Knee Pain: Causes, Treatment Options, and Chiropractic Care in Pearland

Q: Can a chiropractor help with knee pain?

Yes. In the *Annals of Internal Medicine* trial, hands-on care combined with exercise "yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention." A chiropractic systematic review in JMPT rated the evidence fair for short-term treatment of knee osteoarthritis and patellofemoral pain syndrome. At Premier, care follows the Premier Method: we evaluate all seven components behind knee pain and address every one we find.

Q: Will I need a knee replacement or cortisone injections?

Not necessarily. In the *Annals of Internal Medicine* trial, 5% of patients who received manual therapy and exercise had a knee replacement within a year, compared with 20% of the placebo group. Shockwave therapy and MLS laser therapy give us two more non-surgical options for an arthritic knee, and the research on both is described above. Injections and surgery have their place, and if your exam points to something that needs a medical or surgical opinion, we will tell you and help you get to the right provider.

A sore knee has a way of shrinking your world. Stairs become something to plan around. Getting up from a chair takes a second longer than it used to, and the first few steps are stiff. A lot of people put up with it for months before they ask for help, because they assume knee pain is just part of getting older or part of being active.

By the time most people call us, they have already been searching. "Why does my knee hurt when I climb stairs?" "Knee pain without injury." "Is my knee pain arthritis?" "Can a chiropractor help with knee pain?" "Chiropractor for knee pain near me." Knee pain is one of the conditions we care for at Premier Chiropractic, for patients from across Pearland, Friendswood, Manvel, Alvin, and Shadow Creek Ranch. This guide explains what causes knee pain, what the research shows about hands-on, non-surgical care for it, and what to expect from knee pain treatment at Premier Chiropractic in Pearland.

What is knee pain?

The knee is the largest joint in the body, and it does a hard job. It carries your weight, bends thousands of times a day, and has to be stable enough to land on and loose enough to squat with. Two long bones meet there, cushioned by cartilage and two shock-absorbing pads called menisci, held together by ligaments, and moved by the big muscles of the thigh. The hip above and the ankle below decide how the knee is loaded with every step.

Knee pain can feel like a deep ache after a long day, a sharp catch going down stairs, stiffness after sitting, swelling, or a knee that feels like it might give way. A chiropractic clinical practice guideline published in 2020 listed osteoarthritis of the knee and hip among five of the most common chronic musculoskeletal pain conditions, alongside low back pain, neck pain, tension headache, and fibromyalgia (Hawk et al., 2020).

Most knee pain is mechanical. It comes from how the joint, the kneecap, the muscles, and the joints above and below are moving and sharing the load. That is the kind of problem chiropractors are trained to evaluate and care for.

What causes knee pain?

Knee pain usually involves more than one structure, and the knee is often where the pain shows up rather than where the problem started. Common causes include:

Knee osteoarthritis: The cartilage that cushions the joint wears over time, and the joint gets stiff, achy, and sometimes swollen. It is a common reason for knee pain after 50, and it tends to be worst first thing in the morning and after sitting.

Runner's knee and jumper's knee: Pain around or under the kneecap (patellofemoral pain) shows up with stairs, squats, and long sits. Pain just below the kneecap (patellar tendinitis) comes with jumping and running.

Meniscus and ligament injuries: A twist with the foot planted, a hard landing, or a collision can tear a meniscus or sprain a ligament. Clues include swelling, catching, locking, or a knee that gives way.

Bursitis and tendon irritation: The small fluid sacs that cushion the knee, and the tendons around it, can get inflamed from kneeling, overuse, or a direct blow.

The hip, the foot, and the lower back: Weak or stiff hips, flat or rolling feet, and a lower back that is not moving well all change how the knee tracks and how much load it takes. The nerves that run the leg leave the spine in the lower back, so a back problem can send pain into the knee. See our hip pain care page and our article on lower back pain.

Overuse, sudden changes, and injuries: A new running plan, a new job on your feet, or a pickleball habit can ask more of a knee than it is ready for. Falls, sports, and car accidents can damage the knee even when the first X-ray looks normal. If your knee pain started after a collision, see our auto accident care page.

A thorough exam is how you find out which of these is behind your knee pain.

What the research says about chiropractic care for knee pain

Chiropractic research started with the spine, and the knee studies came later. They point the same direction: hands-on care, combined with exercise, helps people with knee pain move better and hurt less, and it may keep some of them out of surgery.

