Therapeutic Strategies for the Management of Knee Pain – A Review of Current Therapies and Perspectives
DOI:
https://doi.org/10.12775/QS.2026.54.70104Keywords
pain, knee, OsteoarthritisAbstract
Background. Knee pain can significantly impact patients' quality of life. Pain emerging with age is most commonly associated with osteoarthritis of the knee.
Aim. Current clinical management comprises three lines of treatment.
Results. The first and second lines focus on conservative and pharmacological management, while the third involves surgical intervention.
Conclusions. This paper discusses both current therapeutic standards and innovative treatment methods.
References
[1] J. Runhaar, M. Kloppenburg, M. Boers, J. W. J. Bijlsma, and S. M. A. Bierma-Zeinstra, “Towards developing diagnostic criteria for early knee osteoarthritis: data from the CHECK study,” Rheumatology (Oxford), vol. 60, no. 5, pp. 2448–2455, May 2021, doi: 10.1093/RHEUMATOLOGY/KEAA643.
[2] V. Duong, W. M. Oo, C. Ding, A. G. Culvenor, and D. J. Hunter, “Evaluation and Treatment of Knee Pain: A Review,” JAMA, vol. 330, no. 16, pp. 1568–1580, Oct. 2023, doi: 10.1001/JAMA.2023.19675.
[3] W. Zhang et al., “EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis,” Ann. Rheum. Dis., vol. 69, no. 3, pp. 483–489, Mar. 2010, doi: 10.1136/ard.2009.113100.
[4] X. Wang et al., “Associations Between Knee Effusion-synovitis and Joint Structural Changes in Patients with Knee Osteoarthritis,” J. Rheumatol., vol. 44, no. 11, pp. 1644–1651, Nov. 2017, doi: 10.3899/JRHEUM.161596.
[5] D. J. Hunter and S. Bierma-Zeinstra, “Osteoarthritis,” The Lancet, vol. 393, no. 10182, pp. 1745–1759, Apr. 2019, doi: 10.1016/S0140-6736(19)30417-9.
[6] J. L. Couch et al., “Noisy knees - knee crepitus prevalence and association with structural pathology: a systematic review and meta-analysis,” Br. J. Sports Med., vol. 59, no. 2, pp. 126–132, Jan. 2025, doi: 10.1136/BJSPORTS-2024-108866.
[7] B. A. Hills and K. Thomas, “Joint stiffness and ‘articular gelling’: inhibition of the fusion of articular surfaces by surfactant,” Br. J. Rheumatol., vol. 37, no. 5, pp. 532–538, 1998, doi: 10.1093/RHEUMATOLOGY/37.5.532.
[8] L. Sharma, J. Song, D. T. Felson, S. Cahue, E. Shamiyeh, and D. D. Dunlop, “The role of knee alignment in disease progression and functional decline in knee osteoarthritis,” JAMA, vol. 286, no. 2, pp. 188–195, Jul. 2001, doi: 10.1001/JAMA.286.2.188.
[9] P. Suri, D. C. Morgenroth, C. K. Kwoh, J. F. Bean, L. Kalichman, and D. J. Hunter, “Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative,” Arthritis Care Res. (Hoboken)., vol. 62, no. 12, pp. 1715–1723, 2010, doi: 10.1002/ACR.20324.
[10] “Co-morbidities of patients with knee osteoarthritis - PubMed.” Accessed: Nov. 20, 2025. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/19494370/
[11] O. Buhaiov and O. Tarabrin, “Modern view of mechanisms of chronic pain syndrome in patients with knee joint damage,” Journal of Education, Health and Sport, vol. 53, pp. 242–255, Feb. 2024, doi: 10.12775/JEHS.2024.53.020.
[12] D. Primorac et al., “Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations,” Genes (Basel)., vol. 11, no. 8, pp. 1–35, Aug. 2020, doi: 10.3390/GENES11080854.
[13] B. Olesiak, A. Przedborska, and J. W. Raczkowski, “Degeneration grade of a femoropatellar joint and functional status of a knee joint,” Pedagogy and Psychology of Sport, vol. 5, no. 2, pp. 44–55, Feb. 2019, doi: 10.12775/pps.2015.05.02.003.
[14] M. Blagojevic, C. Jinks, A. Jeffery, and K. P. Jordan, “Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis,” Osteoarthritis Cartilage, vol. 18, no. 1, pp. 24–33, Jan. 2010, doi: 10.1016/j.joca.2009.08.010.
