. This does not treat any underlying conditions that are causing pain, but it does allow for other treatments or rehabilitative exercise to occur, pain-free.

Sometimes a corticosteroid will be injected for inflammation, as well. But unlike other joint injections, a genicular nerve block is most frequently simply an anesthetic medication with no steroid.

Benefits of genicular nerve blocks 

Genicular knee blocks come with a host of benefits, some of which we discuss in more detail below. Overall, there are several benefits that are common for all conditions eligible for this procedure.

To start, a genicular knee block is minimally invasive with a low risk of side effects or complications. It can help relieve pain safely so that you can begin other treatments (e.g. physical therapy or other targeted exercise).

Genicular nerve blocks can also help you avoid more invasive knee surgeries when other conservative pain control methods are not working. It’s a good option for people who are not eligible for surgery but need pain control without oral medications.

Finally, because a genicular nerve block does not require a steroid to be effective, it’s a good option for people who are allergic to steroids or wish to avoid potential steroid side effects.

There are other benefits unique to specific causes of knee pain, too.

Osteoarthritis

Osteoarthritis is one of the most common causes of chronic knee pain. It can also be one of the most stubborn to treat. For intractable osteoarthritis, researchers have found that a genicular nerve block (with or without a corticosteroid) provided pain relief that lasted for at least two weeks. For people concerned about the side effects of steroids, this is good news—anesthetic alone was just as effective.

Research has also found that those who suffer from osteoarthritis knee pain and experience pain relief from a genicular nerve block are good candidates for long-term radiofrequency ablation.

Chronic knee pain

Osteoarthritis is the most common cause of chronic knee pain, but it’s not the only one. Gout, tendinitis, and injury can cause pain and swelling that is either episodic or constant.

These conditions are approached with a variety of treatments that includes addressing the underlying condition while relieving pain with a knee nerve block.

Failed total or partial knee replacement

While most people who undergo total or partial knee replacement have good results, for some, pain and swelling marks a failure of the implant. It might shift and become loose, causing tremendous pain, swelling, and instability in the knee.

Whether a knee revision surgery is performed or not, a genicular nerve block can help control pain before and after this procedure.

Pain management during and after knee surgery

Genicular nerve block for knee surgery can speed recovery and provide more comfort than oral pain medications. Patients who received a genicular nerve block for knee pain after surgery also took less than half the dosages of opioids during their recovery and up to a week afterward. They also reported lower pain scores than patients who did not receive a genicular nerve block.

As a minimally invasive procedure with few risks, side effects, or potential drug interactions, these are promising study results for those undergoing knee replacement.

What can I expect with a genicular nerve block procedure? 

Unlike some nerve blocks that target a single nerve, a genicular nerve block is placed in at least three separate locations in the knee for best results. These nerves are located at the top of the knee, on the inside and outside of the knee, and below the knee on the inside of the leg.

This procedure is performed on an outpatient basis with local anesthetic. It’s best to bring a friend or family member to drive you home, but they won’t have to wait long. The entire procedure takes less than 30 minutes.

You’ll position yourself on the exam table, and the injection areas will be cleaned and sterilized. A numbing medication applied to the skin provides comfort during the injections. If you are anxious about the procedure or concerned about pain, talk to your doctor about mild sedative options.

Once your skin is numb, your doctor uses X-ray guidance to properly place the injections, but here’s another difference from other joint injections. This time, medications are injected outside of the joint. This cuts the pain signaling off where the nerves begin (instead of waiting until they hit the joint itself).

You may start to feel pain relief within minutes. Your doctor may ask you to walk around for a bit to see if the medication takes immediate effect (even if it’s not fully working). After 15 minutes or so, you’ll be released to go home and rest for the remainder of the day.

Recovery

It’s important to talk to your doctor for specific recovery instructions. This is especially true if you are treating underlying conditions or other health issues at the same time.

In general, there are some common guidelines for your recovery. As noted above, it’s best to have someone drive you home the day of your knee nerve block. Some people experience numbness in their leg, so driving is off the table for the first 24 hours.

During that time, it’s okay to move around, but best to avoid any strenuous activity. This includes exercise or standing for long periods of time. Take the day off and rest.

You may notice mild swelling, bruising, or soreness at the injection sites. Over-the-counter, non-steroidal anti-inflammatory medications like ibuprofen and naproxen sodium can help. Take only as directed by your doctor. You can also apply ice to ease swelling in a 20 minutes on, 20 minutes off pattern as needed.

Keep track of your pain levels in the days following your procedure. It can be helpful to keep a pain diary to note when and if you feel any changes to your pain. It is normal to feel a dramatic drop in pain directly after your nerve block for knee pain, followed by a slight increase before pain levels stabilize.

Side effects

Although the risks of genicular nerve block are few, it’s important to note them. They can include the following:

• Drug allergy
• Heavy bleeding
• Increase in pain
• Nerve damage
• Tissue damage

These risks are very rare. Most of these risks can be prevented by using X-ray guidance to place the injections and practicing proper sterilizing of the injection site. Talk to your doctor if you have had an allergic reaction to anesthesia in the past.

Whenever a medical procedure punctures the skin, though, the risk for infection exists. Call your doctor if you experience any of the following symptoms, as they may be a sign of infection:

• Heat, redness, or excessive swelling in the knee
• Oozing or bleeding at the injection site
• Fever
• General feeling of being unwell

Length of pain relief

Pain relief is as individual as each patient who receives a genicular nerve block. In general, most patients experience some level of pain relief immediately after the block is administered. For some patients, pain is completely relieved for a few hours. Others experience total or partial relief for days, weeks, and even months.

It is difficult to predict how long a genicular nerve block will relieve pain. Talk to your doctor about what you can expect.

Integrated pain management treatments

A genicular nerve block works best when it’s part of a comprehensive treatment plan. Chances are good that your journey to pain relief won’t start with a nerve block. It’s important to explore integrated pain management treatments that include not only interventional procedures, but also lifestyle changes that include diet, exercise, and complementary therapies (like physical or biofeedback therapy).

As noted, with a successful genicular nerve block, you may also be a candidate for radiofrequency ablation. Genicular radiofrequency ablation offers the possibility of long-term pain relief that has few side effects and can be repeated as needed with no ill effects.

Study after study has found significant pain relief for as long as six months after a single radiofrequency ablation procedure. Limited risks are associated with this procedure as well, making it a good option for people who cannot have knee surgery.

Our pain specialists at Arizona Pain develop individualized pain management plans for every patients. A genicular nerve block for knee pain can be key to helping you get your life back. Schedule an appointment to talk with one of our pain doctors today!

Climbing stairs, walking down the street, hiking up a mountain, even standing up from a chair: all of these movements are made possible by your knees. When knees start to ache, it’s crucial to know how to help arthritis is knees. Here are the best tips to get started with.

How to help arthritis in knees: The basics

Your knees are the largest, strongest joint in the body. Knowing a bit about the anatomy can help to appreciate not only their strength but also their unique vulnerabilities.

Knee joints consist of three bones. The femur (thighbone) connects to the tibia and the patella (kneecap). Cartilage wraps around the end of each bone to protect and smooth movement where the three bones meet.

Two wedges of cartilage called the meniscus act as shock absorbers as the femur presses down into the tibia. Synovial fluid lubricates all of the cartilage in the joint and helps with smooth movement.

In addition, stabilizing ligaments and tendons include:

• Lateral and medial collateral ligaments: Stabilize side-to-side movement
• Posterior and anterior cruciate ligament: Frames movement forward and backwards

Knees absorb the impact of your upper body coming down on the lower leg: every day, all day. This means that everything you do—walking, running, hiking up a mountain, or simply standing up from a seat—relies on healthy knees.

When our knees are not healthy, the resulting knee pain can make it challenging to go about our normal daily activities or even get to sleep at night.

Causes of knee arthritis and pain

The most common cause of pain is knee osteoarthritis. Known as a wear-and-tear disease, osteoarthritis occurs as the knee joint gets used over time. The structures that once supported and eased movement (e.g., tendons, cartilage, and synovial fluid) may begin to wear out, causing knee pain with movement.

Other common causes of knee pain include the following:

• Injury: Injury such as torn ligaments and tendons, bone fractures, bursitis, and tendinitis can cause knee pain both at rest and during activity.
• Mechanical problems: Mechanical problems occur when something in the joint fails. This might include dislocated kneecap, iliotibial band syndrome, or a foreign body in the joint (e.g., a broken bit of bone or cartilage).
• Other forms of arthritis: There are over 100 forms of arthritis, many of which can cause knee arthritis pain. In addition to osteoarthritis, rheumatoid arthritis, gout, and septic arthritis can cause knee pain.

Finally, a less common cause of knee pain is patellofemoral pain syndrome. This pain between the patella and the femur is most often seen in young athletes but can develop as a consequence of arthritis in the kneecap.

Risk factors for knee pain

Anyone with knees can have knee pain, but there are some risk factors that increase your chances. Carrying extra weight is a primary risk factor, as is having a job that places lots of stress on the knees. Professional athletes and enthusiastic amateurs alike are all at risk of knee pain due to wear-and-tear and injury also.

Other risk factors include:

• Age
• Previous injury
• Lack of flexibility or strength in supporting muscles

How to help arthritis in knees

If you are experiencing severe knee arthritis that is impacting your quality of life, it’s important to talk to your doctor first. They can help diagnose any underlying causes and design a treatment plan to improve your daily life.

For mild to moderate pain, here are our tips for how to help arthritis in the knees. As always, talk with your doctor before starting a new treatment.

1. Just add ice

When knee pain flares up, one of the simplest things to do is to ice the inflammation. Yes, extended days of rest can actually increase stiffness and pain, but in the acute phases of knee pain, ice can really help.

Try a 20-minutes-on, 20-minutes-off program of icing for a few hours to see if that relieves pain.

