Knee Osteoarthritis
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Knee pain is one of the most common health problems seen in adults, especially after the age of 40–50 years.
For the medical management of this condition, a patient should consult a Physiatrist (Physical Medicine and Rehabilitation Specialist). A physiatrist focuses on reducing pain, improving movement, and helping people return to their daily activities without surgery whenever possible.
Osteoarthritis (OA) is a condition in which the protective cartilage covering the ends of the bones gradually wears away. As a result, the knee joint becomes painful, stiff, and swollen.
OA is not simply a disease of ageing. Excess body weight, previous injuries, genetics, and lifestyle also play important roles.
A physiatrist looks beyond the X-ray. Instead of treating only the damaged joint, they evaluate:
The goal of treatment is to reduce pain, improve function, and delay or even avoid surgery whenever possible.
Patients are taught:
Every extra kilogram of body weight places several kilograms of additional force on the knee during walking.
Even losing 5–10% of body weight can significantly reduce pain and improve mobility.
Weight reduction combined with exercise gives the best results.
Exercise is the most effective long-term treatment for knee OA.
A trained physiotherapist, under the guidance of a physiatrist, may prescribe:
Regular exercise often reduces pain more effectively than prolonged rest.
Treatment may include:
When pain continues despite medicines and exercise, a physiatrist may recommend interventions with or without ultrasound (USG) guidance.
This injection helps reduce inflammation inside the joint. It is useful when:
Pain relief may last from several weeks to a few months.
Hyaluronic acid acts like a lubricant inside the knee. It may:
Results vary from person to person.
PRP is prepared from the patient’s own blood.
Platelets contain growth factors that may help reduce pain and improve knee function in selected patients.
Pain signals from the knee travel through small nerves called the genicular nerves.
A local anaesthetic, sometimes combined with corticosteroid, is injected around these nerves to reduce pain.
For patients with long-standing knee pain who are not suitable for surgery or wish to postpone it, radiofrequency ablation may be considered.
In this procedure:
Pain relief may last 6–12 months or longer in selected patients.
The procedure does not damage the knee joint—it only interrupts pain signals.
Newer treatments are being studied, including:
While some patients report improvement, many of these treatments are still under research, and not all have strong evidence for routine use.
A physiatrist can help determine whether such treatments are appropriate.
Sometimes simple devices make a big difference. These include:
Using the correct aid reduces stress on the painful knee.
Surgery may be required only in advanced conditions when all conservative measures fail. A PMR specialist can help assess the need for surgical treatment such as Total Knee Replacement (TKR).
Rehabilitation under a physiatrist plays a key role in restoring strength, flexibility, and independence.
Osteoarthritis of the knee is a common condition. It does not mean the end of an active life.
With the right combination of:
Most people can reduce pain, improve mobility, and continue doing the activities they enjoy.
A physiatrist works with each patient to create a personalized treatment plan, helping them move better, stay independent, and improve their quality of life.