Chronic Knee Pain, Adult

• A long-term immune-related disease that causes inflammation of the knee (rheumatoid arthritis). This usually affects both knees.
• Inflammatory arthritis, such as gout or pseudogout.
• An injury to the knee that causes arthritis.
• An injury to the knee that damages the ligaments. Ligaments are strong tissues that connect bones to each other.
• Runner's knee or pain behind the kneecap.

Treatment for chronic knee pain depends on the cause. The main treatments for chronic knee pain are physical therapy and weight loss. This condition may also be treated with medicines, injections, a knee sleeve or brace, and by using crutches. Rest, ice, pressure (compression), and elevation, also known as RICE therapy, may also be recommended.

Follow these instructions at home:

If you have a knee sleeve or brace:

• Wear the knee sleeve or brace as told by your health care provider. Remove it only as told by your health care provider.
• Loosen it if your toes tingle, become numb, or turn cold and blue.
• Keep it clean.
• If the sleeve or brace is not waterproof:
  • Do not let it get wet.
  • Remove it if allowed by your health care provider, or cover it with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, apply heat to the affected area as often as told by your health care provider. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • If you have a removable knee sleeve or brace, remove it as told by your health care provider.
  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
• If directed, put ice on the affected area. To do this:
  • If you have a removable knee sleeve or brace, remove it as told by your health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
  • Remove the ice if your skin turns bright red. This is very important. If you cannot feel pain, heat, or cold, you have a greater risk of damage to the area.
• Move your toes often to reduce stiffness and swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Activity

• Avoid high-impact activities or exercises, such as running, jumping rope, or doing jumping jacks.
• Follow the exercise plan that your health care provider designed for you. Your health care provider may suggest that you:
  • Avoid activities that make knee pain worse. This may require you to change your exercise routines, sport participation, or job duties.
  • Wear shoes with cushioned soles.
  • Avoid sports that require running and sudden changes in direction.
  • Do physical therapy. Physical therapy is planned to match your needs and abilities. It may include exercises for strength, flexibility, stability, and endurance.
  • Do exercises that increase balance and strength, such as tai chi and yoga.
• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Lose weight if you are overweight. Losing even a little weight can reduce knee pain. Ask your health care provider what your ideal weight is, and how to safely lose extra weight. A dietitian may be able to help you plan your meals.
• Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. These can delay healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits. This is important.

Contact a health care provider if:

• You have knee pain that is not getting better or gets worse.
• You are unable to do your physical therapy exercises due to knee pain.

Get help right away if:

• Your knee swells and the swelling becomes worse.
• You cannot move your knee.
• You have severe knee pain.

Summary

• Knee pain that lasts more than 3 months is considered chronic knee pain.
• The main treatments for chronic knee pain are physical therapy and weight loss. You may also need to take medicines, wear a knee sleeve or brace, use crutches, and apply ice or heat.
• Losing even a little weight can reduce knee pain. Ask your health care provider what your ideal weight is, and how to safely lose extra weight. A dietitian may be able to help you plan your meals.
• Follow the exercise plan that your health care provider designed for you.