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Knee pain – comprehensive physiotherapy treatment
Our mildly overweight patient came to us with knee pain that had appeared a few months earlier. Although the intensity of the pain varied, it increasingly interfered with daily activities.
A large proportion of knee pain is caused by degenerative wear of the joint. This process eventually affects everyone, and its first common symptom is pain—typically triggered by load or movement and easing when the joint is rested. Many people recognise the so-called start-up pain: after prolonged sitting or lying down, the first few steps are painful. If the pain wakes the patient at night, inflammatory complications are likely in the background. Osteoarthritic knee pain usually has a fluctuating course.
The knee is the body’s largest weight-bearing joint. With every step, a force several times our body weight loads it. There is a clear link between body weight and knee pain: the greater the weight, the greater the pressure on the cartilage surfaces of the joint. Beyond mechanical overload, excess body fat also produces inflammatory substances (adipokines), which are thought to contribute to joint degeneration. Once destructive processes begin, instability develops, and the surrounding tendons and ligaments may stretch—making early, targeted therapy essential to prevent further deterioration.
Our patient received a comprehensive treatment plan. The most important element was specialised movement therapy to preserve knee health. One of the gentlest and most enjoyable methods is therapeutic exercise in thermal water. The pleasantly warm water relaxes the muscles, tendons, and ligaments around the joint, allowing a wider, less painful range of motion.
To stimulate joint metabolism, we applied mud packs and underwater jet massage, the latter providing thorough mechanical stimulation to the lower limbs and boosting circulation. Once blood flow around the joint improved, knee stiffness gradually decreased and we could introduce land-based physiotherapy. At this stage, movement becomes easier and less painful, and exercise plays a crucial role in restoring knee stability and load-bearing capacity.
For major joints, sonophoresis—a form of ultrasound therapy—can also be beneficial, during which an anti-inflammatory, pain-relieving ointment is applied under the ultrasound head to enhance its absorption through the skin.
Our patient reported significant improvement and learned a personalised exercise routine that they now perform regularly at home to maintain the positive results.
