Different stages of getting Knee Pain

Knee pain is one of the common problems facing by many people that can develop due to the damage in any of the bones making up the knee or the kneecap or the muscles and ligaments of the knee. Any physical activity that strains your knee may aggravate knee pain. Obesity, Arthritis, trauma and some problems can also trigger knee pain. People of any age can be a victim of knee pain, and home remedies can provide relief as long as the pain does not become severe.

Facts you should know about knee pain

  • There are a variety of causes of knee pain, including acute injuries and medical conditions.
  • Knee pain can be restricted to a particular part of the knee, or it can occur all over the knee.
  • Physical restrictions are often associated with knee pain.
  • Knee pain is usually diagnosed through a thorough physical examination.
  • In order to treat knee pain, one must identify the underlying cause.
  • Severe knee pain is sometimes treated with surgery or other procedures.

Arthritis is one of the leading causes of joint problems in the world. And your knee is the first joint to be affected by Arthritis. It is well known that knee arthritis causes knee pain and, as it progresses, it may lead to disability. Osteoarthritis is a condition that results from cartilage degeneration which is caused by wear and tear. As the knees bear most of our body’s weight, osteoarthritis of the knee is a common problem.

Knee pain due to osteoarthritis (OA) is classified into various stages, starting from normal or minor pain to severe or advanced stage.

Stage 1 – Minor

Patients with arthritis tend to develop minor wear and tear and bone spurs along the ends of their knees. At this stage, a patient may experience minor or no pain & discomfort.


Orthopedic doctors usually prescribe treatment for stage 1 if there is any genetic predisposition to osteoarthritis. In addition, chondroitin and glucosamine supplements may be suggested by the doctor. An active lifestyle such as regular exercise and a good diet can also prove helpful.

Stage 2 – Mild

In this stage, the growth of bone spur increases, resulting in joint pain even though the distance between the bones appears to be normal. In most cases, it is normal to feel stiff and uncomfortable surrounding the knee joint. Especially if you sit for a long time and when you wake up in the morning or after working out. Although the cartilage and soft tissues are in good condition, the cartilage matrix is being degraded due to the increased production of enzymes, like metalloproteinases.


In the early stages of OA, it is easy to prevent the disease from progressing by following a treatment regimen. A variety of therapies are available that help to relieve the pain and discomfort caused by this mild stage of the disease. In addition, most of the patients are instructed to follow a strict exercise program to improve strength and joint stability. To protect the knee from stress, protective gears like braces, knee supports, and shoes may also be used.

Stage 3 – Moderate

In this moderate stage, the cartilage around the bones is eroded, and the space between the bones is narrowed due to inflammation. As the disease progresses, the fragments of proteoglycan and collagen are discharged into the synovial fluid, which leads to the development of bone spurs at the joints as the surface becomes more rough.

When osteoarthritis of the knee becomes advanced, the joint becomes inflamed and painful while walking, running, squatting, extending or kneeling. Along with joint stiffness, you may notice popping or snapping sounds when you wake up and walk in the morning. 


Initially, NSAIDs or pain-relief treatments might be recommended. When they fail to resolve the problem, an orthopedic specialist suggests taking stronger painkillers like codeine and oxycodone.

In some cases, intra-articular injections of hyaluronic acid are directly injected into the knee joint. Moderate knee arthritis may require three to five hyaluronic acid injections within 3-5 weeks’ time. The effects of the treatment usually take a few weeks to show, and pain relief usually lasts around six months.

Stage 4 – Severe

At this stage, the condition is considered severe. The condition progresses as the space between the bones in the knee joint narrows. It leads to cartilage erosion which eventually develops stiffness in the joint. When cartilage breaks down, it causes chronic inflammation and a reduction in synovial fluid causes friction, increased pain, and discomfort during joint movement.

The soft tissue around the knee is damaged as the production of synovial metalloproteinases, cytokines and TNF is increased and diffuses back into the cartilage. In its advanced stages, the disease causes the further formation of spurs, which causes a great deal of pain, making it difficult to perform daily activities such as walking and climbing stairs.


When knee osteoarthritis becomes severe, knee osteotomy or bone realignment surgery is one treatment option. The procedure helps to relieve stress on the knee joint as the orthopedic surgeon shortens the length and realigns it by trimming the bone above or below in the knee. 

The surgery works by redirecting the body’s weight away from the place where the bone spur grows, and fractures occur, which eventually protects the knee joint.

Total knee replacement, also known as arthroplasty, is another surgical treatment option. This procedure involves removing the damaged knee joint and replacing it with an artificial joint made of plastic or metal. It takes several weeks to recover from the surgery completely, so patients need to be patient and disciplined. However, with regular physical and occupational therapies, one can regain the full functions of the knee.

If you are suffering from knee pain, contact Dr. Ajay Kumar Tiwary to receive a proper diagnosis and treatment plan. He has more than a decade of experience in treating all kinds of knee problems, including knee replacement surgery. Call +91 98499 82203 to book an appointment with the doctor.


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