Knee pain is one of the most common reasons adults visit an orthopaedic clinic, and surgery is far less often the right answer than patients expect.
For mild to moderate osteoarthritis and most non-traumatic knee pain, the first-line treatments with the strongest evidence are exercise and weight management. Strengthening the quadriceps and the muscles around the hip significantly reduces the load placed on the knee joint with every step.
Physiotherapy-guided exercise programmes consistently outperform rest for long-term outcomes. Pain during movement can feel like a signal to stop moving, but gentle, progressive activity is usually part of the recovery.
Anti-inflammatory medications can help manage acute flares but should not become the primary long-term strategy. They address the symptom, not the underlying mechanics.
Injections — corticosteroid or hyaluronic acid — are sometimes useful for short-term relief, particularly before a patient can tolerate exercise. But the evidence for repeated injections over years is much weaker than is often assumed.
Surgery is appropriate for specific structural problems such as a torn meniscus with locking, or advanced arthritis where function is severely limited despite optimal non-surgical management. For most people with aching knee pain, the conversation about surgery comes too early.