Effective non-surgical treatments for knee pain: what to try

Knee pain can make it tough to enjoy the activities you love — whether that’s going for a run or playing pickleball — or doing your usual daily routine, like climbing stairs. While knee replacement surgery is one of the most common procedures for chronic knee pain (often knee arthritis-related) and can be life-changing for some, many people find relief and recover well with non-surgical treatments. 

For most cases of chronic knee pain, such as pain from arthritis, surgery is often not needed. Research has shown that conservative strategies are often the best first line of defense when treating knee pain connected to arthritis.  

“Approaches like exercise therapy, low-impact physical activity, and lifestyle changes are often very effective for improving comfort and helping people get back to what matters most to them,” says Emily Davis, PT, DPT, a physical therapist at Hinge Health.

Read on to learn how to relieve knee pain with effective non-surgical treatments, including exercises recommended by our Hinge Health physical therapists.

Causes of knee pain

Knee pain is common and usually manageable without surgery. Surgery is typically considered only after completing conservative treatments first. Common causes of knee discomfort include:

• Knee arthritis. Osteoarthritis (OA) commonly affects the knees, particularly as people age. OA — the most common type of arthritis — occurs when the protective cartilage that cushions the ends of bones changes over time. It contributes to knee pain and knee stiffness. 

• Overdoing it. Sometimes, knee discomfort develops when you do more activity than your body is ready for. This can contribute to conditions like patellofemoral pain syndrome (runner’s knee), patellar tendonitis (jumper’s knee), and knee bursitis. These knee issues are common and can often heal with time, as well as conservative treatments like physical therapy and targeted exercises.

• Knee ligament injury. Ligaments are short bands of strong connective tissue that connect bones or hold a joint together. When knee ligaments are overstretched or torn, it can lead to a sprain. This common knee injury can happen after a direct impact like a sports injury or car accident, quick changes in direction, and repetitive movements like twisting. Of all the knee ligaments, the ACL and MCL are more commonly injured. Depending on the severity — and the ligament your tear — as well as your athletic goals, surgery may be needed to recover.

• Meniscus injury. The meniscus is a rubbery C-shaped piece of cartilage that acts as a shock absorber, cushioning the knee. Tears in the meniscus are common and can happen during quick turns in sports, in everyday activities, and even as part of normal aging. Meniscus tears are also linked to arthritis. Similar to knee ligament injuries, the need for surgery depends on the severity of the tear and the limitations it causes in your athletic or daily activities. Though, many can be managed with conservative, non-surgical treatments — especially degenerative tears in older adults.

Non-surgical treatments for knee pain

Before considering knee surgery, know that there are many effective, non-surgical approaches to help you manage knee pain. These include:

• Try physical therapy and targeted exercises. Targeted exercises can help strengthen the soft tissues in and around the knees. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit

• Stay active. Movement is medicine — it’s one of the most effective ways to support knee comfort and overall well-being. Whether it’s everyday tasks or simple, targeted exercises like those below, staying active is a key part of managing knee pain. Physical activity also builds strength, improves flexibility, and increases blood flow to the soft tissues in and around your knee, which supports healing. Regular movement retrains how your body and brain respond to pain, which can make working out more comfortable.

• Make activity modifications. If higher-impact activities (like running and jumping) feel tough on your knees, you don’t have to give them up entirely. “Instead of running five days a week, try cutting back to three, or shorten your runs,” says Dr. Davis. Exploring low-impact activities like cycling or swimming can also support knee comfort. 

• Apply compression and elevation. To manage knee swelling, you can use a brace, elastic athletic tape (like k-tape), or a wrap around your knee. “A brace and tape can also help stabilize the knee and reduce discomfort,” says Dr. Davis. This can help you feel more comfortable as you perform your targeted exercises. Additionally, raising your leg above heart level can help decrease swelling by improving blood flow and reducing fluid buildup.

• Alternate cold and heat therapy. Heat alleviates tension and improves blood flow to the tender area, says Dr. Davis. Ice, or cold therapy, helps tame inflammation in your knee. “I like alternating between heat and ice, especially starting with heat to improve circulation and then switching to ice to decrease swelling,” Dr. Davis says. If one method works better for you, stick with that one.

• Consider weight loss. Carrying excess weight can put extra stress on the joints in your lower body. This can contribute to pain during activities like walking and using the stairs. 

• Eat healthy and stay hydrated. “Be mindful of what you’re putting in your body to nourish it, making sure to drink enough water, avoid processed foods, and eat more anti-inflammatory foods,” Dr. Davis says.

• Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take medications, check in with your provider to make sure these OTC options are ‌safe to take.

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce knee pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Braces or assistive devices. Knee braces and orthotics are often used to help with knee pain from arthritis. Both can make it easier to move and hurt less. They aren’t meant to be worn all the time, but can give extra support when needed so you can stay active and keep up with your exercises.

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for knee pain relief, such as massage, acupuncture, or chiropractic care.

• Consider injections. If your knee pain is so severe that you can’t do physical therapy or your exercises, your doctor may recommend a steroid injection in your knee. This can help relieve inflammation and pain so that you can do the movements you need to heal. Alternatively, your doctor may suggest other injection treatments, such as hyaluronic acid to help lubricate the joint or platelet-rich plasma (PRP) to promote tissue healing. These options can help relieve pain and may delay the need for surgery. 

These exercises are designed to support knee comfort, promote steadiness, and gently build strength in surrounding muscles. “Movement encourages healthy circulation, which can help soothe discomfort,” says Dr. Davis. Practicing these movements can help you move around with ease and increased comfortability.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

When to see a doctor about surgery

Conservative treatments for knee pain can provide relief, but for some people, they’re not enough. Research shows up to 30% of people with knee arthritis will undergo a ‌knee replacement surgery in their lifetime. Some conditions may make surgery necessary for you to be fully functional and get back to the activities or sports you enjoy. It’s a good idea to speak with your doctor about next steps if: 

• You’ve tried conservative treatments for three to four months with no improvements.

• You’ve seen some improvements, but are still unable to perform daily, recreational, or athletic ones you want to participate in.

• You’re still experiencing severe pain.

• The pain is getting worse, despite conservative treatments.

If you’re considering surgery, have an open conversation with your care team about what to expect. Ask whether you’re a good candidate for surgery, what the possible risks and benefits are, how long recovery might take, and what kind of results you can realistically expect. It’s also helpful to discuss what the rehabilitation process will look like and how surgery would affect your ability to return to the activities you enjoy.

Don’t hesitate to seek more than one opinion — including input from your physical therapist — and ask any questions that come to mind. 

“Your care should be personalized and focused on what helps you feel your best,” says Dr. Davis. And remember, any effort you put into non-surgical treatments is valuable, regardless of whether or not you ultimately have surgery: “Most surgeons recommend physical therapy before surgery because it can support your recovery, both now and in the future,” adds Dr. Davis.

PT tip: Embrace squats for stronger knees

When it comes to knee pain, squats often get a bad rap — many people worry that squatting will make their knees hurt more. “But you’re essentially squatting every day whenever you get up from a chair,” says Dr. Davis. Practicing squats can help strengthen many lower-body muscles that support your knees, and may even help ease knee discomfort over time. If squats feel challenging or uncomfortable, a physical therapist can work with you to find movements that feel best for your body, such as making small adjustments to your form or proposing modifications like wall squats.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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