Knee surgery should never be your first option. You can sometimes help your knee pain with alternative treatments instead. You and your doctor should discuss less invasive ways to ease knee pain.

Weight Loss and Exercise

Losing pounds may help you lose the pain. Being just 10 pounds overweight adds up to 60 pounds of force on your knee with each step. One study found that shedding even 15 pounds could lead to big improvements in your comfort level and the quality of your life. Exercise can help you achieve your weight loss goal while strengthening your muscles and reducing pain.

Working with a Physical Therapist

A physical therapist can design a regimen that helps you reduce pain and strengthen the key muscles that affect your knees. They can work with you to make sure you’re doing exercises correctly. Your physical therapist may apply ice and heat or use transcutaneous electrical nerve stimulation (TENS) or ultrasound imaging. These and other therapies can increase your cutaneous blood flow.

Knee Injections (Hyaluronic Acid)

Knee injections of hyaluronic acid lubricate the knee and act as shock absorbers. They help the cartilage and bone tissues slide more smoothly in the joint. The technique helps reduce pain and improve knee mobility. Potential side effects include additional swelling and pain. You may have an allergic reaction if you’re already allergic to eggs or poultry.

Medication or Cortisone Shots

Medication, including over-the-counter pain relievers and topical creams with the numbing agents lidocaine or Marcaine, may help control your knee pain. Your doctor might also recommend an injection of either steroids or cortisone.

The steroids are injected at the site of inflammation. They mimic naturally occurring hormones in your body. Cortisone injections usually work to relieve pain within a few days and last several weeks.

Side effects include:

  • temporary increased pain
  • whitening of the skin
  • allergic reaction
  • infection


This ancient Chinese method uses sharp, thin needles to impact nerves and change the flow of energy within the body. Acupuncture has become more popular recently as an alternative treatment for pain. Some studies show that acupuncture can dramatically reduce knee pain for some people. However, a recent study has called acupuncture’s effectiveness for treating knee pain into question.


Prolotherapy is an approach that uses a dextrose solution injected into the ligament or tendon to increase the blood flow and supply of nutrients. The dextrose solution is a sugar mixture. This treatment aims to stimulate the tissue so it will repair itself. The therapy usually requires four to six treatments and with periodic retreatment. It isn’t clear how effective this procedure is. It may be helpful when it’s used with other therapies.

Arthroscopic Surgery

A surgeon may suggest arthroscopic surgery to remove bone fragments or repair tendons and cartilage inside the knee. An arthroscope is a type of camera that allows a surgeon to view the inside of your joint through a small incision. After making two to four incisions, the surgeon uses the arthroscope to operate on the inside of your knee.

This technique is much less invasive than traditional surgery. People mostly go home the same day as their surgery. Within a week, you no longer need crutches and you can drive and resume your daily activities. However, a recent study found “no benefit” to this procedure.

Stem Cells

This experimental treatment uses bone marrow stem cells from the hip to help regenerate cartilage tissue in the knee. A small but growing number of doctors are turning to cutting-edge stem cell therapy as an alterative to knee replacement surgery. One study found that stem cell therapy after knee surgery helped reduce pain and repair the knee.

Knee Osteotomy

People with a knee deformity or damage to only one side of their knee may benefit from an osteotomy. This procedure shifts the weight-bearing load off the damaged area of the knee. However, relatively few people are good candidates for the procedure. Knee osteotomy is usually used for younger patients with limited knee damage.

Weigh Your Options

It’s important to consider all your options and explore alternatives to knee replacement surgery. However, discuss the procedure with your doctor if you’ve exhausted your options or your surgeon feels that your knee requires a total or partial replacement. Delaying a necessary surgery can cause additional long-term problems.