Warning

Signs/symptoms

  • Longstanding ache in knee with no acute trauma/injury
  • May have evidence of OA/degenerative change on x-ray (though x-ray not required to diagnose OA of the knee)
  • May have restriction in AROM of the knee
  • May have reduced quadriceps strength due to pain inhibition
  • Absence of red flags for knee pain
  • Possible antalgic gait due to pain on weight bearing

Primary care management

  • Chronic Knee Pain is effectively managed within primary care with analgesia, advice and signposting to appropriate information and exercises
  • Encourage use of NHS Inform and Versus Arthritis for information on OA of the knee (downloadable leaflet available on Versus Arthritis) and use of strengthening to support of the muscles around the knee to support the joint
  • Weight management/advice if applicable
  • Prescribe/advise analgesia where required and appropriate to pt
  • Consider Corticosteroid Injection for symptom relief where required and if no contraindications present (please note CSI should not be given for 6 months prior to Knee Joint replacement if on waiting list for Orthopaedic surgery)
  • X-ray to confirm OA if it will alter current management plan (to inform further referrals)
  • Smoking Cessation
  • Exercise Referral Scheme for general strengthening and fitness
  • Signpost to DG Doing More for activity and maintenance of strength and function

Refer

  • Walking aid provision may be required if acute on chronic flare and weight bearing affected – refer to MSK physiotherapy as Urgent if for walking aids only.If pt is housebound please refer to appropriate Home team.
  • Where reduction in function and management in PCT has not been effective – refer MSK Services
  • Ensure pt understands they may see EITHER a physiotherapist or a member of the orthopaedic team and that will be further managed from point of contact in Secondary care with no need for Dual referral to Orthopaedics and Physiotherapy

Editorial Information

Last reviewed: 26/04/2023

Next review date: 26/04/2024

Reviewer name(s): Ruth Bell.