By Dr. Ted Schlegel
UCHealth Steadman Hawkins Clinic – Denver
Myth No. 1: The cause of persistent knee pain is always the same, and arthritis is always to blame.
Reality: There are many causes for knee pain, so it’s important to see an expert who can give you the correct diagnosis and the proper treatment plan.
Myth No 2: When I have knee pain, the best way to deal with it is to “power through it” and grab a handful of anti-inflammatories to allow me to keep going.
Reality: Although over-the-counter medications like ibuprofen and naproxen can be helpful for acute flare-ups of pain, it’s best to use them only for short periods of time. Medications have potential side effects including gastric bleeds and kidney and liver dysfunction. If you intend to take these medications for longer periods of time, then it is best to be under the care of a physician who can monitor you through intermittent blood tests to lessen the chance of a serious complication.
Myth No 3: I’m stuck with my knee pain.
Reality. Depending on the problem, many people with knee pain can get relief through a non-operative treatment program. This can include the use of short-term medications, along with a well-designed physical therapy program.
Myth No 4: A steroid injection will fix my knee pain.
Reality: Steroid injections can provide short-term relief for knee pain, particularly in patients with an acute flare-up of their knee arthritis. However, we don’t like to use steroid injections repeatedly since they can create harmful side-effects including weakening of tissues and a higher risk for infections if you ever need surgery.
Myth No. 5 Surgery for knee pain is better than physical therapy.
Reality: In almost all cases, we recommend that our patients try physical therapy before resorting to a surgical solution.
Myth No. 6: Stem cell treatments will fix my knee pain.
Reality: Stem cell treatments offer hope for many ailments, but we don’t have the scientific evidence yet to show they’re effective in curing knee pain. We hope that stem cell therapies will someday help regenerate tissue. But, in the U.S., we are not allowed to manipulate or multiply your stem cells. Current research shows we need about 10 million cells to regenerate tissue in your knees. Patients are paying up to $8,000 for stem cell therapies with no proven benefit. We urge our patients to be cautious. Wait for scientific proof that stem cell therapies work before spending money on experimental treatments.
Myth No. 7: Since I tried a few weeks of physical therapy and haven’t gotten better, I need surgery to fix my knee pain.
Reality: Before considering a surgical option, you should explore all non-operative alternatives. If your knee pain is related to arthritis, you could benefit from an injection of either hyaluronic acid or platelet rich plasma (PRP). Research shows both of these types of injections can provide short-term relief for knee pain by reducing inflammation. They work about 60 percent of the time and can last 6 to 12 months.
Myth No. 8: A knee scope “clean-up” will cure my problem and allow me to return to my sporting activities.
Reality: Prior to considering any surgical procedure, patients need a complete work-up. A doctor must get a detailed history, perform a physical exam, see X-rays and sometimes review more advanced imaging, such as an MRI. If the patient has a mechanical source of pain, such as an unstable meniscal tear, chondral flap lesion or loose body without evidence of underlying arthritis there may be as high as a 90 percent cure rate with arthroscopic surgery. If there is no evidence a mechanical source of pain, and the knee pain is due to arthritis, then arthroscopy has less than a 50 percent chance of success.
Myth No. 9: Being overweight isn’t that hard on my knees.
Reality: If you are overweight or obese (click here for charts), the single greatest change you can make to reduce your knee pain is to lose weight. Excess weight puts pressure on your knees. Losing weight eases that pressure.
Myth No. 10: Knee replacement surgery will allow me to jump back into all the sports I used to love.
Reality: Total knee replacement is a last resort. It’s a good option for patients with intractable knee pain that doesn’t respond to any of the alternatives I have listed above. In the right group of patients, it can allow individuals to be pain-free with daily activities and return to lower-impact sports like hiking, biking and swimming. Even so, people with knee replacements should be cautious. If you put too much stress on the implants, the metal capping will wear away the plastic spacer that replaces the natural cartilage in your knee.
Dr. Ted Schlegel is an orthopedic surgeon at UCHealth Steadman Hawkins Clinic – Denver. He is a former team doctor for the Denver Broncos and the Colorado Rockies. He cares for both professional athletes and weekend warriors. Dr. Schlegel specializes in sports medicine and joint, muscle and bone injuries with a special focus on knee and shoulder pain. Schlegel believes that no one with knee pain should suffer without help. If you are coping with knee pain, visit a specialist. There’s a good chance you can relief for your knee pain. You can reach Dr. Schlegel at 303-694-3333 or click here for more information.