Date Published: Aug 17, 2023

Pain Management (Non-Pharmaceutical)

These pages contain information on pain management options that are directly applied to the knee. Please contact us if there is an option that you want to know about that does not appear here.

Heat and Cold Therapy

There is strong evidence that heat and cold therapies are effective and provide rapid relief from knee arthritis pain and inflammation, although the duration of time for which the relief lasts varies from patient to patient.

Surgery For Pain

Radiofrequency genicular nerve ablation is an emerging therapy for which there is a developing evidence base. This currently consists of case reports, case series and a single randomised trial.


Ultrasound uses sound waves to heat and deliver energy to the structures in the knee joint. Apart from the benefits of heat (see relevant section), the sound waves are thought to create small amounts of trauma at the cellular level, stimulating a healing response.

TENS Therapy

A TENS machine is a small electronic device that sends pulses to the nerve endings via pads placed on the skin of the knee. The device produces a tingling sensation which is thought to modify the pain messages sent to the brain.


Acupuncture is part of traditional Chinese medicine, and involves inserting fine needles into to specific acupuncture points around your knee and body. For painful conditions, sometimes electrical stimulation of these needles is used.

Capsaicin Cream

Capsaicin is the ingredient found in different types of hot peppers, such as chillies and cayenne peppers, that makes them spicy and hot. It is available as a dietary supplement and in topical creams that you apply to your skin.

The Psychology of Pain

Have you ever noticed that two people can have the same injury, but react differently to it? That is because the way their mind processes pain signals is different, giving us a clue on how we might better manage pain.

Topical Non-Steroidal Anti-Inflammatories (NSAIDS)

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are applied to unbroken skin where it hurts in the form of a gel, cream, or spray.  Topical NSAIDs penetrate the skin, enter tissues or joints, and reduce pain by blocking the production of prostaglandins. Drug levels in the blood with topical NSAIDs are very much lower than with the same drug taken by mouth. This minimises the risk of harmful effects.

Mahima Kalra
Aug 23, 2023

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