2. Watch your diet

While changes to the diet alone are not enough to completely ease knee arthritis pain, it is a great (and easy) place to start. Not only does maintaining a healthy diet improve overall levels of health and energy, the food you eat can also help treat pain and inflammation.

How? Focusing on anti-inflammatory foods means choosing healthy whole grains, dark leafy greens, and lean proteins as the foundation of your diet. Add in foods and spices with natural anti-inflammatory properties. These foods like include turmeric, tart cherries, avocado, and even dark chocolate.

Finding a great anti-inflammatory cookbook can make eating to ease knee pain a snap.

Avoiding processed food, trans fats, and sugars can also help manage weight, improve health, and ease inflammation in the body.

3. Keep an eye on your BMI

If you are carrying extra weight, know this: every pound above the BMI recommended for your frame adds another two to four pounds of pressure on your knee joint.

Suddenly, being just ten pounds over your target body-mass index can mean an additional forty pounds of pressure with every step!

4. Quit smoking

By now, everyone knows that smoking is dangerous to overall health, but it also increases the risk of knee pain. Smoking increases the chances of cartilage loss, which then increases the chances of developing osteoarthritis knee pain. Smokers are also more likely to be obese and have comorbid health conditions that contribute to poor health outcomes and high mortality rate.

Quitting smoking is arguably the best thing you can do for yourself.

5. Start walking

Even when your joints feel their most stiff and sore, a little movement can go a long way. Walking for knee pain helps you maintain a healthy BMI, builds muscles in the lower body, and provides good overall exercise.

If you have knee pain, choose good shoes for support. Take walks on level, sturdy terrain that is not too hard (or too soft, like sand). Start a walking program slowly, adding either time or increasing the pace as you feel stronger.

Walking with a friend can help keep you motivated, as can incorporating extra walking in your daily life. Park the car farther from the entrance to buildings, walk to pick up a few items at the store, or add another walk to your dog’s schedule. They’ll thank you for it, and so will your knees!

6. Consider meditative exercise

Meditative exercise like yoga or t’ai chi can both help ease knee pain. Why? Focusing on proper alignment, balanced muscular engagement, and conscious breathing have the following research-based benefits:

• Yoga increases the volume of grey matter in the brain, which builds resilience in chronic pain patients
• Yoga triggers a relaxation response, helping to moderate the emotional impact of pain
• Finally, yoga reduces inflammation in the body
• T’ai chi builds muscle strength, improves balance, and increases flexibility

Both yoga and t’ai chi can be adapted for any skill or fitness level, and neither require special equipment. Read more about incorporating yoga for arthritis into your routine here.

7. Keep movement low impact (and full-body)

Maybe yoga or t’ai chi are not for you, but it’s important to move your body. Any full-body, low-impact exercise can help ease knee pain. Try swimming, or look online for low-impact workouts that get you moving, regardless of where you start.

8. Use a brace

Knee braces bring stability to knees in pain, especially during exercise. Your doctor or physical therapist can suggest the best knee brace for you.

9. Get a gait analysis

Sometimes knee pain is a matter of an improper or imbalanced way of moving. A gait analysis looks at the way you move your body and suggests corrections in alignment (or even footwear) to help.

Talk to your doctor, a physical therapist, or even a high-quality running store for help with this.

10. Visit a physical therapist

Physical therapists work with your doctor to design specific exercises for knee rehabilitation. Many of these will focus on lengthening and strengthening the supporting muscles of the upper and lower legs, such as quadriceps, hamstrings, and calves.

Even one visit to learn the proper form for knee arthritis exercises can help support your recovery.

11. Consider medications

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium provide arthritis pain relief for mild to moderate pain. It’s important to follow the dosage directions carefully, as too much can cause gastrointestinal upset or liver damage. In conjunction with other therapies and exercise, though, NSAIDs can help you move comfortably through your day, even with knee arthritis.

Further, if your knee pain is a result of septic arthritis, your doctor will likely prescribe antibiotics to get the infection under control. An infected joint will not allow much movement and can cause serious damage. Antibiotics treat the infection to ease swelling and pain.

12. Explore supplements and natural remedies

Supplements for knee osteoarthritis may increase production of synovial fluid in the knee joint. This helps smooth out rough movement that could be causing knee pain. Talk to your doctor before adding these into your regimen.

Natural remedies for knee pain can also be remarkably effective. These include things like transdermal magnesium, acupuncture, and mindfulness meditation.

13. Try TENS

TENS, or transcutaneous electrical nerve stimulation, uses electrodes placed on the skin to deliver a mild electrical current to the nerves. This current replaces the pain signals sent to your brain with a tingling sensation.

TENS is a non-invasive treatment for knee pain that is controlled by the patient (and a good therapy to try before exploring more invasive options).

14. Talk to your doctor about knee joint injections

Knee joint injections should only be explored when more conservative treatments for knee pain have proven ineffective. Before the procedure, your doctor will inject a numbing agent to reduce pain, followed by a corticosteroid to decrease inflammation. They may also discuss options like PRP injections.

While injections may work to decrease pain, knee joint injections do not treat any underlying knee pain causes or halt progressive joint deterioration. Still, when combined with a healthy diet, regular exercise, physical therapy, and other lifestyle changes, they can provide profound relief. Learn more about this option in the following video.

15. Consider surgery

When all other treatment options have failed, knee replacement surgery may be helpful.

It’s important to note that some people still experience pain after knee replacement. Talk to your doctor to assess the potential risks of this option. It should only be used after other less invasive measures have failed and as a last resort.

16. Find a new location

Our final recommendation may not be possible for some people with knee arthritis, but sometimes a change of scenery (and weather) helps ease chronic pain.

Some of the best places to live with knee arthritis include those with steady, temperate weather and low humidity. If you’ve already been considering a move, think about finding a location that could help ease your pain.

How to help arthritis in knees? Find a trusted pain doctor

Finally, the best way find relief is to work with a pain doctor you trust. If you’re in Arizona, we can help. The Arizona Pain team knows how to help arthritis in knees, designing comprehensive, individualized treatment plans to help you get your life back.

Get in touch to schedule an appointment today.

When you finally lay yourself down to sleep after a busy day, the last thing you want to experience is pain that keeps you awake. When knee pain at night sends you tossing and turning, though, there are ways to care for yourself during the day (and right before bedtime) to make it better. Here’s your guide to managing and preventing knee pain at night.

What causes knee pain at night?

Our knees are complex joints responsible for bearing the weight of our bodies as it travels to our feet. They literally help us move through the world smoothly, connecting four bones—the femur, the tibia, the fibula, and the patella—and two major muscles groups (the quadriceps in front and the hamstrings in the back).

Connecting and stabilizing these bones and muscles are ligaments and tendons, including:

• The anterior cruciate ligament (ACL): Located on the front of the knee, the ACL prevents the femur from moving backwards onto the tibia
• The posterior cruciate ligament (PCL): The PCL keeps the femur nestled back where it belongs
• Medial ligaments: Stabilize the inside of the knee
• Lateral ligaments: Stabilizs the outside of the knee

In addition to this, articular cartilage lines the patella to smooth movement, as does the meniscus (lateral and medial) tissue that allows the femur and tibia to glide together. Bursa are fluid-filled sacs inside the joint. They further cushion movement, preventing painful bone against bone rubbing.

Any part of this structure can develop painful conditions or suffer from issues that could cause knee pain at night. In general, the five main causes of knee pain at night are:

1. Knee replacement pain at night
2. Arthritis
3. Gout
4. Injury
5. Overuse

Knee replacement pain at night

Knee replacement surgery is often the treatment of last resort when other conservative measures have failed to address painful damage to the knee. A total knee replacement removes the kneecap and removes or repairs damaged bone and other surfaces before inserting an artificial replacement. Partial knee replacement surgery is less invasive and preserves the parts of the joint that are healthy.

The level of your knee replacement pain at night depends on which type of knee replacement surgery you get. The recovery time for total knee replacement can be from one to three months. Partial knee replacement offers a faster recovery time of a week or two. Regardless, during recovery, knee replacement pain at night can be extreme and make daytime activities even more challenging.

Arthritis

The most common form of arthritis, osteoarthritis, is also the most common cause of knee pain at night.

Osteoarthritis is a wear-and-tear condition that affects the joints of the body. As we age, cartilage begins to thin and bursa provides less cushion in the joint. If we exercise less and lose supportive muscles in the quadriceps, hamstrings, and calves, the knee joint begins to press more firmly together, rubbing bone on bone as we move.

This rubbing causes inflammation in the joint. It can also cause pain two ways: when we move and when we are still.

Gout

When uric acid builds up in the blood, it is deposited as uric acid crystals in the joints. This can cause painful swelling. Gout most often occurs in the toes but can affect the knees, too. Swelling and uncomfortable warmth from gout can cause knee pain at night.

There is another condition called pseudogout that is less common but found in the knee more often than any other joint. A different type of crystal (calcium pyrophosphate) lodges in the joint, causes similar symptoms to gout (i.e., redness, swelling, warmth, and pain).

Injury

Injury to any part of the knee, even what you might consider minor, can cause knee pain at night.

This may not be chronic pain but can cause disrupted sleep, nonetheless.

Overuse

Whether you are a seasoned athlete or a weekend warrior, overuse of the knees can lead to knee pain at night. This includes going for a long bike ride after some time off, playing pick-up basketball games on Saturday mornings, a leisurely hike through the woods, or anything that taxes your knees.

Even if your knees feel good after the activity, you may experience pain when you lay down to rest. You are not as distracted by the demands of your day, which gives pain a chance to present itself.

What does knee pain feel like?

Knee pain can take many different forms. You might experience burning knee pain at night as an uncomfortable, steady warmth in the joint. You may also have throbbing knee pain at night, no matter what position you lie in.

Some people have pain that is sharp when they switch positions after being still. Other forms are not pain at all but can consist of tenderness or swelling inside the joint.

