Physical Therapy and Treatment for Knee Pain in New Jersey

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requent knee pain affects about 25% of adults, limiting their strength, stability, and functional mobility. Knee pain can prevent or limit participation in sports, and reduce enjoyment of hiking, walking, hobbies, and daily living responsibilities. The most common cause of knee pain in people 30 and above is osteoarthritis. But often knee pain is the result of a sports injury, slip and fall, motor vehicle accident, or poor gait mechanics and posture.

Centers for Neurosurgery, Spine & Orthopedics (CNSO), provides physical therapy and other treatments for patients with knee pain at locations throughout northern New Jersey. Learn more about this condition, its risk factors, and care plan options.

Causes and Risk Factors for Knee Pain

Causes

Knee pain can be caused by a myriad of factors including arthritis, mechanical abnormalities, injuries, or infection. Here are some of the most common causes of knee pain:

• Arthritis: There are many different types of arthritis, but the most common ones that affect the knee are:
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Septic Arthritis
  • Gout
  • Pseudogout
• Mechanical Abnormalities
  • Dislocated kneecap/poor patellar tracking
  • ITB syndrome (a tendon, the iliotibial band, becomes swollen or irritated)
  • Loose body in joint, such as a bone or cartilage fragment
  • Pain or abnormalities at the hip or ankle
  • Poor gait mechanics
• Injuries
  • ACL injury
  • PCL injury
  • MCL injury
  • LCL injury
  • Meniscus injury
  • Fractures (of the kneecap, tibial plateau, or end of the femur)
  • Bursitis
  • Patellar tendonitis

Risk Factors

Some people are more likely to develop knee pain than others due to different risk factors. Below are several known risk factors that could lead to knee pain:

• Natural aging: Knee pain often occurs due to age-related wear and tear on the joint surfaces of the knee, causing a decrease in shock absorption and stability. This process is normally classified as osteoarthritis and tends to affect most people as they age.
• Excess Weight: Being overweight or obese increases the force through the knee when standing, walking, or negotiating stairs, which increases the wear on the joint.
• Lack of Mobility or Strength: A lack of flexibility will increase the chances of injuring the knee and can cause gait abnormalities if it limits the range of motion. Meanwhile, good strength through the knee improves the stability of the joint during daily activities.
• Job or Sport Responsibilities: Depending on the sport or job responsibilities, there can be increased wear and tear (if the job or sport requires a lot of repetitive movements or prolonged time standing or walking) or increased risk for injury (if the job or sport requires placing knees in unnatural positions or requires a lot of dynamic movements).
• Previous Injury: Previous injuries to the knee such as meniscus tears, cruciate or collateral ligament injuries, or injuries to the muscles around the knee, including the hamstrings, quads, adductors, and calves, all can make a person more likely to develop knee pain.

Differential Diagnosis of Knee Pain

Primary care doctors often diagnose knee pain but not the root cause of it. Orthopedic surgeons and physical therapists will specify the diagnosis in terms of the anatomical structures of the knee or conditions originating from the lower back or spine that cause knee pain. This detailed diagnosis will allow them to specify a treatment plan. Generally, a physical therapist or orthopedic surgeon will diagnose the cause of knee pain through the following:

• Physical Examination: The patient’s lumbar spine, hips, knees, and ankles are examined to check for pain distribution, changes in reflexes, loss of sensation, range of motion deficits, and muscle weakness, along with other signs and symptoms indicative of a knee pathology.
• Medical History Assessment: The patient’s medical history is analyzed to determine whether another condition or genetic factor could be causing knee pain.
• Diagnostic Imaging Tests: These may include X-rays, magnetic resonance imaging (MRI), ultrasound, or computed tomography (CT) scans.

These diagnostic tests will help determine what structures are causing the knee pain and what needs to be modified or repaired to relieve pain and allow a return to full functionality.

Non-Surgical Treatments for Knee Pain

As one of New Jersey’s premier rehabilitation providers, CNSO prides itself on promoting the use of conservative treatment before more invasive options are considered. Patients will be evaluated by a practicing orthopedic surgeon, neurosurgeon, doctor of physical therapy, or physiologist, who will assess the root cause of the patient’s pain and formulate a personalized care plan with the patient to return them to their prior level of athleticism. In many knee pain cases, patients respond well to non-surgical treatment options, such as:

Rest, With Activity and Lifestyle Modifications

Most patients are advised to prioritize rest, make activity modifications, and form better lifestyle habits to reduce their symptoms. These may include:

• Use of better form or limiting sports and other strenuous activities (running, hiking, etc.)
• Maintaining a healthy weight to reduce stress on the knee
• Practicing better posture when sitting, standing, or walking
• Making ergonomic adjustments at work

Physical Therapy and Exercise

A physical therapy regimen often improves symptoms of knee pain. A physical therapist will use specific exercises and manipulations of the musculature surrounding the knee, hip, and ankle to help decrease pain and improve range of motion and muscle strength and stability. CNSO offers physical therapy services in Wayne, Paramus, Morristown, and Jersey City, NJ.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are either prescribed or available over the counter at many retail locations and pharmacies. They are recommended for patients who have pain that is limiting their functional mobility.

Oral Corticosteroids

These medications aim to reduce inflammation and swelling in the knee. They usually are prescribed in a short course, over five to seven days, and often are followed by a course of NSAIDs.

Steroid Injections

A small injection of steroids directly beside the anatomical structures causing the knee pain can reduce the problematic swelling of the ligaments, tendons, and bursae. This concentrated dose of steroids within the knee joint significantly reduces the amount of steroids required and limits any systemic side effects.