Knee pain is a common issue that affects people of all ages and activity levels. Whether caused by an injury, arthritis, or gradual wear and tear, knee pain can impact mobility and overall quality of life.
The good news is that various treatment options are available, ranging from conservative approaches like physical therapy to more advanced interventions such as surgery.
But how do you know when physical therapy is enough and when it’s time to consider surgery? Understanding the causes of knee pain and the available treatment options can help you make an informed decision about your care.
Common Causes of Knee Pain
Knee pain can result from injuries, medical conditions, or the natural aging process. Some of the most common causes include:
- Osteoarthritis – The most common form of arthritis, osteoarthritis occurs when the cartilage in the knee joint wears down over time, leading to pain, stiffness, and inflammation.
- Rheumatoid arthritis – An autoimmune condition that causes inflammation in the knee joint, leading to pain, swelling, and damage to the joint lining.
- Tendonitis – Inflammation of the tendons, often caused by overuse or repetitive movements, such as running or jumping.
- Meniscus tears – The meniscus is a cushion-like cartilage in the knee. Tears often occur due to sudden twisting motions or degeneration over time.
- Ligament injuries – Damage to the ACL, MCL, or other knee ligaments can cause instability, swelling, and severe pain. These injuries are common in athletes.
- Bursitis – Inflammation of the small, fluid-filled sacs (bursae) that cushion the knee joint, often caused by prolonged kneeling or repetitive stress.
- Patellofemoral pain syndrome – Also known as runner’s knee, this condition causes pain around the kneecap due to misalignment or overuse.
Regardless of the cause, early intervention can help prevent worsening symptoms and improve recovery outcomes.
When to Try Physical Therapy for Knee Pain
Physical therapy is often the first line of treatment for knee pain. It focuses on strengthening the muscles around the knee, improving flexibility, and correcting movement patterns to reduce strain on the joint.
Signs That Physical Therapy May Be Right for You:
- Your knee pain is mild to moderate and does not interfere with daily activities.
- You experience pain when walking, climbing stairs, or exercising, but it improves with rest.
- You have recently suffered a minor knee injury, such as a sprain or mild meniscus tear.
- You have arthritis but want to delay or avoid surgery by improving joint function.
- You experience instability or weakness in the knee due to muscle imbalances.
How Physical Therapy Helps with Knee Pain:
- Strengthening exercises – Targeted exercises build the muscles around the knee (quadriceps, hamstrings, and glutes) to provide better joint support.
- Flexibility training – Stretching helps maintain a full range of motion and reduces stiffness.
- Manual therapy – Techniques such as massage, joint mobilization, and dry needling can alleviate pain and improve function.
- Gait and movement training – Therapists analyze your walking and movement patterns to correct imbalances that may be contributing to knee pain.
- Pain relief techniques – Ice, heat therapy, and electrical stimulation can help manage pain and inflammation.
For many patients, a structured physical therapy program can significantly reduce knee pain and restore mobility without the need for surgery. However, not all cases respond to conservative treatment alone.
When to Consider Surgery for Knee Pain
While physical therapy can be highly effective, there are situations where surgery may be the best option for long-term relief. If knee pain becomes severe, limits mobility, or does not improve with non-surgical treatments, an orthopedic specialist may recommend surgical intervention.
Signs That Surgery May Be Necessary:
- You experience persistent pain that does not improve with physical therapy or medications.
- Your knee pain significantly interferes with daily activities, such as walking, standing, or sleeping.
- You have advanced arthritis with severe cartilage loss and joint damage.
- You have a major injury, such as a torn ACL, meniscus, or fracture that does not heal properly.
- You experience knee instability or frequent buckling that affects your ability to walk.
Common Surgical Procedures for Knee Pain:
Arthroscopic Surgery
A minimally invasive procedure where a small camera and instruments are used to repair torn cartilage, remove damaged tissue, or smooth out rough joint surfaces. It is commonly used for meniscus tears and mild arthritis.
Partial Knee Replacement
If only one part of the knee joint is damaged, a partial knee replacement can be performed to replace the affected area while preserving the healthy portions of the knee.
Total Knee Replacement
In cases of severe arthritis or joint damage, a total knee replacement (TKR) may be necessary. This involves replacing the entire knee joint with an artificial implant to restore function and reduce pain.
ACL or Ligament Reconstruction
For athletes or individuals with severe ligament injuries, reconstructive surgery is performed to repair or replace torn ligaments using grafts.
Each surgical option has its own benefits and recovery timeline, and an orthopedic specialist can help determine the best approach based on your condition and lifestyle.
The Recovery Process: What to Expect
The recovery timeline varies depending on the type of knee surgery performed.
- Arthroscopic surgery – Recovery typically takes 2 to 6 weeks, with physical therapy beginning shortly after surgery.
- Partial knee replacement – Most patients return to normal activities within 4 to 6 weeks, but full recovery may take several months.
- Total knee replacement – Recovery takes longer, with most patients resuming daily activities within 6 to 12 weeks and continuing physical therapy for several months.
- ACL or ligament reconstruction – Recovery can take 6 to 9 months, with extensive rehabilitation required to regain strength and stability.
Regardless of the procedure, post-surgical physical therapy plays a crucial role in regaining strength, flexibility, and function in the knee.
Making the Right Decision for Your Knee Health
Deciding whether to pursue physical therapy or surgery depends on several factors, including the severity of your knee pain, the underlying cause, and how much it affects your daily life.
For many people, physical therapy offers an effective, non-invasive solution that improves mobility and reduces pain without the need for surgery. However, if conservative treatments are no longer working and knee pain is limiting your ability to enjoy daily activities, surgical intervention may provide the long-term relief you need.
At OCC Ortho, our Colorado Orthopedic Specialists are here to guide you through every step of your knee care journey. Whether you’re exploring non-surgical options or considering surgery, we provide expert care tailored to your unique needs. Schedule a consultation today to find the best path toward pain relief and improved mobility.