When should I see a doctor for knee pain at night?

In the days after knee replacement surgery or another type of injury, it is normal to expect a little pain at night. A few nights of lost sleep are not anything to worry about.

However, there are times when you should see a doctor for knee pain at night. Schedule a regular appointment if you experience the following symptoms:

• Unusual or significant swelling
• Excessive redness (redness that does not go away after the injury)
• Fever
• Increased or excessive pain
• Warmth in the joint
• Tenderness to the touch

There are also symptoms that warrant emergency treatment for knee pain. These include:

• Deformed appearance of the joint
• Pain that makes weight-bearing impossible
• Injury that causes your knee to make a popping sound
• Swelling that occurs suddenly

If your knee pain at night consistently interferes with sleep it could make pain during the day worse, too. When it comes to knee replacement surgery, poor sleep can also slow healing times. If pain is steady for three or four days, or intermittent for a week or two, best to schedule a follow-up with your doctor.

How to relieve knee pain at night

Relieving knee pain at night may be simply a matter of practicing a few comfort measures before you settle in for some shut-eye. Other nights, you might need something else.

Here are ten options for knee pain treatments that can help you get some rest.

1. Check your mattress

Is your mattress firm enough to provide the support you (and your knees) need? Sometimes a sagging or too-soft mattress is not a great choice.

As a general rule, replace your mattress every eight to ten years. For knee pain at night, foam mattresses can provide great support, as can a mattress that has independently wrapped coils. Ask your doctor for recommendations, then go give them a try.

Look for mattress companies that offer a money-back guarantee or free exchange, too.

2. Use pillows

Place pillows between your knees for extra support. This relieves pressure on the IT band and also prevents bones from pressing into each other during the night.

3. Establish a nightly routine

Sometimes dreading a poor night of sleep is a self-fulfilling prophecy.

Establish a nightly routine that includes gentle stretches and relaxing routines (e.g., a good book and a hot cup of tea) to set yourself up for sleepy success.

4. Stretch before bed

Knee pain stretches may be as simple as working out tight muscles in your quadriceps, forward folds to release hamstrings, or calf stretches to lengthen and strengthen those muscles, too. Keep your exercises low-key and relaxed. Consider the following:

• Restorative yoga before bed: A quick 20-minute routine can prepare you for bed and keep all of your joints healthy (see the video below)
• Stretches for knee pain: These knee pain stretches work the muscles in the lower leg to relieve tightness that applies pressure to the knee joint
• Strengthening for knee pain: Again, these exercises target the muscles surrounding the knee to provide better support in the joint

As always, check with your doctor before starting any exercise program. If you experience an increase in pain, stop and check in with your doctor again.

5. Time medications

If you are regularly taking medications for chronic knee pain or are on prescribed medicine after surgery, time your medications so that they relieve pain overnight.

6. Use hot or cold packs (or both!)

Hot and cold packs can help alleviate pain and swelling. It may be challenging to sleep with a chilly cold pack on your knee, though.

Alternate this treatment so that you can go to bed with warmth.

7. Treat the underlying condition

If your knee pain is caused by an underlying condition like gout, it’s crucial to get a proper diagnosis and begin treatment. If the condition is unresolved, then further damage can occur.

8. Try TENS

TENS, or transcutaneous electrical nerve stimulation, replaces pain signals with a mild electrical buzzing. Patches are placed on the skin and connected to a patient-controlled device that is about the size of a cellphone. When deployed, a mild electrical current confuses pain signals being sent to the brain.

Some people may find the buzzing sensation distracting, but others are able to get used to it quickly and drift off to sleep. This non-invasive solution is a good conservative treatment option.

9. Consider knee joint injections

There are several types of knee joint injections that can provide long-term relief from knee pain when more conservative measures have failed. Corticosteroid injections can provide relief from pain and swelling. Hyaluronic injections rejuvenate the cushioning and lubrication in the knee.

Knee joint injections are generally recognized as safe, but there are risks and side effects. It’s important to talk to your doctor about all of your options.

10. Look into nerve blocks

A nerve block is a specific type of knee joint injection that prevents nerves from delivering pain signals to the brain.

After a knee replacement, the most common kind of nerve block for knee pain is a saphenous nerve block. For patients who cannot have knee replacement surgery or who are experiencing chronic knee pain at night from other causes, genicular nerve blocks are another option.

Schedule your appointment

At Arizona Pain, we know how challenging it is to be up all night in pain. If you’re in Arizona and knee pain at night is disrupting your sleep and impacting your life, get in touch today. We can help you get back to your life and reduce your nighttime aches.

Running with arthritis in the knee has long been a controversial subject. Traditionally, some people believed that running was so stressful on the knees that it could actually lead to arthritis in the first place. Fortunately, this idea has little to no merit; runners are generally no more susceptible to knee arthritis than anyone else. However, if you have just been diagnosed with knee arthritis, you probably have a lot of questions about what activities, including running, you can still safely perform. This article will discuss what you should know about running with knee arthritis, as well as what you can do to protect your knees while running.

Can I run with knee arthritis?

Arthritis is characterized by inflammation and pain, and it can affect virtually every joint. There are over 100 different kinds of arthritis. Osteoarthritis and rheumatoid arthritis are among the most common. Risk factors for arthritis include:

• Heredity
• Advanced age
• Obesity
• Smoking
• Joint stress or overuse (e.g. your job requires long-term, repetitive movements)

A knee arthritis diagnosis is tough for anyone, but if you previously enjoyed an active lifestyle that depended on having healthy knees, it can be especially devastating. Knee pain may tempt you to forget about doing any exercise at all, but a sedentary lifestyle will do you more harm than good.

The truth is, exercise can help arthritic joints feel better.

Running (safely) in particular may reduce your chances of needing surgery down the line. Better still, running is one of the cheapest forms of exercise out there; all you need is yourself, a good pair of running shoes, and someplace to run.

For most people, running with knee arthritis is safe. However, use common sense, talk to your doctor first, and pay attention to your body. If running worsens your pain, stop and take a break before you try again. Work with your doctor to create an exercise regimen that works for you.

Know too that any type of activity is great. It doesn’t need to be running. Walking briskly or swimming may be a better option for your body.

Does running make arthritis worse?

Even though the myth that running causes knee arthritis was debunked, other worries remain. For example, if you already have knee arthritis, will running make it worse?

The answer is complicated and likely depends on the patient and severity of the arthritis.

Some doctors say yes. They warn that running is bad for arthritis in the lower body, including the knees. This is especially true for people who have had knee surgery, and for people whose knees have already been damaged by arthritis. Running may increase arthritis pain and cause your knees to deteriorate faster.

However, a recent study found that running neither damages arthritic knees nor worsens arthritis pain. This is great news for runners, but the study does have flaws. For example, it neglected to record how and how much the participants ran.

More research needs to be done to truly determine what impact, if any, different running styles and speeds have on knee arthritis. But the newer study’s results suggest that a blanket ban on running with knee arthritis is not the best solution to preventing arthritis pain.

If you do have mild knee arthritis and genuinely want to run, talk to your doctor. If you have their permission, you may be able to continue running safely. You can also talk to them about other exercise options.

How to safely run with knee pain from arthritis

While exercise can improve any number of medical conditions, including arthritis, it’s important to exercise smartly and carefully. Before beginning any new running program, talk to your doctor, and then follow these general guidelines.

Consider your running routine

If you want to continue to run with knee arthritis, you can change your exercise routine to accommodate your condition. Alternatively, if you’ve never run before, begin slowly. Set an overall goal for yourself and then set small, attainable goals that you can achieve along the way as you gradually build your strength and endurance.

That said, if you have been running for a while and find that you truly don’t like it, don’t push it! Try different exercises until you find one that works for you. Exercise is an essential component of a healthy life, but forcing yourself to do an exercise you hate is setting yourself up for failure.

Even if you love to run, don’t let running be the only exercise you do.

Alternate running sessions with low-impact exercises, like swimming and weight-lifting. This will give you a well-rounded workout and strengthen your whole body. It will also give your knees a break from the motions and pressures of running.

When you do run, make sure you are doing so safely and properly. Proper running technique requires training your whole body to move in sync. With respect to your knees, always keep them aligned with your feet, and lift your knees high enough that you don’t shuffle as you run. If you find yourself getting so tired that you can’t maintain a proper running technique, it’s time to slow down.

You will also have to decide whether you want to run outside or on a treadmill. Running on a treadmill is easier on your joints, but running along a sand or dirt path is generally softer than a sidewalk. Try options near you to see which one works best for you.

Finally, if you’re having trouble motivating yourself to run, find a friend or group of friends to run with you. A 2017 study published in Nature Communications found that “exercise is socially contagious.” In other words, running with friends makes you more likely to stick to your exercise routine and push yourself harder than you would if you exercised alone.

No matter what, be kind to yourself.

It’s always hard to start a new exercise routine, especially when you’re already in pain. Your progress may not be a straight line. Some days, you may be able to run a mile with ease, while other days you may struggle to get around the block. This is normal, and you shouldn’t be discouraged by setbacks.

Do what you can when you can, and remember the goals that you are working towards: reducing your arthritis pain and living a healthier life.

Find proper equipment

In addition to proper running form, invest in high-quality running gear to ensure your knees get the support they need. Quality running shoes are perhaps the most important investment you can make. Shoes that are worn, don’t fit properly, or aren’t designed for running can damage your body, whether or not you have arthritis.

What is a “quality” running shoe? That can be tricky to determine.

The first step is to find a shoe that is the right size and fits comfortably. It may be tempting to stay home and buy your running shoes off the internet with the simple click of a button. With an investment as important as running shoes, though, it’s better to go to a store where you can try on different shoes and ask a sales rep for help. Many shoe stores can guide you through the decision-making process, depending on your running form and needs.