In a randomized trial published in Annals of Internal Medicine, hands-on care plus exercise improved walking and function, and fewer patients went on to knee replacement.* Researchers studied 83 patients with osteoarthritis of the knee. The treatment group "received manual therapy, applied to the knee as well as to the lumbar spine, hip, and ankle as required," and did a standardized knee exercise program in the clinic and at home. The comparison group received a placebo treatment. "By 8 weeks, average 6-minute walk distances had improved by 13.1% and WOMAC scores had improved by 55.8%" over baseline in the treatment group. WOMAC is a standard questionnaire that scores knee pain, stiffness, and function. A year later, "20% of patients in the placebo group and 5% of patients in the treatment group had undergone knee arthroplasty," which is knee replacement surgery. The authors concluded that this combination "yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention" (Deyle et al., 2000). That trial tested manual physical therapy rather than chiropractic care, and the result still matters here: the lower back, hip, and ankle were treated along with the knee. The knee does not work alone.

A follow-up trial found that hands-on care in the clinic roughly doubled the improvement from home exercise alone. The same research group compared 134 patients with knee osteoarthritis who either received supervised exercise, individualized manual therapy, and a home exercise program in the clinic, or received the same home exercise program with one clinic check-in. "By 4 weeks, WOMAC scores had improved by 52% in the clinic treatment group and by 26% in the home exercise group." The authors concluded that "Adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief" (Deyle et al., Physical Therapy, 2005).

A chiropractic systematic review rated the evidence "fair" for knee osteoarthritis and runner's knee. Chiropractic researchers reviewed 48 clinical trials of manipulative therapy for conditions of the hip, knee, ankle, and foot in the Journal of Manipulative and Physiological Therapeutics (JMPT). They reported "a level of B for short-term and C for long-term treatment of knee osteoarthritis, patellofemoral pain syndrome, and ankle inversion sprain," where B means fair evidence and C means limited evidence, and the same B level for short-term treatment of hip osteoarthritis (Brantingham et al., JMPT, 2012).

A chiropractic trial of a hands-on knee protocol reduced arthritis pain in two weeks. In a randomized controlled trial published in the Journal of the Canadian Chiropractic Association, a team from the Department of Health and Chiropractic at Macquarie University in Australia studied 43 participants, aged 47 to 70, with chronic osteoarthritic knee pain. After two weeks, "the intervention group reported a significant decrease in the present pain severity (mean 1.9) when compared to the control group (mean 3.1)" on a visual analogue pain scale. The authors concluded that "A short-term manual therapy knee protocol significantly reduced pain suffered by participants with osteoarthritic knee pain and resulted in improvements in self-reported knee function immediately after the end of the 2 week treatment period," and they reported no adverse reactions in the treatment group (Pollard et al., 2008).

A chiropractic clinical practice guideline recommends it. The 2020 guideline mentioned above was built by a 62-member expert panel using a formal consensus process. For knee osteoarthritis it names exercise and manual therapy among the interventions to consider, and it says imaging is not required for a typical presentation (Hawk et al., 2020).

Injections and surgery have their place, and when an exam shows that a patient needs a medical or surgical opinion, we say so. The research above supports starting with conservative, hands-on care.

The Premier Method for knee pain: why an adjustment alone is not enough

A lot of knee pain care addresses one cause of the problem, or two or three. Treating the knee itself is one of them, and it matters. But the knee sits between the hip and the ankle, it takes its orders from the muscles of the thigh and hip, and the nerves that run it leave the spine in the lower back. More than 30 years of outcome assessments on our own patients have taught us that there are seven components behind a spine losing its health, and that getting results means addressing all of them, not some of them.

That is the Premier Method. It is not only an exam, and it is not a single treatment. It is how we care for knee pain from start to finish: every patient is evaluated for all seven components, and every one that is part of that patient's knee pain is addressed, in the right order. Not every patient has all seven, which is why two people with the same achy knee can need very different plans. What does not change is that nothing we find is left unaddressed. In our experience, that is why patients get better faster and stay better longer. We apply the same approach to every condition we specialize in, and knee pain is one of them.

What happens during a knee pain evaluation at Premier?

Your plan starts with the exam, not a template. The evaluation is the first step of the Premier Method, not the whole of it. We evaluate all seven components, find the ones behind your knee pain, and explain what we found and what it will take to address them. Then the care begins.

Come with two or three goals. "I want to take the stairs at work without holding the rail." "I want to get back to my morning walks around the lake." "I want to kneel in the garden again." Goals like these let us measure your progress in terms that matter to you.

