Tory McJunkin, MD
Pain Medicine News
ISSUE: DECEMBER 2014 | VOLUME: 12(12)
Knee pain is a very common complaint that can be debilitating when severe. A proper evaluation must begin with a thorough history and physical examination.
If the patient is not a surgical candidate, there are several conservative treatment options—such as physical therapy for retraining of proper mechanics, kinesiology taping to improve proprioception, acupuncture and chiropractic treatment—that may alleviate the patient’s symptoms. Depending on the nature of the pain, a variety of analgesic medications may be prescribed, including anti-inflammatory drugs, membrane-stabilizing agents and in severe cases, opioid analgesics. Unfortunately, these medications may not significantly reduce the pain and their long-term compliance may be limited by untoward side effects. Additionally, many patients have intractable chronic pain after more invasive treatment options such as a total knee arthroplasty (TKA). Studies have reported that 20% of patients undergoing TKA have persistent postsurgical pain.1 These patients often present to the pain clinic frustrated by the failure of conservative and possible surgical interventions. Fortunately, depending on the pain generator, there is a wide array of interventional treatment options that can be implemented.