In addition to shoes, you can try using compression pants to support your knees while you run. You may also find knee braces helpful. Different types of knee braces can alleviate arthritis pain for a short amount of time. The primary purpose of compression pants and braces is to hold the knee in place as you run. This compensates for any damage or deterioration caused by the arthritis, allowing you to more comfortably enjoy physical activities.

How to treat arthritis knee pain

Exercise is a vital part of staying strong and healthy, whether you have arthritis or not. But there are other ways you can treat arthritis knee pain.

The arthritis treatments listed here can help you to improve not only your running experience, but your overall sense of wellbeing. Remember to talk with your doctor before trying a new treatment. Not all treatment options are safe and effective for all people.

Stretches

Stretching is a simple form of exercise that you can perform before or after more strenuous activity, or whenever you feel the need to move.

You can start with these simple stretches for knee arthritis pain. As with other forms of exercise, stop if you feel pain or your pain worsens.

Medication

Over-the-counter painkillers like Advil and Tylenol can help on your worst days.

Some people also rely on glucosamine supplements, a compound found in both cartilage and shellfish shells, to ease their arthritis aches. Glucosamine is generally safe, but as with other medications, make sure there aren’t any contraindications. In other words, that it won’t interact negatively with other medicines you take.

Heat and cold therapy

Heat/cold therapy is a simple but effective way to reduce arthritis pain. Cold therapy is especially effective immediately after exercise. You can buy ice packs or you can make your own packs by wrapping ice or frozen vegetables in a towel.

Heat therapy can range from heat packs to baths. Always use caution with both heat and cold therapy. Improper use can lead to burns or other injuries.

Physical therapy

If you want professional guidance in dealing with your knee arthritis pain, physical therapy is a great option.

A trained physical therapist will examine your knees and outline a treatment plan for you. This plan will likely include a combination of treatments, including exercise, stretches, and lifestyle changes.

Injections and surgery

In severe or advanced arthritis cases, some people turn to knee joint injections to provide relief. Depending on the type and severity of your arthritis, the type of medicine injected and the frequency of the injections will vary. Cortisone injections are just one of several treatments your doctor may recommend. Injections can provide relief for some patients, but they do have potential side effects. You should consider injections after trying less invasive options. They’re also best done in concert with other therapies, like physical therapy.

Another interventional measure is surgery, such as total or partial knee replacement. As with injections, you should only consider this treatment if other, more conservative treatments have failed. Post-surgery rehabilitation often takes weeks or months. During this time, you will work with your doctor and a physical therapist to strengthen your knee with careful exercises and a gradual return to your normal routine.

Learn more

It will take time to figure out what your new normal is after an arthritis diagnosis. We can help.

If you live in Arizona and need more help managing your knee pain from arthritis, click below to get in touch with one of our pain specialists.

After a long bike ride, it’s common to feel a good type of sore. It’s what most bikers love about the sport. But, what happens if the soreness seems to linger on? How do you know if the aches are something more serious? Sharp knee pain after biking is usually a bad sign, as well as pain that doesn’t go away over time. With that in mind, it’s best to pay attention to these symptoms as they could indicate a bigger problem.

The good news, though, is there are ways to find relief. Whether you suffer from knee pain due to a biking injury or gradual wear-and-tear, a qualified pain specialist like the ones at Arizona Pain can help. This article will cover everything you should know about knee pain from cycling.

What causes knee pain after biking? 

Biking is actually a great method of low-impact exercise for runners who have hurt themselves pounding the pavement. So, how does it end up being the cause of knee pain for some people?

It’s not uncommon for cyclists to struggle with sore knees from time to time. However, if you are wincing after every pedal stroke, it’s time to get to the root of the cause.

In some cases, this can simply be the result of overuse. In others, knee pain after biking can be due to structural abnormalities or damage to your joints and tendons. Here are some of the most common causes of knee pain after biking.

1. Overuse

You’ll hear it often, but it’s worth repeating: Don’t overdo it!

Many athletic injuries are a result of repeatedly overdoing it. You love your time on that bike, but pushing yourself too hard or riding for too long without a scaled exercise program isn’t going to do you any favors. It will only lead to injuries that set you back.

Take it one day at a time. Always warm up before you ride and slowly condition your body to attempt longer, more strenuous rides.

2. Patellofemoral pain syndrome (PFPS)

Often called “runner’s knee,” patellofemoral pain syndrome is the term doctors use to describe pain in the front of the knee or kneecap.

Symptoms include dull, aching pain that is typically related to a specific activity, in this case, biking. Many patients also experience a popping or crackling sound when standing up or climbing stairs.

In most cases, repeated stress on the knee due to biking will only further the pain. Many people find relief from making simple changes to their activity level.

3. Tendinitis and tendinosis

Tendinitis is commonly found in the knee due to overuse and strenuous athletic activity. It occurs when repeated stress causes tiny tears in the tendon connecting your kneecap to your shinbone. As more tears continue to occur, it causes pain and inflammation. This common overuse injury may worsen without medical attention.

While many people confuse the two, tendinosis is a separate condition, but may also be seen in avid bikers. Tendinosis shares many of the same symptoms as tendinitis. However, it is persistent or recurring in nature due to repetitive trauma to the knee. It can also be the result of an injury that never fully heals.

One major difference to know is that tendinosis does not involve inflammation. This is the best way to determine which condition you’re suffering from.

4. Chondromalacia patella

This type of knee pain occurs due to the breakdown of cartilage on the underside of the kneecap. As a result, the knee and thigh bone may begin to rub together.

People who suffer from this condition report a “grinding” feeling when they flex their knee. Dull, aching pain will also be present behind, below, and on the sides of the kneecap.

How to prevent knee pain after biking

The best way to prevent knee pain that keeps you off your bike is to treat it before it becomes chronic. Over time, lack of care and overuse can lead to more damage that causes unrelenting pain.

First, take a break from cycling and check out your bicycle setup. The height of your seat is essential to the health of your knees. Most cases of knee pain are because of a poor-fitting bike with a seat that is either too high or too low. Go into a bicycle store and ask for a professional fit. Your bike specialist should also take several personal factors into account, including your fitness level, riding style, and typical biking routine.

Take this opportunity to reevaluate the intensity of your rides as well. Perhaps you are riding too frequently or for too many miles during each session. Maybe it is as simple as changing your route to avoid steep hills that require forceful pedaling. Be honest with yourself about whether you’re overdoing it.

7 treatment options for knee pain after biking

A well-trained pain specialist relies on a comprehensive, natural approach to treating pain. That means trying non-invasive or minimally-invasive treatments that target the source of your pain before turning to surgical interventions. Find a doctor who looks at the big picture. You want to work with someone who will take the time to explore a range of options before turning to more serious forms of treatment.

Some of the common methods of treatment (ranging from non-invasive to minimally invasive) include:

• Physical therapy
• Active release techniques (ART)
• Chiropractic care
• Knee joint injections
• Spinal cord stimulation
• Genicular nerve block

Again, your doctor should work through several non-invasive options first, only approaching invasive methods of treatment when absolutely necessary. Here’s what you should know about each approach.

1. Physical therapy

In nearly every case of knee pain after biking, a doctor will first recommend physical therapy. This is one of the best ways to rehabilitate your knee and repair the damage that comes with overuse, as well as simple wear-and-tear.

By stretching and strengthening all of the muscles around your knee, you will be able to repair some of the damage. More importantly, you’ll be able to prevent further injury if you continue a rigorous biking routine.

A reputable physical therapist can develop a routine tailored to your symptoms, but you’ll also need to stretch at home. It’s important to stick to your routine on a daily basis to ensure long-term healing and prevention.

2. Active release techniques (ART)

Active release techniques (ART) are patented movement-based soft tissue massage techniques. Experts who are certified in this technique will use their hands to assess the tightness of your affected muscles, ligaments, and tendons. From there, they apply deep pressure while you carry out precise movements that cause the muscles to shorten and lengthen.

This approach to repairing soft tissue damage has a success rate of over 90% and no significant adverse effects. Due to the increasing popularity of this technique, more than 14,000 people are certified to perform ART. Those certified may include physicians, chiropractors, massage and physical therapists, athletic training staff, and other health care disciplines familiar with the evaluation and treatment of soft tissue injuries.

3. Chiropractic care

Chiropractic care is a great way to treat a range of joint issues, including knee pain after biking. Through joint manipulation and massage, your chiropractor will work to improve the alignment of your joints.

Chiropractors firmly believe in spinal manipulation to solve a host of problems throughout the entire body. With this in mind, most chiropractic professionals will also want to work on this area to ensure proper alignment from head to toe.

Much like physical therapy, you will need to do some homework in order to achieve long-term pain relief. Your chiropractor will probably give you specific stretches to complete every day in the comfort of your own home.

4. Knee joint injections

There are two common types of knee joint injections, corticosteroid and hyaluronic acid. Both serve as another minimally-invasive option for reducing pain and inflammation. Corticosteroid injections are placed directly into the affected knee joint in order to reduce the degree of inflammation in the area. In hyaluronic acid injections, the naturally occurring substance provides lubrication and functions as a shock-absorbing cushion. Because hyaluronic acid is already present in our joints, some cases of knee pain are believed to be the result of this substance breaking down.

With both types of injections, you can expect to see a significant reduction in knee pain within 24 to 48 hours. Most patients will experience pain relief for up to three months after the procedure. Some studies have suggested that patients can receive two or three repeat treatments a year due to the low-risk nature of the procedure.

5. Spinal cord stimulation

For patients who suffer from unrelenting chronic pain that doesn’t respond to more conservative treatments, neuromodulation can be a helpful option.

Neuromodulation, in the form of spinal cord stimulation (SCS) or TENS units therapy, sends tiny electrical signals to block the transmission of pain signals from the damaged nerve to your brain. This can be done through an implanted SCS device or a TENS unit worn outside the body. A unit like this sends pain-blocking signals to the spinal cord as needed.

