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Knee Osteoarthritis

Knee arthritis wears away the cartilage that cushions the joint. Remix Medical's Houston pain physicians offer knee injections, viscosupplementation, and genicular nerve ablation — without surgery.

The knee carries several times your body weight with every step, and it does so through a joint with a demanding geometry and a poor blood supply to its cartilage. It is the joint most likely to wear out, and the one that most reliably shrinks a person's world when it does. At Remix Medical in Houston, our pain management physicians offer a full ladder of non-surgical options for knee arthritis.

What is Knee Osteoarthritis?

Knee osteoarthritis is the degeneration of cartilage within one or more of the knee's three compartments — medial, lateral, and patellofemoral. As cartilage thins, bone contacts bone, the joint lining inflames, and osteophytes form at the margins.

The medial compartment is most commonly affected, which is why many patients develop a progressively bowed alignment as the disease advances.

Common Causes of Knee Arthritis

1. Prior Meniscal or Ligament Injury

A torn ACL or meniscus, even one repaired successfully, markedly increases the risk of arthritis in that knee years later.

2. Body Weight

Each additional pound translates to several pounds of force across the knee during gait. Weight change is one of the few interventions that modifies the disease rather than the symptom.

3. Malalignment

Varus (bowed) or valgus (knock-kneed) alignment overloads one compartment.

4. Occupational and Athletic Load

Repetitive kneeling, squatting, stair climbing, and high-impact sport.

5. Age and Genetics

Both substantially increase risk, and neither is modifiable.

How Remix Medical Can Help

Weight-bearing X-rays reveal joint space narrowing and alignment. MRI is reserved for cases where a meniscal tear or other soft-tissue problem is suspected alongside the arthritis.

The gap between anti-inflammatories and joint replacement is wide, and it is where most of interventional pain medicine lives.

ApproachWhat it involves
Weight management + physical therapyQuadriceps and hip abductor strengthening, with weight change one of the few interventions that modifies the disease rather than the symptom
Medication managementAnti-inflammatories and topical agents, with dosing coordinated against your kidney function
Image-guided corticosteroid injectionDelivered into the joint for inflammation and effusion during flares
ViscosupplementationHyaluronic acid to improve lubrication and shock absorption, as a single or three-injection series
Platelet-rich plasma (PRP)For selected patients with early to moderate disease
Genicular nerve radiofrequency ablationInterrupts the sensory nerves carrying pain from the knee, commonly giving six to twelve months of relief — particularly valuable for patients who aren't surgical candidates or want to defer replacement
Arthroplasty referralTotal or partial knee replacement for advanced arthritis that limits walking, stairs, or sleep

Signs & symptoms

Signs and symptoms to watch for

  • Pain with weight-bearing, stairs, and standing from a chair
  • Stiffness after sitting, easing after a few minutes of movement
  • Swelling, warmth, or a sense of fullness in the knee
  • Grinding or crunching (crepitus) with bending
  • Buckling or a feeling that the knee may give way
  • Difficulty fully straightening or fully bending the knee
  • Night pain in advanced disease

When to see a specialist

Should you see a specialist?

See a pain specialist if knee pain limits walking, stairs, or sleep, if the knee buckles, or if injections from another provider have stopped working. A knee that is suddenly hot, red, and swollen with fever needs urgent evaluation for infection.

Treatment options

Possible treatments

Frequently asked

Knee Osteoarthritis questions, answered

What are the first signs of knee arthritis?

Early signs are stiffness after sitting or in the morning, aching with activity that eases with rest, and occasional swelling. Many people notice it going up and down stairs first.

What is the best treatment for knee arthritis?

The most effective long-term steps are weight management and physical therapy, supported by anti-inflammatory medicines. Injections help flares, and joint replacement is reserved for advanced disease.

Do knee injections work for arthritis?

They can. A steroid injection calms a painful flare, and viscosupplement or PRP injections may help selected patients. They work best paired with exercise, not on their own.

Can knee osteoarthritis be reversed?

The cartilage loss can't be reversed, but the pain and progression can be managed well. Weight control and strengthening the muscles around the knee often reduce symptoms substantially.

Should I keep walking with knee arthritis?

Yes, staying active is one of the best things for it, since motion nourishes the joint and strengthens support muscles. Choose low-impact activity and build up gradually.

Can I keep playing pickleball with knee arthritis?

Many people with knee arthritis can continue playing with the right mix of strength work, load management, footwear, recovery, and treatment. An evaluation is worthwhile if pain limits stairs, walking, sleep, or play, or if the knee swells, locks, or gives way.

What is genicular nerve ablation?

Radiofrequency ablation interrupts the sensory (genicular) nerves that carry pain from the knee, commonly giving six to twelve months of relief. It's especially valuable for patients who aren't surgical candidates or want to defer replacement.

Do I need an MRI for knee arthritis?

Usually not. Weight-bearing X-rays show joint-space narrowing and alignment. MRI is reserved for when a meniscal tear or other soft-tissue problem is suspected alongside the arthritis.

When should I consider knee replacement?

For advanced arthritis that limits walking, stairs, or sleep and no longer responds to conservative care. Total or partial replacement is highly effective when indicated — but a wide range of non-surgical options exists before that point.

When is knee pain urgent?

A knee that's suddenly hot, red, and swollen with fever can signal infection and needs prompt evaluation. Locking, giving way, or inability to bear weight after injury should also be assessed.

Sources

References

  1. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res 2020;72(2):149–162 — https://doi.org/10.1002/acr.24131
  2. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage 2019;27(11):1578–1589 — https://doi.org/10.1016/j.joca.2019.06.011
  3. U.S. Department of Veterans Affairs/Department of Defense. VA/DoD Clinical Practice Guideline for the Non-Surgical Management of Hip and Knee Osteoarthritis (2020) — https://www.healthquality.va.gov/guidelines/CD/OA/
  4. American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty), 3rd Edition Clinical Practice Guideline (2021) — https://www.aaos.org/oak3cpg
  5. Sen R, Hurley JA. Osteoarthritis. StatPearls. NCBI Bookshelf — https://www.ncbi.nlm.nih.gov/books/NBK482326/
  6. National Institute of Arthritis and Musculoskeletal and Skin Diseases: Osteoarthritis — https://www.niams.nih.gov/health-topics/osteoarthritis

Your care team

Clinicians who treat this.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Everald Manning, MD

    Everald Manning, MD

    Family Practice & Primary Care Physician

    4.6 · 178 Google reviews

    Accepting New Patients

  • Raju Mantena, DO

    Raju Mantena, DO

    Pain Medicine Physician

    4.8 · 118 Google reviews

    Accepting New Patients

SpecialtyPain ManagementICD-10 codeM17.9Associated anatomyKnee joint, articular cartilage, medial compartment, meniscus, genicular nerves, patellofemoral joint

Also called Knee Arthritis, Knee Osteoarthrosis, Degenerative Knee Disease, Wear-and-Tear Knee Arthritis, Gonarthrosis

This page is for general education and is not a substitute for medical advice from your physician. Contact a Remix Medical clinician about your specific situation.

Updated July 31, 2026. Medically reviewed by Raju Mantena, DO.

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