Chronic Knee Pain

Chronic Knee Pain

What Is Chronic Knee Pain?

Chronic knee pain refers to discomfort, stiffness, or swelling that persists for 12 weeks or longer, regardless of whether the pain is constant or comes and goes.

Unlike acute pain, which is typically caused by a sudden injury (like a fall or sports strain), chronic knee pain usually develops from underlying conditions such as osteoarthritis, repetitive strain, or long-standing joint degeneration.

Chronic knee pain is not “normal aging” and should never be ignored. Early diagnosis and treatment dramatically improve long-term outcomes.

 

Common Causes of Chronic Knee Pain

1. Osteoarthritis (OA)

The most common cause of chronic knee pain, OA is a degenerative condition where joint cartilage gradually wears away. Symptoms include stiffness, swelling, grinding, and difficulty with walking or climbing stairs.

2. Rheumatoid Arthritis (RA)

An autoimmune condition in which the body's immune system attacks joint lining.
It causes inflammation, heat, swelling, and severe morning stiffness.

3. Meniscus Tears

The meniscus is the cartilage that cushions the knee. Tears may develop suddenly (sports injury) or gradually with age.
Pain typically worsens with twisting or squatting.

4. Tendonitis and Bursitis

Inflammation of the tendons (tendonitis) or small fluid-filled sacs (bursae) around the knee can cause persistent pain and swelling.

5. Past Injuries or Surgeries

Ligament injuries (ACL/MCL), fractures, or previous surgeries can leave behind long-term biomechanical issues that cause chronic discomfort.

6. Obesity-Related Joint Strain

Excess weight increases force on the knees, accelerating cartilage degeneration and worsening symptoms.

 

Symptoms to Watch For

Persistent knee pain is often accompanied by:

  • Swelling or warmth
  • Stiffness, especially after sitting or in the morning
  • Instability — the knee “gives way”
  • Grinding or clicking sounds
  • Sharp pain with movement, or dull ache at rest
  • Pain at night or after minimal activity
  • Reduced range of motion

Seek urgent medical attention if you experience:

  • Inability to bear weight
  • Visible deformity
  • Sudden severe swelling
  • Signs of infection (redness, fever)

 

Risk Factors

Several factors increase the likelihood of developing chronic knee pain:

Age (40+)

Cartilage naturally thins over time, raising the risk of osteoarthritis.

Obesity

Each extra kilogram adds up to four kilograms of pressure to the knee joint.

Previous Joint Injuries

Past trauma weakens joint structures and accelerates degeneration.

Repetitive Strain

Manual labour, running, squatting, and high-impact sports all increase wear.

Genetics

Family history of arthritis or autoimmune conditions raises risk.

Inflammatory Conditions

RA, gout, lupus, and other systemic disorders commonly affect the knees.

 

How Chronic Knee Pain Is Diagnosed

A proper diagnosis ensures that treatment targets the underlying cause, not just the symptoms. At The Pain Collective, diagnosis includes:

1. Detailed medical history

Understanding the pattern, location, and severity of pain.

2. Physical examination

Assessing joint mobility, swelling, stability, and gait.

3. Imaging

  • X-rays for arthritis and structural changes
  • MRI for soft tissue injuries like meniscus or ligament tears
  • Ultrasound for bursitis or tendon issues

4. Blood tests

Used when infection or autoimmune diseases are suspected.

A precise diagnosis forms the foundation of an effective, personalised treatment plan.

 

Proven Treatment Options

Chronic knee pain rarely improves with rest alone. Evidence-based treatments focus on reducing inflammation, restoring joint function, and preventing long-term damage.

Conservative Treatments

RICE Method
Rest, ice, compression, elevation for inflammation flares.

Weight Management
Even modest weight loss significantly reduces knee load and pain.

Physiotherapy
A cornerstone of treatment. Strengthens surrounding muscles, improves mobility, and restores alignment.

 

Medication

  • NSAIDs for short-term inflammation
  • Paracetamol for mild pain
  • Corticosteroids for severe flare-ups
  • Joint supplements (glucosamine, omega-3s) — evidence varies

Medication is helpful, but not a long-term standalone solution.

 

Injection Therapies

Corticosteroid injections
Fast relief during acute inflammation phases.

Hyaluronic acid (viscosupplementation)
Replaces lost joint lubrication (not suitable for everyone).

Platelet-Rich Plasma (PRP)
Uses your own blood platelets to stimulate repair — helpful for tendinopathy and early arthritis.

 

Interventional Pain Procedures

Provided at The Pain Collective:

  • Genicular nerve blocks
  • Pulsed radiofrequency neuromodulation of the genicular nerves
  • Periarticular nerve modulation
    These treatments reduce pain without damaging nerves, improving mobility for 12–24 months.

 

Surgical Options

Reserved for severe or progressive cases:

  • Arthroscopy for mechanical issues (meniscus, loose bodies)
  • Osteotomy to realign joint mechanics
  • Partial or total knee replacement for advanced osteoarthritis

Surgery is not always necessary — and often not the first step.

 

Rehabilitation

Post-treatment rehabilitation includes:

  • Strength training
  • Joint mobilisation
  • Gait retraining
  • Balance and proprioception work

Rehab ensures long-term success and prevents future injury.

 

Lifestyle Adjustments for Knee Health

Movement and daily habits play a major role in recovery.

  • Low-impact exercise: swimming, cycling, elliptical
  • Strength training for quadriceps, hamstrings, glutes
  • Supportive footwear
  • Anti-inflammatory diet focused on whole foods
  • Avoiding deep lunges, heavy squats, and high-impact sports

Specialists at The Pain Collective often combine physiotherapy, nutrition guidance, behavioural therapy, and interventional pain care to create a full, integrated plan.

 

When to See a Pain Specialist

You should consult a specialist if:

  • Your pain persists for more than 3 months
  • You have swelling that keeps returning
  • Your knee feels unstable
  • Pain affects your sleep, work, or mobility
  • You want to avoid or delay surgery
  • Medication is no longer effective

The Pain Collective offers interdisciplinary, non-surgical approaches that help many people avoid joint replacement entirely.

 

Final Thoughts

Chronic knee pain is not something you have to live with. Early diagnosis and modern treatment can dramatically reduce pain, restore joint function, and improve quality of life. Whether your symptoms are new or long-standing, there are effective options available — from physiotherapy and nerve modulation to regenerative therapies and, when necessary, surgery.

If knee pain is limiting your movement, mood, or independence, reach out to a pain specialist for a personalised treatment plan. Relief is possible, and recovery starts with the right support.

 

FAQs

1. What are the main causes of chronic knee pain?
Osteoarthritis, old injuries, meniscus tears, tendonitis, autoimmune disorders, and repetitive strain.

2. Can chronic knee pain heal without surgery?
Yes. Many cases improve with physiotherapy, weight management, nerve modulation, and injection therapy.

3. What treatment options are available in South Africa for knee osteoarthritis?
Physiotherapy, NSAIDs, cortisone injections, hyaluronic acid injections, PRP, pulsed radiofrequency, and knee replacement surgery.

4. When should I see a specialist for knee pain?
If pain lasts longer than 12 weeks, affects daily function, or keeps returning.

5. How does weight affect chronic knee pain?
Extra weight increases joint stress, accelerates cartilage wear, and worsens inflammation

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