Spinal cord stimulation is considered reversible, safe, and effective. Surgical intervention is necessary to put the spinal cord stimulator in place. However, it is considered minimally-invasive and can usually be completed on an outpatient basis.

6. Genicular nerve block

A genicular nerve block uses anesthetic injected into one or more of the genicular nerves. This anesthetic interrupts pain signals sent to the brain and can bring you tremendous relief from pain.

The catch? A genicular nerve block’s effects only last anywhere from eight to 24 hours. For this reason, doctors primarily use it as a diagnostic tool. By blocking pain signals from one area, your doctor can determine what the cause of your pain might be. This is one way to provide a more targeted and effective pain treatment plan.

Due to the short-lived effects, a genicular nerve block is often paired with radiofrequency ablation. This type of therapy uses radio waves to create an electrical current through the body. This current delivers heat to targeted nerve tissues in a way that impairs or destroys the nerves. Together, these two procedures can offer pain relief that lasts from six months to a year.

Get back to the hobby you love

If you suffer from knee pain after biking, there are many options for finding relief. The therapies and procedures listed here are just the beginning of approaches your pain specialist may use. The right pain doctor won’t rest until they find a way to treat your specific case. Soreness is okay, but persistent pain is never normal, especially if it interrupts daily activities.

Take the first step today. If you’re in Arizona, reach out to our team at Arizona Pain for help getting back to your life.

Knee pain affects one-third of people in the U.S. every year. It’s the second most common cause of chronic pain! Unfortunately, it makes sense. This weight-bearing joint is crucial to helping us move about our daily lives. Whether you are looking to explore long-distance hiking or just run a few errands pain-free, here’s how seeing a chiropractor for knee pain can help.

How does chiropractic care for knee pain work?

Chiropractic care may have a reputation for cracking backs and popping necks and shoulders, but it goes well beyond that stereotype. Yes, the focus of chiropractic care is on alignment, but it’s specifically interested in both alignment and function. Chiropractic techniques for knee pain focus on the health of the joint itself, ensuring proper function.

This is important because your knee is a complex joint.

The knee joins four bones: the femur, the tibia, the fibula, and the patella. Supporting those bones are the quadriceps in the front of the knee and the hamstrings in the back. Ligaments and cartilage form an intricate network of connections that help stabilize the knee. These include the:

• Anterior cruciate ligament (ACL): Prevents the femur from moving backwards onto the tibia
• Posterior cruciate ligament (PCL): Prevents the femur from sliding forwards
• Medial and lateral collateral ligaments: Provides support inside and outside of the knee

The meniscus (lateral and medial) is tissue that provides ease of movement between the femur and the tibia. Another type of cartilage provides the same function behind the patella. Cushioning all of this are bursae, fluid-filled sacs that help with comfortable movement.

Chiropractors have over 150 techniques they can use to bring your joints back into alignment. Seeing a chiropractor for knee pain can address many of the issues we’ll discuss below.

More than that, chiropractors are looking at whole-body wellness. The knee may be where you feel pain, but that pain may just be a symptom of another issue in your body. The goal of chiropractic for knee pain is to not only help with the pain but to also heal the entire body.

What types of knee pain could benefit from chiropractic care?

Due to this complexity and the role they play in movement, our knees are vulnerable to injury and deterioration due to many wear-and-tear conditions. Some common causes of knee pain include:

• Dislocated kneecap
• Knee bursitis
• Osteoarthritis
• Patellofemoral pain syndrome (runner’s knee)
• IT band syndrome
• Gout
• Loose or injured tissue or bone
• Tendinitis and tendinosis
• Torn meniscus
• Torn ACL
• Rheumatoid arthritis
• Overuse (as occurs during long hikes or bike rides)

There are several types of knee pain that respond well to chiropractic care—and a few that don’t. Let’s look at these in more detail.

Osteoarthritis

Osteoarthritis is a wear-and-tear condition that affects the ligaments, tendons, and cartilage of the knee. Over time, these structures begin to wear out, causing painful bone-on-bone contact. This wear can be increased by poor gait or inadequate footwear. If you are experiencing this type of knee pain, chiropractic care can help to stabilize and align the joint while increasing your range of motion for more comfort.

Research has shown that manual knee therapy helped significantly decrease knee pain while improving mobility.

Runner’s knee

You don’t need to be a runner to suffer from runner’s knee! This condition (also called patellofemoral pain syndrome) occurs when the bones in the knee aren’t lining up properly. This causes pain in the kneecap and a popping or clicking sound when you move.

Misalignment anywhere from the hips to the ankles can cause the knees to be misaligned, so it can be a good type of pain to treat with chiropractic care.

Tears to ligaments and tissues

Since chiropractic care for knee pain does not just focus on the pain symptom alone, tears to ligaments and tissues in the knee often benefit from it.

While research on specific types of tears and strains is limited, many chiropractic patients report they are able to avoid more invasive surgery to treat these conditions or refer patients to the appropriate specialist.

Referred pain

In some cases, knee pain does not actually originate in your knee. Pain that is caused elsewhere in the body is called “referred pain.”

The most common type of referred pain is either caused by compression of the sciatic nerve in your lower back or by injury or damage in the sacroiliac joint. Even injuries to the cervical spine can cause pain in the knees.

Chiropractic care for knee pain that is referred can help resolve not only that pain but also pain elsewhere in the body.

What conditions should not be treated with chiropractic care?

It’s important to note that chiropractic care for knee pain is not recommended when your pain is inflammatory in nature.

For example, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and an active flare-up of knee inflammation should not be treated with chiropractic techniques. Talk to your chiropractor about the best specialist in these cases.

What does a chiropractor for knee pain do?

Chiropractors are interested in locating where the structure of the body is off and causing pain in its function.

Below are some of the basic services they provide in their office, plus an overview of chiropractic exercises for knee pain that you can do at home.

Chiropractic techniques for knee pain

As chiropractors look at the whole body, some of the chiropractic techniques for knee pain may start far away from the knee.

They may start with the spine, making sure you are aligned using different types of chiropractic adjustments. The most common type, direct thrust, is also the most well-known. This technique is what gives chiropractic its “back-cracking” reputation. While this technique is not appropriate for knees, it can be a good place to start for referred pain conditions.

Instead, more specific chiropractic joint adjustments include:

• Articulatory: A slow movement through the joint’s range of motion
• Myofascial release: Pressure applied to stiff areas and then released to help free up tightness
• Functional technique: When the joint reaches the end of its range of motion, gentle pressure is applied until it releases

Your treatment will be customized to your specific type of pain and what your chiropractor finds during your initial consultation.

Chiropractic exercises for knee pain

Chiropractic exercises for knee pain focus on strengthening the muscles above and below the knee while working to increase range of motion.

They might include:

• Full or half squats
• Calf raises
• Seated quadriceps lift, with or without weight
• Heel and calf stretches
• Side leg raises (with or without a resistance band)

Your pain and underlying condition are as unique as you are. Always work with your doctor or chiropractor before attempting any of these exercises. They’ll help determine which will best support your healing.

Beyond chiropractic

Chiropractic techniques for knee pain go beyond the adjustments and treatments described above.

Many chiropractors will also work with you to design a comprehensive treatment plan that includes nutritional guidance and supplementation that supports total body wellness. They can also refer you to other specialists for care.

What can I expect during my chiropractor appointment?

Your first session with your chiropractor will most likely be your longest. During this visit, your chiropractor will take a detailed medical history. This will include not only your current pain condition but also any previous injuries or health issues.

After giving your medical history, it’s time for your chiropractic exam. Your doctor will move your knee through its range of motion, checking for muscle strength, tone, and response. They will consult any imaging or other test results as well. You may also have other testing, such as a posture or gait analysis, before treatment begins.

The medical history, chiropractic exam, and additional evaluations are all used to design your treatment plan. This treatment plan details which adjustments you will receive, how often, and what other complementary treatments your chiropractor recommends.

You will then receive treatment. Most treatments will be conducted fully clothed. Wear loose pants to allow access to the knee. Your first visit may be an hour or more, but each subsequent treatment will be much shorter.

How many treatments will I have?

Depending on the condition, you may visit the chiropractor between one to three times a week in the acute phase, gradually tapering off as your body begins to realign and symptoms improve.

Many patients begin to see positive effects of chiropractic for knee pain after one to four weeks of treatment.

Recovery time

The recovery time after treatment is usually minimal. The majority of patients continue about their day with no stopping.

If you are new to chiropractic care, it makes sense to take it easy after treatment. Swap the intense workout for a more modest pace, and make sure to stay hydrated and eat healthy food to support overall wellness.

Side effects

There are very few side effects or risks of chiropractic care for knee pain. General soreness is most common.

Exceedingly rare but serious side effects can include worsening symptoms and a specific type of stroke (associated with cervical neck adjustments). Patients at risk of stroke, those with cancer of the spine, and anyone experiencing numbness, tingling, or reduced arm and length strength should not receive chiropractic care for knee pain.

Will it hurt?

Most chiropractic adjustments are completely pain-free. Some patients may feel tense, though, or may tense up during treatment. This may cause some discomfort in the beginning.

Your chiropractor can help you to relax with breathing techniques. It also helps if you understand what will be happening before it happens. For some, the unknown is what causes tension. Education can help! Ask your chiropractor any questions you have.

Other knee pain treatments

There are a variety of other knee pain treatments that can be helpful. Many of these are offered in conjunction with chiropractic care.

