Turn to Physical Therapy Before Surgery for Chronic Knee Pain
Knee pain is a growing complaint that physical therapists and orthopaedic surgeons are tackling as millions of aging Americans struggle to stay active.
The most common cause of knee pain is osteoarthritis, a joint disease that results in the degeneration of the cartilage between bones in the knee joint. As cartilage is lost due to accelerated wear and tear, bones in the knee rub against each other and cause damage to the joint – and pain. The most common treatment regiment for osteoarthritis is anti-inflammatory medication (like Tylenol and aspirin), weight loss to help relieve stress on the joint and physical therapy to help strengthen the supporting muscles in the knee.
Meniscal tears are also common, especially among those suffering from osteoarthritis. An X-ray or MRI can show a tear in a specific strip of cartilage around the knee. These meniscal tears most commonly occur when the knee is twisted while the foot is planted.
Both conditions are common and both have similar symptoms of pain, knee popping and knee locking. But it’s difficult to determine, among these patients, whether the source of their pain is a torn meniscus or damage from chronic osteoarthritis.
Some doctors will recommend surgery to fix the meniscal tear while others will recommend a more conservative approach with physical therapy.
A new article in the New England Journal of Medicine suggests that an initial, conservative approach with physical therapy may be a better option for patients suffering from symptoms of knee pain.
A study of 351 patients age 45 and older who had osteoarthritis and a meniscal tear. They randomly assigned patients to receive either knee surgery followed by physical therapy or physical therapy alone.
Then they follows patients’ recoveries and measured their pain, stiffness, and mobility at six and 12 months. Although both groups showed improvement at six and 12 months, there was not a significant difference between the groups.
In other words, the conservative group with physical therapy alone did just as well as the more invasive group who had surgery followed by physical therapy.
These findings suggest that patients with osteoarthritis and a meniscal tear may be better off with an initial trial of physical therapy rather than immediately going to surgery. In general, physical therapy is a relatively safer intervention and may be just as effective for many patients.
If physical therapy doesn’t result in improved range of motion and pain your physical therapist may recommend that you revisit an orthopaedic specialist and pursue a surgical treatment. When performed by a qualified surgeon, minimally invasive knee surgery can provide relief and healing beyond the means of physical therapy alone.
+ Find a physical therapy clinic near you!
+ Learn more about minimally invasive knee surgery in Hampton Roads.