Chronic knee pain affects one in four people aged 55 and older. For many, the symptoms are mild to moderate. However, when it is severe, it can be debilitating.
Ongoing knee pain can also occur after knee replacement or ACL surgery. The triggers and causes of this kind of knee pain are complex and can be related to many different factors.
If you suffer from severe knee pain, it can make the simplest tasks seem almost impossible. Everything from walking to sitting down can be painful. Coping with chronic knee pain without seeking treatment can make the situation even worse.
We’ll look at the major possible causes of severe chronic knee pain along with leading options to treat it.
The Knee Is a Highly Vulnerable Joint
The knee is the joint that connects your thigh to your lower leg. It’s the biggest joint in your body. Like all joints, your knees are part of the bones in your skeletal system. Your knees also contain cartilage, muscles, ligaments, and nerves – all of which are vulnerable to damage.
Trauma
The knee bears a great deal of stress from everyday activities, such as walking, lifting, and kneeling, and from high-impact activities, such as running, jumping sports, and aerobics. Pain and damage from traumatic injuries and overuse are common
Arthritis
Knee pain can also result from different types of arthritis including osteoarthritis, rheumatoid arthritis, gout, pseudogout, and septic arthritis. Osteoarthritis of the knee is very common, with 46% of people developing it at some point in their lifetimes.
Post-Knee Replacement Pain
Although uncommon, a small percentage of knee replacement patients continue to have chronic pain on the outer sides of the knee after surgery. This is where the surviving knee ligaments and tendons are located. Most often these connective tissues are damaged either by the surgery or new stresses placed on them by the implant.
A number of other knee replacement patients have nerve irritations. This nerve irritation can be below or above the knee or within the kneecap. Other people become hypersensitive to pain after surgery, experiencing more pain than they should.
Preventing Knee Pain
Although it’s not always possible to prevent knee pain, there are some things you can do to ward off injuries and slow joint deterioration.
Maintain a Healthy Weight and Keep Extra Pounds Off
It’s one of the best things you can do for your knees. Every extra pound puts additional strain on your joints, increasing the risk of injuries and osteoarthritis.
Regularly Exercise to Be Strong and Flexible
Strong muscles will help stabilize and protect your knee joints and muscle flexibility can help you achieve a full range of motion. Prepare for the jumps and pivots of sports like basketball with good hip control by building glute strength. Work on normal ankle mobility to decrease unnecessary stress on the knee.
Use good cushioning shoes and focus on form when running or jogging to minimize pounding on the knees. And approach repetitive work knee stress in jobs such as construction or farming by preparing with exercises to strengthen impacted muscles.
Seeking Medical Help for Chronic Knee Pain
If knee pain persists and impacts the quality of your life, you should see a qualified medical professional to evaluate your condition. Putting off an appointment to address your chronic knee pain issues when they become critical will often allow things to further deteriorate and get worse.
There are a variety of treatments that may be appropriate for each individual situation. They include:
- Physical therapy can help strengthen the muscles around your knee and make it more stable.
- Medications can be prescribed to relieve pain and address the symptoms causing it.
- Corticosteroids can be injected into your knee joint and may help reduce the symptoms of an arthritis flare and provide pain relief that may last a few weeks to a few months.
- Hyaluronic acid is a natural substance found in joints. It is a viscous, gel-like substance. A treatment called viscosupplementation injects it to augment the fluid that naturally lubricates your knee joints. This may reduce friction within the joint, thereby reducing pain and stiffness, and preventing the loss of cartilage and bone.
- Platelet-rich plasma (PRP) injections may benefit certain people with osteoarthritis with a PRP concentration of many different growth factors that appear to reduce inflammation and promote healing.
But what if these options aren’t sufficiently effective? Or if you want to avoid prolonged use of pain medications? What additional options are there short of surgery?
Peripheral nerve stimulation may be an answer for some patients. Itpresents a drug-free alternative that has proven to be highly effective to control chronic knee pain in appropriate cases.
Peripheral Nerve Stimulation
Neurostimulation has been used successfully to manage intractable chronic pain for over 40 years.
You may have heard of spinal cord stimulation (SMS) which was the first therapeutic approach that used neurostimulation. This therapy uses gentle electrical impulses to interrupt pain signals before they reach your brain. SMS offers a drug-free approach that does not require drugs or physical therapy to work.
Peripheral Nerve Stimulation (PNS) describes a localized and miniaturized approach to using neurostimulation. Peripheral nerve stimulation is different from spinal cord stimulation because it places the stimulating device directly over the nerve at the targeted pain area, not on the spinal cord where the nerve originates.
There are several medical device manufacturers that offer variations of peripheral nerve stimulation devices. Some of these devices are designed for a course of treatment that is 60 days or less. Others are designed for longer term use. Doctors will select specific devices based on each individual patient’s situation.
These PNS devices are small in size, minimally invasive, discreet, and upgradeable. The diameter of the leads implanted to provide stimulation is smaller than the size of a thin strand of spaghetti. There are both temporary and permanent PNS therapy options. They can be removed by your doctor if you decide to discontinue the therapy.
Peripheral Nerve Stimulation and Knee Pain
Peripheral nerve stimulation devices are increasingly used to help patients control their chronic knee pain. Very small electrodes are implanted next to the nerves involved, which can then be stimulated with the goal of relieving knee pain. Control of applying that stimulation is in the hands of the patient when they need it.
Appropriate candidates for peripheral nerve stimulation should have exhausted more conservative treatments without adequate improvement.