• Ice: One of the lowest-tech treatments, this standby helps with inflammation and pain
• Physical therapy: Physical therapy includes range-of-motion and strengthening exercises
• Braces: A knee brace provides additional support while treatment progresses
• New shoes and gait analysis: If your shoes aren’t supportive and your balance is off, new shoes for knee pain and a gait analysis can help
• TENS therapy: This therapy replaces pain with a mild buzzing sensation that can make it possible to proceed with other treatments (especially good for knee pain at night)
• Injections: A variety of knee pain injections are available to reduce pain and inflammation, especially during the initial rounds of therapy
• Nerve blocks: These may be necessary when a person has pain after knee replacement or if they suffer from severe osteoarthritis
• Spinal cord and peripheral nerve stimulation: These two treatments are more invasive than TENS therapy but can provide long-lasting relief for chronic, severe pain

Knee surgery is only indicated in serious cases when other conservative treatments have failed (or the injury must be repaired before rehabilitation).

Arizona Pain has many different ways to manage your knee pain. Our goal is to help you live a full life with less pain. If you are interested in exploring chiropractic care for knee pain (or have questions about our other treatment options), get in touch today.

Spending time outdoors can reduce stress and keep you healthy. In Arizona, picturesque trails cover every corner of the state, which makes hiking a popular activity year round. Unfortunately, time spent on the trails can result in knee pain, especially for older residents with aging joints. If you’re experiencing knee pain after hiking, you don’t have to suffer. There are plenty of ways to get your discomfort under control. Here’s what you should know.

Why do I have knee pain after hiking?

Our knees endure a significant amount of stress during daily activities, let alone hours spent on rocky and uneven trails. This is why knee pain is very common among avid hikers.

For many people, this pain occurs around or behind the kneecaps and can also cause stiffness. This type of pain typically worsens while walking downhill or up stairs because of the excessive pressure you put on your knees in these situations. Research suggests the force on your knee joint is up to eight times your body weight when going downhill. Furthermore, the force on your knees is two to three times heavier by simply walking up stairs.

Other hikers report inner knee pain in the area closest to your inner legs, which is usually due to a tear or sprain. This may be the result of a specific injury or one of many overuse conditions that cause inflammation.

What causes knee pain after hiking?

In order to begin treating knee pain after hiking, you first have to find the cause of your pain. A diagnosis from your doctor is the first step toward developing a plan for relief.

These are some of the most common causes of knee pain after hiking, along with the symptoms that typically follow. Talk to your doctor if you believe you may be experiencing one of these injuries or conditions.

1. Bursitis

If your knee feels warm, tender, and swollen, you may be experiencing bursitis. This pain typically occurs on the inner side of your knee below the joint.

Knee bursitis is due to inflammation of a small fluid-filled sac called a bursa. These sacs reduce friction and cushion the pressure points between your bones and the tendons, muscles, and skin near your joints. When they become inflamed, they can lead to pain.

While this condition is often caused by frequent kneeling or a blow to the knee, it can also develop after overuse or strenuous activities.

2. Knee tendinitis

Sharp, shooting pain and tenderness above or below your kneecap may be an indication of tendinitis. You may also have swelling and a burning feeling in your kneecap.

This condition is typically brought on by repetitive stress on the knee. Tendons are bands of fibrous tissue that connect muscle to bone. Tiny tears in the tendon can occur, which eventually become weak and inflamed.

3. Tendinosis

In contrast, tendinosis doesn’t involve inflammation. It will be painful, but there is usually no redness or burning feeling as there is with tendinitis. You may also experience stiffness and restricted movement due to the tendons beginning to break down.

Again, this condition is generally caused by overuse and hobbies that put repeated stress on the knees. It is more common in older individuals as the joints become less flexible due to aging. Patients with arthritis are also more prone to tendinosis.

4. Meniscus tear

If you hear or feel a popping sensation in your knee while hiking, it’s likely that you’ve experienced a meniscus tear. This commonly occurs when you forcefully twist your knee, especially while putting your weight on it. Perhaps you were going down a steep hill or kneeling down while carrying a heavy backpack.

Each knee has two menisci, pieces of cartilage that cushion your shin and thigh bone. When torn, you’ll experience swelling and stiffness, along with a sharp pain when twisting or rotating your knee.

5. ACL damage

One of the most commonly injured ligaments in the knee is the anterior cruciate ligament (ACL). An ACL injury tear or sprain can take place because of sudden stops or changes in the direction you’re moving, as well as excessive flexing of the ankle.

Signs and symptoms include:

• Rapid swelling
• Severe pain
• Loss of range of motion
• A loud “popping” sensation
• Instability while putting weight on your knee

6. Synovial plica syndrome

The plica is a fold in the tissue surrounding your knee joint. It is surrounded by a fluid-filled capsule called the synovial membrane.

Synovial plica syndrome is a result of your plica becoming inflamed after stressing or overusing it. This usually happens in the middle of your kneecap. You may be able to feel your swollen plica when you press on this area.

Pain related to this condition is usually achy, rather than sharp or shooting. It may also worsen while using stairs or bending down.

7. Iliotibial band syndrome

The iliotibial band is a thick band of tissue that connects muscles to other structures in the lower body. It runs from the hip region all the way down to the back of the knee.

Iliotibial band syndrome, also referred to as IT band syndrome, is a condition in which this tissue becomes inflamed, tight, or swollen. Pain will typically present on the outside of your knee and can spread up the thigh to the hip.

Again, this condition occurs with overuse of the joint. It may result in knee pain that intensifies in response to movement.

8. Patellofemoral pain syndrome

Patellofemoral pain syndrome is a condition in which you feel pain in the kneecap or at the front of the joint. It is often called “runner’s knee” because it’s more common in people who participate in sports that involve running and jumping.

The pain is usually dull or aching, but can be aggravated by walking up or down stairs, kneeling, and sitting for extended periods of time.

9. Knee osteoarthritis

Unfortunately, overuse in older individuals can lead to osteoarthritis. This condition is the progressive degeneration, or loss, of cartilage from a joint over time.

While osteoarthritis can be found in any part of the body, it is commonly seen in the knees. Severe and advanced cases of osteoarthritis may lead to direct bone-on-bone contact, which can cause chronic pain.

How to prevent knee pain after hiking

As with any medical injury or condition, prevention is your best line of defense. With a few changes and modifications to your hiking routine, you can get back to enjoying the great outdoors without pain.

Try these simple steps for preventing pain:

• Choose supportive footwear: Hiking involves uneven terrain, rocks, and a lot of other obstacles. Finding supportive and comfortable hiking boots is essential. They should fit properly and offer plenty of cushion to relieve excess pressure on your joints. Be sure to replace them as needed after excessive wear.
• Stretch before you hit the trails: Start your hike with a stretching routine that warms up your muscles. Focus on letting your legs loosen up with long, slow stretches that promote elasticity.
• Reduce the weight of your gear: A heavy backpack puts unnecessary strain on your knees. Think about what you really need before each hike. While essentials like sunscreen and water are important, find ways to lighten your load. Instead of water bottles, try a lightweight water pouch.
• Invest in support garments: Get additional knee support in the form of a brace. This will restrict or stabilize joint movement to give you stability. Some hiking enthusiasts also find relief from kinesiology tape.
• Get a hiking pole: There is research to suggest that hiking poles are effective in redistributing some of the pressure you feel in your knees. Especially while hiking downhill, hiking poles can allow your arms and shoulders to absorb some of the impact. They also serve as an added layer of protection from falls that could cause serious injury.
• Take your time: Take trails with a slow and steady approach. Going too fast will only put additional strain and pressure on your knees. Try carefully side-stepping when you’re trying to navigate steep downhill areas. This will help shorten and soften your steps.

Treating knee pain after hiking: 5 approaches

If you’re already suffering from knee pain after hiking, there are several options that could bring you relief. Some are simple at-home remedies, while others will require guidance from your doctor.

1. At-home remedies

You should typically start with simple at-home remedies before moving on to more invasive treatment options, especially if your pain is mild.

At-home care includes:

• Applying ice or cold packs to your knee. This will help reduce swelling and restore your range of movement. Repeat three times per day for 10-20 minutes.
• If your knee responds positively to heat and mild activity, alternate the application of heated and cold packs.
• Trying to keep your affected knee(s) elevated while resting. You can do this with a few pillows, but remember that it’s important to elevate your entire leg all the way down to your ankle.

2. Physical therapy

In some cases, a specific routine of conditioning and stretching is needed to retain or regain flexibility. Physical therapy can help heal the pain you’re currently experiencing, while also conditioning your knees to prevent further injury.

A skilled physical therapist will develop a plan that is specific to your goals and comfort level.

3. Medications

For many patients, conventional over-the-counter medications provide significant relief from pain associated with hiker’s knee, especially during the acute phase of healing after an injury. These include non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen.

These drugs act by inhibiting the production of inflammatory molecules in the body, thus reducing the associated pain.

However, in serious cases, these medications may not provide adequate relief. If you have stopped participating in rigorous activity, but are still experiencing significant knee pain, your doctor may recommend more advanced treatments.

4. Knee injections

If your knee pain has not improved with conventional therapies, your doctor may suggest interventional pain management.

Steroid knee injections can help reduce pain and inflammation in a specific area. While some patients respond to one injection, others may need several injections over time. Most people experience pain relief and reduced inflammation for approximately six months.

5. Surgery

The last resort in cases of severe knee pain is surgery. However, your doctor will generally only recommend this after trying a range of other options that aren’t invasive.

In general, the need for surgery will be due to serious damage caused by aging, injury, or excessive overuse. Your doctor will either repair and replace torn ligaments or replace the knee as a whole (arthroplasty).

Find help

Hiking is a great way to unplug, get exercise, and enjoy the beauty of the great outdoors in Arizona. Don’t let knee pain stop you from enjoying one of your favorite hobbies.

The team at Arizona Pain can work with you to pinpoint the exact cause of your knee pain after hiking. It could be due to any of the different injuries and overuse conditions discussed in this article. You can rest assured knowing we will find the cause and develop a treatment plan that works for you.

If you’re in Arizona and need more help with your knee pain, contact our pain specialists today at Arizona Pain.

