Knee Joint Pain and Problems

Knee pain is often caused by osteoarthritis (OA), a degenerative joint disease that was long considered a “wear and tear” disease of the cartilage in the knee joint.  Lately, scientific studies suggest that OA is a much more complex disease with release of local inflammatory mediators by cartilage, bone and synovium, with low grade systemic inflammation that can reach the cartilage and cause its degradation. Unlike other tissues, cartilage once damaged cannot respond to healing as it does have blood or nerve supply.  Several risk factors can increase incidence of OA such as age, obesity, deformity, family history, and past knee injuries. 

Knee pain from osteoarthritis can be quite debilitating, but there are several treatments to manage the symptoms and improve your quality of life. We offer a holistic approach to you and your treatment, instead of focusing solely on pain causing conditions. Our treatments are more effective as we combine physical therapy, non-operative pain management options and lifestyle modifications to help avoid or delay surgery such as a knee replacement.

Physical therapy:  Often the only treatment required is a tailored, physician directed and patient specific physical therapy program. Certain muscles for example such as

VMO in the quadriceps muscle is key to improve stabilization of patella and minimize pain.  Physical therapy is customized to patient and their ongoing condition, as well as targeted for prevention of future episodes of pain.  Objective measurements are utilized to chart patient progress and outcomes. This multi-faceted approach is designed to restore functional movement, relieve pain, and promote healing and recovery. 

Non-operative Pain and Orthopedic interventions:

If pain is overwhelming and patients are not able to tolerate or progress in physical therapy, our pain medicine MD specialists can evaluate and recommend interventional pain procedures to get to the source of pain to facilitate early healing and recovery.

a)  Cortisone injection:  The most widely used medication injected intra-articular is a corticosteroid, which helps in reducing inflammation and pain.  Repeated use of cortisone injections is however, associated with cartilage degradation.

b)  Gel injections:  FDA approved hyaluronic acid gel injections administered directly in the knee joint to help relieve pain by lubricating and cushioning the joint.  No regenerative properties, only short-term pain relief is noted with this treatment.

c)  PRP and BMAC/Lipoaspirate (Lipogems) cells used for blood plasma, bone marrow aspirate or fat from patients own body are injected intrasubstance in meniscus and or joints under ultrasound and or fluoroscopic guidance.  This cell therapy uses growth factors to aid and AMPLIFY the healing process in joint, cartilage, meniscal, tendons or muscle conditions.

d)  Genicular nerve knee block & radiofrequency ablation (RFN) Knee nerve block that helps in diagnosis and long-term pain management by turning off the pain sensation in the nerves of the knee.  For chronic joint pain solutions, we may use Radiofrequency Ablation (RFA) a safe, effective and minimally invasive intervention using heat waves for unremitting spine knee joint pain. 

 e) Spinal Cord Stimulator can be indication for knee pain syndromes such as complex regional pain syndrome (CRPS).  This neuromodulation program uses mild modulating electric currents to stimulate certain nerve fibers in the spinal cord to block pain signals in the leg/knee area to block pain and improve function.

f) Lifestyle modifications. Each patient at New York Spine and Sport is managed with treatment targeted at not only the condition causing the pain but also the related co-morbidities of chronic pain such as: sleep, mood, emotional disorders, lifestyle related such weight loss, cessation of smoking, anti-inflammatory diet and nutrition to treat pain in joints early and effectively.  Improving overall fitness and conditioning are essential in the recovery and reoccurrence of future episodes of pain.

Combining these therapies in multidisciplinary approach is key for early recovery and favorable outcome.

If you are experiencing knee pain of any kind, we encourage you to reach out to our pain experts at New York Spine and Sport today for an accurate diagnosis and appropriate treatment plan. We can help you develop a personalized treatment plan that considers your specific needs and medical history.

Our team of board certified physicians and licensed physical therapists at NYSSRM are dedicated to assure your pain condition is identified and managed early and appropriately to improve your quality of life.  We have clinics located in North Bronx, North Yonkers and Manhattan. We accept most insurance plans and Medicare.

Please visit our website to book your appointment or to contact us

Keep in mind where you receive your initial treatment for your pain condition will make all the difference in your future outcome!