Knee pain is defined as soreness, tension, and/or stiffness in the anatomical region of the knee and can be secondary to multiple conditions including knee osteoarthritis or patellofemoral pain syndrome. Knee pain may follow a traumatic onset (eg. sports injury) or be related to age-related degenerative change.

Diagnosis

Diagnosis of knee pain is derived from the patient’s history and physical exam with an unremarkable neurological exam and no indicators of potentially serious pathology. Imaging studies are confirmatory for diagnoses of moderate or severe osteoarthritis [109,110].

Evidence based summary for manual therapy [53]

Moderate quality evidence that manual therapy of the knee and/or full kinetic chain (SI to foot) combined with multimodal or exercise therapy is effective for the symptoms of knee osteoarthritis [108,116,117]. Moderate quality evidence that manual therapy of the knee and/or full kinetic chain (SI to foot) combined with multimodal or exercise therapy is effective for patellofemoral pain syndrome [108]. For references please see home page/ chiropractic/ research evidence.

Other effective non-invasive physical treatments or patient education [53]

Exercise therapy, advice about weight loss, appropriate footwear, pulsed electromagnetic field therapy, acupuncture, and TENS [110 -115]

Back-in-Action clinical comment

Chiropractic assessment and treatment of knee pain is aimed at finding and reducing tension and the causes of tension in the joints and muscles. We find much of the discomfort associated with knee pain arises from postural stress, joint dysfunction (tension) or injury through too much movement (sprain). Chiropractors usually aim to address why there is an increase in stress in this area.

In our experience treating the symptoms and underlying causes of knee pain benefits from a combination of treatment techniques to increase the probability of a good result. Our approach often incorporates spinal manipulation, mobilisation, muscle release techniques, cranial work, back exercises (individually tailored self mobilisation, stretching and strengthening), referral for massage therapy, diet and nutritional advice, functional neurological exercises, breathing techniques, acupuncture, cryotherapy (heat and/or ice), postural improvements, foot orthotics, ergonomic advice and relaxation counselling.