Knee Osteoarthritis | The Back Pain Doctor Brisbane

Knee osteoarthritis is a common cause of knee pain and stiffness, particularly with age. While the changes are not reversible, symptoms can often be managed well without surgery for a long time.

Osteoarthritis of the knee involves gradual changes to the cartilage and other structures within the joint. It is very common with age, and the degree of change seen on imaging does not always match how much pain a person has.

The cornerstone of management is keeping the muscles around the knee strong, maintaining activity and a healthy weight, and using simple pain measures as needed. These approaches have strong evidence and remain important regardless of any other treatment.

Where pain persists despite these measures, there are additional options to consider — including injection treatments such as PRP, which has been studied specifically for knee osteoarthritis. We will give you a clear, evidence-based view of what each option can realistically offer for your knee, and when an orthopaedic opinion is appropriate.

Common symptoms

Knee pain that worsens with activity and eases with rest
Stiffness, especially after sitting or first thing in the morning
Swelling, grinding or a feeling of the knee "giving way"
Reduced ability to walk, climb stairs or squat

Evidence-informed treatment summary

How our treatment options may fit for Knee Osteoarthritis

The options below include the treatments offered at The Back Pain Doctor. Listing a treatment does not mean it is recommended for this condition. The evidence, likely benefit and role of each option are considered against the diagnosis, examination findings, imaging where appropriate, patient goals, risks, cost and alternatives.

Core treatment

Diagnosis, education and progressive rehabilitation

Therapeutic exercise, education and weight management where relevant are core osteoarthritis treatments.

For knee osteoarthritis, the first-line plan is usually education, activity modification, strength work, aerobic conditioning and weight management where clinically relevant. Treatment is guided by symptoms and function, not imaging alone.

Limited evidence

Focused / radial shockwave therapy

AAOS states ESWT may improve pain and function in knee osteoarthritis, but the recommendation is limited and downgraded because of inconsistent evidence.

Focused shockwave can be discussed for selected knee osteoarthritis patients, particularly when the aim is symptom reduction and function support. It should not be positioned as cartilage regeneration, disease reversal or a replacement for exercise-based care.

Mixed evidence

Platelet-rich plasma (PRP)

PRP evidence in knee osteoarthritis is inconsistent; AAOS downgraded its PRP recommendation because of inconsistent evidence.

PRP may be discussed for selected patients after a careful conversation about uncertainty, cost, expected time course, severity of OA, alternatives and the fact that responses are variable.

Short-term relief

Image-guided corticosteroid / local anaesthetic injection

Guidelines support corticosteroid injections for short-term symptom relief in selected osteoarthritis presentations.

Corticosteroid injection may help during a painful flare or when pain is preventing rehabilitation. It should be framed as short-term symptom relief, not structural repair.

Insufficient guideline support

EMTT / magnetotransduction

Major osteoarthritis guidelines do not establish EMTT as a core knee osteoarthritis treatment.

EMTT may be discussed only as an adjunct with explicit uncertainty. It should not be presented as a proven disease-modifying treatment for knee osteoarthritis.

Not routine

Prolotherapy

Not a core guideline-supported knee osteoarthritis treatment.

Prolotherapy is not usually a first-line knee osteoarthritis treatment. If discussed, it should be after clear diagnosis and careful explanation of limited evidence compared with core OA care.

Only if overlay

Trigger point / myofascial treatment

Trigger point therapy does not treat osteoarthritis itself.

It may be relevant only if there is a clear secondary myofascial pain component around the hip, thigh or calf. It should not be described as an OA treatment.

Usually not relevant

Nerve-focused treatment / hydrodissection

Nerve hydrodissection is not a treatment for knee osteoarthritis.

Nerve-focused treatment would only be considered if the clinical picture suggests a separate nerve entrapment or neuropathic pain generator.

This is general information only. Suitability is assessed individually. Treatments with limited or condition-dependent evidence may still be discussed, but only with clear explanation of uncertainty, expected benefit, risks, cost and alternatives. Red flags, progressive neurological symptoms or suspected serious pathology require a different pathway.

Frequently asked questions

Is exercise safe if I have knee osteoarthritis?

Yes. Appropriate exercise and strengthening is one of the most effective and well-evidenced treatments for knee osteoarthritis. Activity does not "wear out" the joint, and staying strong and active generally helps symptoms.

What about PRP for my knee?

PRP has been studied for knee osteoarthritis and is one of the better-studied indications, although results vary and it is not a cure. Whether it is reasonable for you depends on your situation, and we will discuss the evidence and costs honestly.

Will I need a knee replacement?

Many people manage knee osteoarthritis for years without surgery. Joint replacement is considered when symptoms are severe and not controlled by other measures, and is a decision made with an orthopaedic surgeon.

Ready for a clearer plan for your back or musculoskeletal pain?

Book an assessment with Dr Joshua Hatch.

Your assessment focuses on understanding the likely source of your pain and the most appropriate non-surgical options for your diagnosis, with the aim of reducing pain and improving function.

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