You have an idea of what’s causing your knee pain, and now you’re looking for effective treatments. Maybe you’re concerned about adding medications. Perhaps you’d like to try a non-invasive treatment. You think that more exercise might help, but what about physical therapy for knee pain? Does it work? Here are some of the key benefits (and ten exercises to get you started).

Is physical therapy good for knee pain? 

We know that exercise is good for overall health and wellness, but what about physical therapy for knee pain? Does it actually work?

The short answer is yes.

In 2014, a study looked at which types of exercise were best for reducing pain and improving function in people with knee pain. Across the types of exercise studied, supervised exercise of all kinds was the most effective. It’s not enough just to get out on your own—a professional therapist made the difference.

This confirms earlier research findings that clinical exercise produced double the improvement over people exercising on their own.

Another recent study even showed that group physical therapy was effective at reducing knee pain. This is crucial for people who are concerned about covering the cost of private physical therapy appointments.

Finally, a meta-analysis of studies looking at the effect of exercise on knee pain found significant improvements in function and quality of life and a statistically significant reduction of pain. These results were true immediately following the exercise and for many months after.

Goals of knee pain physical therapy

Physical therapy for knee pain focuses on four main goals:

1. Stretching
2. Strengthening
3. Restoring mobility
4. Breaking up scar tissue

Your physical therapist will design a specific set of exercises based on your injury, your condition, and your long-term goals for therapy.

What types of knee pain is physical therapy best for?

Nearly all types of knee pain benefit from physical therapy. The old myth that you shouldn’t put pressure on a sore knee is just that — a myth. In fact, inactivity can actually make the vast majority of knee pain conditions worse.

For example, all types of arthritis respond well to physical therapy for knee pain — just check with your doctor first, proceed cautiously, and listen to your body.

If you are still in the acute phases of knee injury — the first 48 to 72 hours — the best course of action is usually rest and comfort measures. This includes the time directly after a broken bone is surgically repaired or set.

Likewise, if you experience an increase in pain after exercise (normal) that does not go away by the next day (not normal), stop your exercises and check in with your doctor.

Is walking good for knee pain?

Walking is good for knee pain, as long as your doctor approves. Walking on an even surface improves overall health, always a bonus, and begins to strengthen the body gradually. It is a low-impact exercise with benefits that are both physical and mental.

It’s a great complement to targeted physical therapy for knee pain.

The best physical therapy exercises for knee pain 

It’s crucial that you start your physical therapy for knee pain with a doctor. They will refer you to a specialist who will make sure your form is correct and tailor a set of exercises to directly address your particular concern (and your anatomy).

Once you’ve gotten the okay from your doctor and therapist, you can also try these general knee strengthening exercises at home. Start with the first five stretches for knee pain before moving on to the last five strengthening moves.

1. Quadriceps stretch

If you experience knee pain after biking or hiking, tight quads and hip flexors might be to blame.  These next two exercises help release those areas.

Start with the quad stretch. Stand next to a wall or use a chair for support. Bring your weight into the right foot. Bend your left knee, bringing your foot up toward the back of your thigh. Reach back and grab your foot. If you cannot reach your foot, loop a towel or a strap around it and use that to make contact.

Stand tall with a long spine. Engage the muscles of your core and be firm in the foot on the ground. Hold here and breathe for 30 seconds. As you relax, you might be able to move your foot closer to your buttocks, but don’t force it.

Release and repeat on the other side.

2. Stretching through the heel and calf

Tight calves and heels can bind the back of the knee and cause knee pain. This simple exercise begins to gently release this area of the lower leg.

Stand facing a wall and extend your arms in front of you, placing both hands flat on the wall at shoulder height. Slowly slide your right foot back as far as is comfortable (keep both feet facing the wall with the left foot staying in place). Begin to stretch the calf and heel by bending the right knee. Hold for 30 seconds, then step forward and switch.

Do this exercise at least twice on each side.

3. Hip flexor stretch

The hip flexor can be tight from tight quads and too much sitting. This puts extraordinary pressure on the front of your knee.

To stretch your hip flexors, come to all fours, with padding under your knees if you need it. Step the right foot between your hands and pause. If this is enough stretch in the left hip flexor, stay here.

To deepen the stretch, walk the left knee back. You can bring your hands up to blocks on either side of your right knee, or you can bring them to your right thigh. Make sure your right knee is directly over your right ankle. Breathe here for 30 seconds, then switch sides. You can also move directly into the next exercise before switching sides.

4. Hamstring stretch

Come to all fours, with knees padded if you need to. Bring your right foot up between your hands into a lunge.

Take a deep breath in, then begin to sink your hips back toward your left heel, pulling your right toes off the ground. Keep a slight bend in your right knee and only fold until you feel sensation in your hamstring. Avoid sudden movements, and back off if you feel a sharp or stabbing pain. You can use blocks for stability if you feel wobbly

Breathe here for 30 seconds, then inhale to come back into a lunge and switch sides.

5. Reclined figure four stretch

This knee physical therapy exercise is especially good for those who experience knee pain at night. When accompanied by deep, even breathing, this stretch releases tight hips and glutes, both of which can cause overworked upper thighs and tightness in the calves.

Lie on your back (in bed is fine), with knees bent and feet hips-width distance apart. Place your right ankle on your left knee. This might give you enough sensation — press your right knee away gently and relax and breathe.

If you’d like to go deeper, pick the left knee up and lace your hands behind your left thigh, pulling toward you with your right knee relaxed. Breathe here for at least 90 seconds (or for as long as five minutes), then release and move to the other side.

6. Chair pose

Build up strength in the quads and glutes with this classic yoga posture.

Stand with your feet hip’s width apart. Make sure your spine is tall, with the crown of the head reaching towards the sky and the tailbone reaching towards the ground. Your hands can rest comfortably on your hips.

Take a deep breath in, then slowly sink your hips back like you’re coming to sit in a chair. Keep your lower belly engaged to support your lower back. Continue to hold your tailbone under slightly. Look down and make sure you can see your toes — if you cannot, reach your hips back further without going lower.

Take five to ten deep even breaths before pressing into your feet to come back to standing.

7. Calf raises

These can be done on the ground (easiest) or on a stair or ledge (more advanced).

Stand with your feet hip’s width apart. If balance is challenging, hold onto the back of a chair (or railing if you’re on the stairs). Take a deep breath in, then lift both heels off the ground. Slowly lower on the exhale. The slower you go, the more benefit this exercise can provide.

Repeat three sets of up to ten repetitions each.

8. Side leg raises

These can help increase stability along the outside of your knee.

Lie on one side, legs extended, with your bottom elbow bent and upper arm resting on the ground, and your head resting in that hand. Your other hand can rest in front of you for balance. On an inhale, slowly lift the top leg. Make sure your toes face the direction you are looking. Pause at the top, then slowly lower on an exhale. Like the calf raises, the slower you go, the more benefit you may get.

Repeat three sets of up to ten repetitions each on each side.

9. Inner thigh lift

We often ignore the muscles on the inside of the legs, but they are crucial in supporting the knees.

Lie on your side. Come to one elbow, making sure your elbow is directly under your shoulder, and bend the knee of your top leg, bringing your foot to cross over and settle in front of you, toes pointing in the direction you are facing.

Following a pattern of inhales and exhales that work for you, lift and lower the bottom leg, keeping that foot flexed. Move slowly and use an engaged core to support the movement.

Switch to the other leg. Repeat three sets of up to ten repetitions on each side, adding weights or repetitions as you get stronger.

10. Face down leg raises

This works the hip extensors underneath your glutes (and the hamstrings and glutes, too).

Lie face down on a firm surface, with your elbows bent and hands in line with your face (you can also place one hand on top of the other and rest your forehead on them). Just as when you were standing, make sure your spine is long.

Keeping your hips stable and rooted firmly down, inhale and lift your left leg as high as you can. Exhale and release slowly down.

If this is not challenging, add ankle weights or repetitions (but not both at once). Repeat three sets of up to ten repetitions on each side.

Knee pain exercises to avoid

At a minimum, avoid knee pain exercises that make your pain worse. Your pain should not increase dramatically or be sharp and shooting while you stretch and strengthen the muscles surrounding the knee.

In general, other specific activities to avoid include:

• Deep lunges
• High impact exercise (e.g. running)
• Deep squats
• Too many repetitions
• Running up stairs

It can be tempting to push yourself during rehabilitation, but resist that urge. You might worsen your condition or do additional damage.

Other knee pain treatments

Physical therapy for knee pain works best when offered in conjunction with other treatments. These may include the following.

Braces

Braces are often recommended both right after injury and during rehabilitation. Ask your doctor for the best brace for your form of knee pain.

Comfort measures 

Comfort measure such as hot/cold therapy can provide relief for acute knee pain. You might also use ibuprofen or naproxen sodium for pain and inflammation.

Acupuncture

The traditional Chinese medical practice of acupuncture provokes a healing response in the brain. These treatments can be deeply relaxing and effective, especially when combined with physical therapy for knee pain.

Chiropractic care

For knee pain that is caused by skeletal misalignment, chiropractic care can help snap you back in place. These treatments are non-invasive and generally side effect–free — an excellent integrative therapy choice.

TENS unit therapy

Transcutaneous electrical nerve stimulation (TENS) is another non-invasive treatment that reduces pain signals with a simple electrical pulse from pads placed at specific points across the body.

These are over-the-counter devices you can buy to manage your pain. Always talk to your doctor about the best approach, pad placement, and more.

Knee injections

For knee pain that is unmanageable and prevents you from starting physical therapy, your doctor might suggest a joint injection to begin. Joint injections use an anesthetic and a corticosteroid to control pain and inflammation that might be slowing down your recovery.

Surgery

If conservative treatments are ineffective, surgery might be another option. There are different knee surgeries that range from minor repairs to major knee replacement. After surgery, physical therapy for knee pain is par for the course, too.

Find help for your knee pain 

No matter the cause, knee pain can have a big impact on your life.

