Knee pain is one of the most commonly reported musculoskeletal complaints world-wide, with high-income countries most affected, according to the World Health Organization (WHO). That seems ironic, considering the billions of dollars Western countries invest in healthcare every year. But the truth is that affluence breeds luxury, and in modern times, luxury includes the option to avoid physical exertion, causing the body – especially the knees – to deteriorate from lack of use.
Learn about the key causes of knee pain, and how integrative therapy is revolutionizing the way chronic knee pain is perceived and treated.
Knee Pain Incidence and Treatment Approaches
The incidence of knee pain has been steadily increasing over the past several decades, nearly doubling since the mid-1900s. In youthful populations, knee pain is most often attributed to traumatic and repetitive use injuries from sports and exercise. But for middle-aged and older adults, knee osteoarthritis (KOA) is a key contributor to chronic knee pain, according to the Knee Pain Centers of America.
Knee osteoarthritis is considered a degenerative joint condition, meaning that it worsens over time. Treatment for KOA typically centers on pain management, with the use of NSAIDs like ibuprofen and naproxen, and corticosteroid injections to reduce pain and inflammation. Knee braces and walking support devices like canes and walkers may help to provide stability while slightly reducing load on the knees. But none of those approaches work to slow the progression of knee pain, they only mask the symptoms.
Today, conventional medicine’s approach to knee pain treatment is being challenged by integrative practitioners who take a more holistic approach to musculoskeletal disorders. Pain is always a symptom, and should never be confused with the condition itself. Rather than focusing on the locus of pain, holistic practitioners look at the whole body to find the root cause of knee pain. Once the underlying cause is identified, a treatment plan can be put in place to eradicate the cause of knee pain and potentially eliminate it for good.
What is Causing Our Epidemic of Knee Pain?
There are multiple factors that contribute to knee pain, and there is no one-size-fits all solution. Treating knee pain does not eliminate its cause – it merely kicks the can down the road until disability sets in and surgery becomes the only option. But we now know that knee degeneration is not inevitable.
If we are able to identify the specific factors contributing to an individual patient’s knee pain, we can leverage advanced regenerative technologies and personalized physical therapy to halt the progression of knee pain and restore pain-free mobility.
Factors contributing to chronic knee pain include:
- Old injuries that were never properly rehabilitated, involving ligaments, tendons and other structures. Without rehabilitation, knee mechanics is compromised, and osteoarthritis is likely to set in, later in life.
- Metabolic disease, marked by chronic systemic inflammation, hypertension, insulin resistance and type 2 diabetes. Research has identified a strong correlation between metabolic syndrome and knee OA progression.
- Obesity. Not only does carrying extra body weight contribute to metabolic disease, but it puts excess strain on the structures supporting the knee joints.
- Physical inactivity. The knees are designed to keep us moving, but modern lifestyles are often sedentary. Failure to load the knees on a regular basis causes the supporting structures to weaken, increasing your risk of injury and knee pain.
- Excessive sitting. Keeping the knees and hips bent at 90 degrees for extended periods of time creates muscle balances that negatively affect joint alignment and function. Over time, the knees can become unstable, and loads are unevenly distributed, causing the knees’ structures to deteriorate.
- Repetitive overuse during activities like running. Inefficient gait mechanics is often a contributing factor, and runners can benefit from a 3D running gait analysis to identify and correct mechanical errors.
How Integrative Therapy Can Help Stop the Progression of Knee Pain
Integrative therapists consider the whole patient, not just your symptoms. Human anatomy is as diverse as eye color, and to be most effective, treatment should be personalized. Contrary to the reductionist approach taken by medical doctors, holistic therapists do not isolate one body part from its neighbors, but recognize that all the body’s structures are interdependent. When one segment of the body malfunctions, it affects other segments along the entire kinetic chain.
Integrative knee treatment addresses multiple factors that affect knee function, such as:
- Tendinopathies that cause tendon degeneration.
- Untreated or undertreated injuries such as meniscus tears and ligament ruptures.
- Post-surgical scar tissue and adhesions.
- Compressed or entrapped nerves that send pain signals to the brain.
- Muscle weaknesses and imbalances that force the knee out of alignment.
- Related issues further along the kinetic chain that interfere with knee mechanics.
- Lifestyle factors that cause knee tissues to deteriorate.
The integrative approach to knee pain is 2-pronged: repair and heal damaged tissues that affect knee function, and strengthen the supporting structures to improve stability and mobility. For physical therapy to be effective, the tissues surrounding and supporting the knees need to be pre-treated and optimized.
A holistic therapist may use regenerative therapies like shockwaves, Prolotherapy, and PRP injections to stimulate tissue neogenesis and repair of collagen fibers and eroded cartilage. Fascial manipulation therapy can help to eliminate scar tissue and adhesions that restrict movement and entrap nerves. Myofascial trigger points that affect muscle action can be eliminated with dry needling.
Once damaged tissues have been addressed and healed, personalized physical therapy can help restore knee stability and mobility by strengthening and balancing the structures that support the knee, improving gait and posture, and optimizing joint alignment.
Where to Find an Integrative Knee Pain Specialist in NYC
There are plenty of physical therapy clinics in NYC, but not all of them offer advanced integrative therapies. Look for a clinic that offers high-resolution diagnostic ultrasound, to ensure an accurate diagnosis. Ultrasound is also an important tool for precisely delivering regenerative therapies to targeted tissues, to ensure effective results.
NYDNRehab is one of the few private clinics to offer regenerative knee pain treatment in Manhattan. The clinic features high resolution ultrasound for accurate diagnosis, and is used to precisely guide advanced regenerative therapies. Their personalized and holistic approach to knee rehabilitation has saved dozens of patients from knee surgery, and helped them to regain pain-free functional mobility, and a better quality of life.
Resources
Nguyen, Uyen-Sa DT, et al. “Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data.” Annals of internal medicine 155.11 (2011): 725-732.
Szilagyi, I. A., et al. “Metabolic syndrome, radiographic osteoarthritis progression and chronic pain of the knee among men and women from the general population: The Rotterdam study.” Seminars in Arthritis and Rheumatism. Vol. 69. WB Saunders, 2024.
About the Author
Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.