[15] L. O. Dantas, T. de F. Salvini, and T. E. McAlindon, “Knee osteoarthritis: key treatments and implications for physical therapy,” Braz. J. Phys. Ther., vol. 25, no. 2, pp. 135–146, Mar. 2021, doi: 10.1016/j.bjpt.2020.08.004.
[16] O. Tudaj et al., “Treatment Methods for Knee Osteoarthritis - A Literature Review,” Quality in Sport, vol. 42, p. 60948, Jun. 2025, doi: 10.12775/qs.2025.42.60948.
[17] D. Primorac et al., “Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines,” Pharmaceuticals (Basel), vol. 14, no. 3, Mar. 2021, doi: 10.3390/PH14030205.
[18] F. Berenbaum, “Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!),” Osteoarthritis Cartilage, vol. 21, no. 1, pp. 16–21, Jan. 2013, doi: 10.1016/j.joca.2012.11.012.
[19] B. R. Da Costa et al., “Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis,” BMJ, vol. 375, Oct. 2021, doi: 10.1136/BMJ.N2321.
[20] C. Cooper et al., “Safety of Oral Non-Selective Non-Steroidal Anti-Inflammatory Drugs in Osteoarthritis: What Does the Literature Say?,” Drugs Aging, vol. 36, no. Suppl 1, pp. 15–24, Apr. 2019, doi: 10.1007/S40266-019-00660-1.
[21] M. C. Osani, L. S. Lohmander, and R. R. Bannuru, “Is There Any Role for Opioids in the Management of Knee and Hip Osteoarthritis? A Systematic Review and Meta-Analysis,” Arthritis Care Res. (Hoboken)., vol. 73, no. 10, pp. 1413–1424, Oct. 2021, doi: 10.1002/ACR.24363.
[22] S. Mathieu, A. Tournadre, M. Soubrier, and J. Sellam, “Effect of disease-modifying anti-rheumatic drugs in osteoarthritis: A meta-analysis,” Joint Bone Spine, vol. 89, no. 6, Nov. 2022, doi: 10.1016/J.JBSPIN.2022.105444.
[23] N. Gupta et al., “Long-term effectiveness of intra-articular injectables in patients with knee osteoarthritis: a systematic review and Bayesian network meta-analysis,” J. Orthop. Surg. Res., vol. 20, no. 1, Dec. 2025, doi: 10.1186/S13018-025-05574-W.
[24] A. Alzarooni et al., “A Comprehensive Review of Operative Considerations, Surgical Techniques, Outcomes, and Future Perspectives in Total Knee Arthroplasty,” Cureus, vol. 17, no. 10, Oct. 2025, doi: 10.7759/CUREUS.94345.
[25] D. D. Chlorogiannis, A. Vasilopoulou, C. I. Konstantinidis, A. E. Pagona, and D. K. Filippiadis, “Knee pain improvement after genicular artery embolization for the management of knee osteoarthritis: an updated systematic review and meta-analysis of 21 studies,” Radiologie (Heidelberg, Germany), vol. 64, no. Suppl 1, pp. 32–46, Nov. 2024, doi: 10.1007/S00117-024-01388-9.
[26] Y. Epelboym et al., “Genicular Artery Embolization as a Treatment for Osteoarthritis Related Knee Pain: A Systematic Review and Meta-analysis,” Cardiovasc. Intervent. Radiol., vol. 46, no. 6, pp. 760–769, Jun. 2023, doi: 10.1007/S00270-023-03422-0.
[27] T. Hong, H. Wang, G. Li, P. Yao, and Y. Ding, “Systematic Review and Meta-Analysis of 12 Randomized Controlled Trials Evaluating the Efficacy of Invasive Radiofrequency Treatment for Knee Pain and Function,” Biomed Res. Int., vol. 2019, 2019, doi: 10.1155/2019/9037510.
[28] J. Liu, T. Wang, and Z. H. Zhu, “Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials,” J. Orthop. Surg. Res., vol. 17, no. 1, Dec. 2022, doi: 10.1186/S13018-021-02906-4.
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Copyright (c) 2026 Tymoteusz Białowąs, Dominika Karolak, Natalia Sara Kuśmierowska, Monika Kuś, Grzegorz Słomkowski, Kacper Cholewiński, Daria Valipur Kolti, Milena Polak, Magdalena Natalia Nowak, Konrad Wiśniewski
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