When you’re ready to get your life back, the pain specialists at Arizona Pain can help. We specialize in comprehensive treatment plans designed for you (including physical therapy for knee pain).

Get in touch to schedule an appointment today.

Joint pain can range from a mild ache to severe, life-altering pain. And because your joints are so crucial to everyday activities, any level of joint pain can have a significant impact on your health, mood, and quality of life. Read on to learn more about common joint pain causes and what you can do to relieve your pain.

Where do most people experience joint pain?

You have joints all over your body. Any place where one bone connects with another, a joint is there bringing them together. This includes everything from the ball-and-socket joints connecting your legs to your hips, to the hinge joints in your knees and fingers.

Where you experience joint pain will depend on what’s causing it, but some joints are more susceptible to certain conditions than others. Osteoarthritis affects 27 million people in the United States, making it the most common chronic joint condition. Osteoarthritis can affect any joint but is most common in the knees, hands, back, and hips.

Other conditions tend to target other joints. Tendonitis, for example, generally occurs in the legs, arms, and feet, and bursitis often affects the hips, knees, elbows, and shoulders. We’ll discuss each of these in more detail below.

Bilateral vs. unilateral pain

Many of your joints are part of a “set,” so to speak. In other words, you generally have two of each, and it is possible to experience pain in the matching joints on both sides of your body. This is called bilateral joint pain. Other people experience unilateral joint pain, or joint pain that only happens on one side of your body.

Whether your pain is unilateral or bilateral may change over time, and for a variety of reasons. Sometimes this happens as you attempt to compensate for the painful joint. If your left foot hurts, you are likely to move differently, putting more pressure on your right foot while walking or standing. This additional pressure can eventually result in pain in both of your feet.

Other times, the shift from unilateral to bilateral pain is part of the disease’s progression. According to a study published in BMC Musculoskeletal Disorders in 2012, 80% of people with osteoarthritis in one knee (unilateral) will develop it in both knees (bilateral) within twelve years.

What causes joint pain?

The causes of this type of pain are as numerous and complicated as the joints themselves. Here are a few of the most common ones.

Arthritis

Arthritis is perhaps the most well-known cause of joint pain. There are many different kinds of arthritis. What they all have in common is that they cause your joints to become swollen, causing pain and a variety of other symptoms. Older people are more likely to develop arthritis, but it can affect people of all ages.

Among the most common forms of arthritis are osteoarthritis and rheumatoid arthritis. However, there are many other varieties. Ankylosing spondylitis usually, but not always, affects the spine. Gout is another form of arthritis that, rather than causing constant pain, flares up for days or weeks at a time before subsiding. It most often affects your big toe, though occasionally symptoms manifest elsewhere in the foot and even in other joints.

Injury

This can refer to unpredictable, one-time injuries, such as a fall or an accident. But more often, joint injuries come about from gradual wear and tear rather than a single event.

If you engage in a lot of physical activity, especially activity that involves repetitive movements, you are at increased risk of hurting your joints. A sport like gymnastics or a job that involves a lot of lifting or bending are examples of activities that may result in joint injuries.

Bursitis

The bursa are fluid-filled sacs that cushion your joints. When they become inflamed, they cause joint pain.

Bursitis is often the result of many small injuries brought about by repetitive movements. For example, if your job or hobby requires you to reach over your head a lot, you are more likely to develop shoulder bursitis.

Tendonitis

Your tendons connect your bones to your muscles. Sometimes, a tendon becomes inflamed, and this condition is called tendonitis (also spelled tendinitis).

Tendonitis can be caused by overuse, injury, or another condition, such as arthritis.

Fibromyalgia

This potentially devastating condition affects women more than men. It may be caused by another medical event, such as an illness or infection, although this isn’t always the case.

One of its most distinguishing traits is chronic pain throughout the body, especially in the joints. Other symptoms include chronic fatigue and memory problems.

Lupus

Lupus is an autoimmune disease that affects everyone differently.

For many people, lupus means joint pain and stiffness, especially in the hands and knees.

Previous surgeries

Surgery can be an effective method of treating conditions too serious for more common treatments. But it is also very traumatic for your body.

Symptoms like pain can linger for a while after the operation. And if you’ve had an operation on your joints, such as a knee replacement, you will likely suffer from joint pain for a while afterward.

Depression

Not all joint pain causes are physical. It is an established fact that mental illnesses, such as depression, also lead to physical symptoms.

Depression can cause a variety of physical symptoms in addition to joint pain, including insomnia and changes in appetite.

4 common joint pain symptoms

As if joint pain on its own isn’t bad enough, it is often accompanied by a host of other, equally troublesome symptoms. Here are four of the most common.

• Stiffness is a very common complaint among joint pain sufferers. You might have trouble bending the affected joint, especially when you first wake up in the morning.
• Swelling is the result of too much interstitial fluid, or the fluid in the tissue, building up in one area. It usually happens when an area has been irritated or injured, such as by an injury or a chronic disease like arthritis. If you have swelling, your joint(s) will appear larger than normal.
• Warmth often occurs in tandem with swelling. An excess of interstitial fluid causes them both. Your joint may appear red and feel warm to the touch.
• Finally, weakness may accompany your joint pain. You may find it difficult to perform even simple tasks, such as lifting a gallon of milk or buttoning a shirt, that you once performed with ease.

Is joint pain serious?

The severity of joint pain will depend on a variety of factors, including the cause of pain, how long you’ve had the condition, and how long you’ve gone without treatment.

Some joint pain causes will resolve over time with proper treatment. Others will never go away completely and may even get worse. Arthritis, for example, is a degenerative condition; the symptoms will continue to worsen over time.

If you are experiencing fever, prolonged or extreme swelling, and/or joint pain severe enough to prevent you from performing your regular activities, see your doctor right away. This is true regardless of what’s causing your pain: if you have these symptoms, it’s time to go to the doctor.

How do I get a joint pain diagnosis?

Only a doctor can officially diagnose the cause of your symptoms. At your appointment, your doctor will go over your medical history with you. They might also recommend running diagnostic tests to figure out the cause of your joint pain. The exact nature of the tests will depend upon your other symptoms.

For example, different blood tests are commonly used to diagnose arthritis. To diagnose lupus, on the other hand, your doctor will likely run several tests designed to diagnose other conditions with similar symptoms. Once all other possibilities have been eliminated, a lupus diagnosis can be made.

X-rays or CT scans are also used in cases of joint pain. These tests provide a clear picture of your bones and can show if there is any deterioration or damage.

In general, the earlier you get a diagnosis and begin treatment, the better chance you have of preventing permanent damage and ensuring the maximum possible recovery for your joints.

How do you treat joint pain?

There are many ways to relieve joint pain. You may have already tried some of them. If your current treatment plan is working for you, there’s no reason to change it. If not, one or more of the joint pain remedies listed below may be worth a try.

Before experimenting with new treatments, always talk to your doctor to ensure that each treatment is safe for you. Some could actually worsen symptoms or lead to more damage.

Medication

Over-the-counter pain relievers, such as ibuprofen, can help in many cases of joint pain. But when these medications aren’t enough to relieve joint pain, your doctor may prescribe something stronger. This is especially true in cases of depression or lupus, when more specialized medication may be required to keep symptoms under control.

Regardless of whether the medicine you take is prescription or over-the-counter, take care to read all instructions and to never take more than the recommended dose.

Heat/cold therapy

Heat/cold therapy is a simple treatment that has the potential to work wonders on your joint pain. Whether you use heat, cold, or both will depend on what’s causing your pain.

The Cleveland Clinic recommends heat therapy for arthritis, since heat generally works better in cases of chronic pain. Do some research and talk to your doctor about which treatment is best for you.

Rest and exercise

Exercise and rest can both be very effective joint pain treatments. Of course, if you’re experiencing chronic joint pain, the prospect of resting is probably much more tempting than exercising. And in some cases, that instinct is exactly right!

If your joint pain is caused by an injury or a condition brought about by an injury (e.g. bursitis), resting and giving your joint the chance to properly heal is usually more important than exercising it—at first.

Once the affected area starts to feel better, you can generally begin physical activity again. Exercise is also important in cases of chronic joint pain; it strengthens your joints so they feel better longer. There are numerous gentle exercises designed for people with chronic joint pain. Always talk to your doctor before beginning any exercise or stretching program.

Lifestyle changes

Maintaining a healthy weight may also improve joint pain. Being overweight puts extra pressure on your joints, while being at a healthy weight can improve both your joint health and your overall health.

In cases of gout, avoid seafood, red meat, and alcohol. These increase the amount of uric acid in the blood, which in turn can lead to a flare-up of gout.

Physical therapy

A physical therapist is someone specially trained to help people whose injury or illness has reduced the range of motion in a joint or limb. They will examine the affected area and guide you through a treatment regimen.

A physical therapy regimen will likely include several of the treatments mentioned above, including exercises and lifestyle changes. Physical therapy can help reduce pain and increase your range of motion.

Injections and surgery

In the more extreme cases, when none of the treatments listed above are working, you may consider injections or surgery. Neither injections nor surgeries are first-line joint pain remedies. The overwhelming majority of joint pain causes do not require such drastic measures.

However if you’re still suffering in pain, cortisone shots are often used when pain is caused by inflammation, such as arthritis. This treatment can help ease your pain and allow you to undergo physical therapy or another program to correct the underlying cause of your pain. However, long-term use of this treatment has potential side effects. It’s important to go over the pros and cons with your doctor before making a decision.

Surgery may be necessary in, for example, especially tough cases of bursitis, tendonitis, or arthritis. Which surgery your doctor chooses for you–and whether you are a candidate for surgery at all–will depend on the cause and severity of your joint pain.

If you are in Arizona and suffer from joint pain, the team at Arizona Pain can help. Contact us today to learn more about that potential causes of your joint pain and how to treat it.