Knee pain treatment at Premier: addressing every cause, not just one

Chiropractic care for knee pain at Premier follows the Premier Method. Your plan addresses every component your evaluation found, in the right order, instead of treating one and leaving the others alone.

Two of the tools we use for knees deserve a word of their own, because patients ask about them by name and because the research behind them is strong: shockwave therapy and MLS laser therapy.

Shockwave therapy for knee pain

Shockwave therapy (extracorporeal shock wave therapy, or ESWT) sends acoustic pulses into painful tissue to stimulate it to heal. A session takes a few minutes, and there is no needle and no downtime. We use it at Premier for arthritic knees and for the stubborn tendon problems around the knee that have not settled on their own.

A 2019 systematic review and meta-analysis in Clinical Rehabilitation pooled 50 randomized trials with 4,844 patients who had knee osteoarthritis. Shockwave therapy produced significantly less pain and significantly better function on the WOMAC scale than the comparison groups, and the authors' conclusion was plain: "Shockwave therapy is beneficial for knee osteoarthritis." They also noted that the energy level and the length of the course of treatment may affect how well it works, which is why the settings are chosen for your knee, not pulled from a chart (Liao et al., 2019).

MLS laser therapy (cold laser) for knee pain

MLS laser therapy uses light energy to calm inflammation and ease pain in the tissue under the skin. Treatment is painless, takes minutes, and has no downtime. Most of the research on therapeutic laser for the knee has tested low-level laser therapy, often called cold laser; MLS laser is the therapeutic laser we use at Premier.

A systematic review and meta-analysis in BMJ Open combined 22 randomized, placebo-controlled trials with 1,063 participants who had knee osteoarthritis. When the laser was used at the recommended doses, "pain was significantly reduced by the recommended LLLT doses compared with placebo at the end of therapy," the benefit was largest two to four weeks after the course of treatment ended, and "Disability was also statistically significantly reduced by LLLT." The authors added that "No adverse events were reported" (Stausholm et al., 2019). The 2020 chiropractic clinical practice guideline mentioned above also lists low-level laser therapy among the interventions to consider for knee osteoarthritis (Hawk et al., 2020).

Shockwave and laser are tools, not the plan. They are used when your evaluation shows they fit, alongside the hands-on care the research above supports. We re-examine along the way, measure your progress against the goals you gave us, and adjust the plan if you are not progressing the way we expect.

Why Pearland patients choose Premier for knee pain

If you are searching for a chiropractor for knee pain near you in Pearland, here is what you can expect from us:

The Premier Method. We evaluate all seven components behind knee pain and address every one we find, not just one or two.

Two Pearland offices. Old Town Pearland on E Broadway and Town Center Pearland on Broadway near Pearland Town Center, so patients from Shadow Creek Ranch, Silverlake, Southdown, Southern Trails, Friendswood, Manvel, and Alvin have a location close by.

Same-day appointments. Available at both offices, so a knee that swelled up after the weekend does not have to wait.

One plan, in our own offices. Your Premier Method plan for knee pain is carried out at Premier, not split across referrals to several different offices.

Experience. Dr. James D. Parsons has more than 30 years of experience caring for patients in Pearland, and the Premier Method is built on what those outcomes have taught us.

Bilingual care. Hablamos español at both locations.

Coverage. We work with Medicare, VA authorizations, and most major insurance plans, and we will check your benefits before your first visit.

Practical self-care tips for knee pain

Keep walking. A knee that is rested completely tends to stiffen, and the muscles around it weaken. Short, regular walks on level ground are usually better than none.

Mind the stairs. Lead with the stronger leg going up and the sore leg going down, and use the rail. It takes load off the painful side.

Sit less, stand more often. Knees stiffen when they stay bent. Straighten your legs and stand up every half hour, especially at a desk or on a long drive.

Check your shoes. Worn-out or flat shoes change how the foot lands and how the knee lines up. Replace running shoes that have lost their cushion.

Ease into new activity. Build up running, pickleball, and yard work over a few weeks instead of a weekend, and warm up first.

Follow your plan. What we give you to do at home is chosen for your knee. Ask before adding exercises you found online.

When knee pain needs emergency care

Chiropractors are trained to recognize the rare cases that need a different kind of help, and screening for them is part of every knee pain exam. Go to the emergency room or call 911 if you have:

A knee that is hot, red, and swollen, with fever or chills

A knee that looks deformed after a fall or collision, or a leg you cannot put weight on

Sudden severe swelling with a pop at the moment of injury

Calf pain, swelling, or warmth below the knee, especially with shortness of breath or chest pain

Numbness, a cold foot, or no feeling below the knee after an injury

These signs are uncommon, but they call for immediate medical evaluation.

