Knee Pain (Gonalgia): Therapy

General measures

  • Depending on the disease and stage of disease:
    • Relief and immobilization
    • Sports leave
  • In case of joint effusion:
    • Immobilization and rest with cooling and elevation of the joint are observed
    • (PECH scheme: “P” rest, sparing, immobilization: “E” ice/cooling; “C” compression e.g. elastic bandage; “H” elevation above heart level).
    • Later, careful mobilization can then be started.
  • In case of osteoarthritis or joint degeneration – see under osteoarthritis.
  • In case of trauma – care depending on the nature of the injury.
  • Nicotine restriction (refraining from tobacco use) – smoking can contribute to pain in the long term; it slows healing processes, worsens blood circulation and increases the risk of, for example, degenerative processes of the knee joint
  • Alcohol restriction (abstaining from alcohol consumption) – alcohol leads to non-deep sleep (reduces the important REM phases and leads to sleep-through problems). The result is not enough restful sleep and decrease in pain threshold, ie increase in pain….
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.

Conventional non-surgical therapy methods

Operative therapy

  • When conservative therapeutic influence is insufficient:
    • Operative arthroscopy (arthroscopy) – primarily first diagnosis by computed tomography (CT) of the knee joint to examine bony structures or magnetic resonance imaging (MRI) of the knee joint to examine menisci, cruciate ligaments, ganglia.
    • Open surgery

Medical aids

  • Immobilization by:
    • Bandages
    • Splints
    • Plaster
    • Orthotics (medical device made by orthopedic technician, which serves for stabilization, relief and immobilization) – in case of ligament instability.
  • Shoe orthopedic measures:
    • Shoe outer or inner rim elevation – for varus or valgus arthrosis.
    • Buffer heels if necessary

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
  • Suitable sports disciplines are cycling and swimming if necessary.
  • Other measures are:
    • Strength building and coordination training
    • Training of the quadriceps femoris (“four-headed thigh muscle”) muscle to center the patella (kneecap).
    • If necessary, leg axis training for malpositions (varus or valgus position).
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Physical therapy (including physiotherapy)

  • Thermotherapy, this consists of heat and cold therapy (cryotherapy):
    • Heat therapy in the form of balneotherapy or electrothermotherapy has analgesic (pain-relieving) effects and may improve walking distance and health-related quality of life.
    • Cryotherapy is used only in active, inflammatory osteoarthritis.
  • Electrotherapy
  • Ultrasound therapy

Complementary treatment methods