Treatment Options for Knee Pain

As explained in our previous post, there can be several reasons for knee pain leading to some very common conditions such as osteoarthritis, patella tendinopathy, and patellofemoral pain syndrome.

Some of the most common factors leading to knee pain can include muscle tightness around the knee joint, reduced mobility of the joints above and below the knee (ankles, hips), poor foot control, poor muscle control and coordination… The list goes on! That is why our initial consultation aims to narrow down the cause of your knee pain for you, which helps us develop a proper treatment plan specific to your condition. Here are among the most helpful treatment options available for knee pain:

Rehabilitative Exercises

This refers to specific exercises done for your condition and should not just be a list of exercises on a piece of paper given to you (and everyone else) to do at home! Rehabilitative exercises aim to strengthen the muscles around your knee, hip, or ankle, all of which contribute to better load distribution throughout your movement chain because when pain feels like it’s coming from the knee, all the surrounding body parts need to be examined:

  • Low back and the pelvis can have imbalances that impact the knee lower down
  • Hip weakness may create less support for the knee
  • Ankle and foot position also influences the knee position, putting painful loads on the knee

Credit: Google

Some common exercises that tend to help those with general knee pain are exercises that help to strengthen the hips, such as clamshells, glute bridges, or resisted leg raises. If you’re having difficulty training the thighs (like squatting, lunges, or deadlifts) due to knee pain, you may need to take a break and focus on low impact, low repetition, and resistance exercises for the glutes.

ESWT (Extracorporeal Shockwave Therapy)

We use this modality sparingly, only when needed. This is because not everyone is suitable for ESWT. Commonly used for ligament or tendon injuries which have scar tissue or are slow to heal such as a chronic patella tendinopathy, it works by creating little bubbles of cavitation in the target site (think bubbles popping) which causes target areas of slight inflammation. This signals our body’s natural healing response to that target site to address that inflammation, thus helping with the healing process.

Dr Chandra getting his knee shockwaved

It also helps to reduce the release of Substance P, which is a pain-causing substance in the tissues, reducing pain over a number of sessions. This makes it an appropriate modality for those suffering from painful knee osteoarthritis as well, as it helps with reducing pain and improving growth factors in the knee joint.

BIXEPS (Magnetic Mitohormesis Therapy)

This technology comes from patented technology by Singapore’s NUS and Switzerland’s ETH Zurich which aims to help improve recovery rates by stimulating your mitochondria to produce more energy and a balanced amount of oxidative stress – just enough to help trigger healing in the body. You can read more about it here: BIXEPS – The Science Behind How It Works.

Credit: NUS Health Singapore

It helps with knee pain by upregulating myokines which help to regulate inflammation levels in the body (of which excessive inflammation in the body is usually present after a knee injury or when the body is recovering), thereby assisting in pain reduction. It also helps to improve muscle adaptation, further accelerating recovery! While it may take time to see effects – the recommended is 12-weeks of BIXEPS sessions for optimal results – many of our patients have reported that it assists in recovery times.

Lifestyle Changes

What you do in that 1-hour session with the physiotherapist is just one part of the story, what you do at home and at work matters a lot as well. To get the most out of your knee recovery, try to:

  • Get in enough protein, fibre, and a diet that can give you enough vitamins and minerals that you need (As mentioned in our previous blog post, knee pain subjects who were lowest in Vitamin D had a 3-fold increased risk for progressive knee OA) – inflammation that influences pain also starts in our gut, and a diet that is minimal in processed food can help greatly.
  • Move around regularly if you have a job or lifestyle that involves sitting down a lot. A quick walk to the bathroom or around the room every hour of sitting will help to reduce pressure on the knee.
  • Complete your exercise regime as prescribed. It may be 3 times a week, or daily, or involve a few components of walking, strength training, or cardio – either way, staying active will help to keep your heart healthy and improve general circulation throughout your whole body, not just your knees!


With modern technology, treatment options now are wide and varied, and knee pain or osteoarthritis does not always need to end up with surgical intervention. Many physicians and orthopaedics are now seeing conservative care – the options listed here today – as the main treatment approach, before considering surgery. If you need help with getting started on figuring out your knee pain, do contact us today!