Knee pain: frequently asked questions

Can a chiropractor help with knee pain?

Yes. In the Annals of Internal Medicine trial, hands-on care combined with exercise "yields functional benefits for patients with osteoarthritis of the knee and may delay or prevent the need for surgical intervention." A chiropractic systematic review in JMPT rated the evidence fair for short-term treatment of knee osteoarthritis and patellofemoral pain syndrome. At Premier, care follows the Premier Method: we evaluate all seven components behind knee pain and address every one we find.

Why does my knee hurt when I climb stairs or squat?

Stairs and squats load the kneecap and the front of the knee far more than walking does. When the kneecap is not tracking well in its groove, or the cartilage behind it is irritated, those movements hurt most, and going down is often worse than going up. A knee pain exam at Premier Chiropractic in Pearland sorts out whether the problem is the kneecap, the joint itself, or the hip and foot that control how the knee lines up.

Is my knee pain coming from my hip or my back?

It can be. Weak or stiff hips change how the thigh bone sits over the knee, and the nerves that serve the knee leave the spine in the lower back. Clues include knee pain with no injury and no swelling, or pain that changes when you move your hip or back. That is one reason we evaluate the whole chain and not just the sore spot.

How long does knee pain take to get better?

It depends on the cause and how long it has been building. In the chiropractic trial above, patients with chronic arthritic knee pain reported significantly less pain after two weeks of care. In the Annals of Internal Medicine trial, patients had improved walking distance and function at eight weeks and were still improved a year later. A knee that has been wearing for years takes longer than one that flared up last month. We re-examine along the way so you can see your progress.

Will I need a knee replacement or cortisone injections?

Not necessarily. In the Annals of Internal Medicine trial, 5% of patients who received manual therapy and exercise had a knee replacement within a year, compared with 20% of the placebo group. Shockwave therapy and MLS laser therapy give us two more non-surgical options for an arthritic knee, and the research on both is described above. Injections and surgery have their place, and if your exam points to something that needs a medical or surgical opinion, we will tell you and help you get to the right provider.

Where can I find a chiropractor for knee pain near me in Pearland?

Premier Chiropractic has two Pearland locations: Old Town Pearland at 2018 E Broadway St and Town Center Pearland at 11470 Broadway St #110. Both offer same-day knee pain appointments and serve patients from Pearland, Shadow Creek Ranch, Silverlake, Southdown, Southern Trails, Friendswood, Manvel, and Alvin. Call (281) 485-2955 for Old Town or (281) 741-1409 for Town Center, or schedule online.

Knee pain care at Premier Chiropractic in Pearland

You do not have to keep planning your day around a knee that hurts, and you do not have to start with pills, injections, or a surgical consult. Learn more on our knee pain care page and our arthritis care page, then choose the location that works for you:

Old Town Pearland: 2018 E Broadway St, Pearland, TX 77581. Call (281) 485-2955.

Town Center Pearland: 11470 Broadway St #110, Pearland, TX 77584. Call (281) 741-1409.

Schedule your knee pain evaluation online or contact Premier Chiropractic with your questions. Bring your goals. We will evaluate all seven components, address the ones behind your knee pain, and give you a clear plan to get back to your life.

References

1. Hawk C, Whalen W, Farabaugh RJ, et al. Best practices for chiropractic management of patients with chronic musculoskeletal pain: a clinical practice guideline. J Altern Complement Med. 2020;26(10):884-901.

2. Deyle GD, Henderson NE, Matekel RL, Ryder MG, Garber MB, Allison SC. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2000;132(3):173-181.

3. Deyle GD, Allison SC, Matekel RL, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85(12):1301-1317.

4. Brantingham JW, Bonnefin D, Perle SM, et al. Manipulative therapy for lower extremity conditions: update of a literature review. J Manipulative Physiol Ther. 2012;35(2):127-166.

5. Pollard H, Ward G, Hoskins W, Hardy K. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. J Can Chiropr Assoc. 2008;52(4):229-242.

6. Liao CD, Tsauo JY, Liou TH, Chen HC, Huang SW. Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials. Clin Rehabil. 2019;33(9):1419-1430.

7. Stausholm MB, Naterstad IF, Joensen J, et al. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2019;9(10):e031142.

This article is for educational purposes and is not a substitute for an examination by a licensed healthcare provider.