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Living with knee osteoarthritis can be frustrating and painful. If you’re in Canada, you’re not alone – osteoarthritis affects about 1 in 8 Canadians, and the knee is one of the most commonly affected joints. You might be dealing with daily knee pain, stiffness in the morning, or swelling after activity. You’ve likely tried the usual advice: rest, ice, painkillers, maybe a brace or a supplement. Yet the pain persists. We understand how discouraging this can be – the aches that limit your walks, the crunching feeling climbing stairs, the worry that it will only get worse.
Empathy is at the heart of our approach. At Unpain Clinic, many of us are clinicians and also former pain sufferers. We know knee osteoarthritis isn’t just “wear and tear” – it’s a condition that affects your mobility, mood, and independence. The good news is, there are evidence-based treatments that can bring you relief and help you stay active. In this post, we’ll break down what knee osteoarthritis is, why it hurts, and what actually helps – from supplements and braces to exercises and advanced therapies. We’ll also share how our clinic’s whole-body approach (including shockwave therapy, EMTT, and more) aims to address not just where it hurts, but why it hurts. (As always, keep in mind: results may vary; always consult a healthcare provider for personalized advice.)
Knee osteoarthritis (OA) is a degenerative joint condition – essentially the wearing down of cartilage (the cushioning surface) in your knee joint. Over time, as cartilage thins, the bones in the knee (femur, tibia, and patella) can rub more closely together, causing pain and inflammation. The body may respond by growing bone spurs (osteophytes) and the joint lining can get irritated, leading to fluid buildup (effusion, or swelling). The classic symptoms of knee OA include joint pain, stiffness (especially in the morning or after sitting), a crunching or grating sensation, and sometimes visible swelling around the knee. In fact, inflammation and knee joint swelling are common in knee OA due to irritation of the joint tissues.
But why does the pain often persist or worsen over time? Knee OA isn’t just about aging or “worn-out” cartilage – there are usually multiple factors at play:
Biomechanical stress: The knee is a hinge joint with relatively limited motion. If other parts of your body (like your hips, ankles, or feet) aren’t moving well, the knee ends up taking extra load. Over years, poor alignment or gait can accelerate wear and tear. For example, weak hip muscles or flat feet can increase the strain on the inner knee, worsening arthritis in that compartment.
Muscle weakness & tightness: When knee pain makes you less active, muscles like the quadriceps (front of thigh) tend to weaken. This creates a vicious cycle – weaker muscles lead to less support for the knee, which leads to more pain. Tight muscles (hamstrings, calves) can also alter knee mechanics and contribute to pain.
Inflammation: Osteoarthritis is not as inflammatory as rheumatoid arthritis, but there is still a low-level inflammation process. The injured cartilage releases enzymes and inflammatory proteins that further degrade tissues and cause pain and stiffness.
Weight and metabolic factors: Carrying extra body weight puts higher loads on the knee joint – every additional 10 lbs can feel like 30-40 lbs to your knees during activities. Over years, this accelerates joint stress. Additionally, fat tissue can release inflammatory chemicals that may worsen joint inflammation. It’s a double impact: mechanical and chemical. No wonder obesity is a major risk factor for knee OA progression.
Previous injuries or surgeries: A past meniscus tear or ACL injury in your knee can set the stage for earlier arthritis. Scar tissue or altered movement patterns from an old injury can cause uneven pressure on the knee. Even surgeries can leave behind scar tissue or slight changes in joint mechanics.
Why the pain “sticks around”: Pain from knee OA often becomes chronic because the underlying issues (like movement dysfunctions or metabolic factors) aren’t fully addressed. Many standard treatments focus on symptom relief (like painkillers or steroid injections) but don’t fix the root cause. As a result, you get temporary relief and then the pain returns as you go back to daily activities. Meanwhile, the degenerative process quietly continues.
In summary: Knee osteoarthritis pain persists when we only chase symptoms and not causes. If you’ve been told “it’s just wear and tear, nothing can be done until it’s bad enough for a knee replacement,” it can feel defeating. However, research and clinical experience suggest there is a lot we can do conservatively to reduce pain, improve function, and slow the progression. In the next sections, we’ll explore what studies say actually helps knee osteoarthritis – and how a comprehensive approach can make a real difference.
When it comes to knee osteoarthritis, everyone wants to know: What will actually help me feel better? Let’s break down the main categories of non-surgical treatments – supplements, braces, exercises, and devices – and see what scientific research says about each. (Hint: there’s no magic cure, but there are several tools that can significantly improve your pain and mobility.)
It’s tempting to look for a pill or supplement to fix knee OA. The shelves of pharmacies are full of options like glucosamine, chondroitin, turmeric, collagen, MSM, and more, all claiming to help joint pain. What does the evidence show?
Glucosamine & Chondroitin: These are perhaps the most famous supplements for osteoarthritis. They are natural components of cartilage. Some studies and meta-analyses have found that glucosamine (alone or with chondroitin) can modestly reduce knee pain and improve function compared to placebo. In fact, one large analysis of 54 studies (over 16,000 patients) concluded that glucosamine + chondroitin combined was as effective as the NSAID celecoxib in relieving pain in knee OA, with a better safety profile. There’s also some evidence these supplements might slow joint space narrowing (a measure of cartilage loss) over time. However – and this is important – not all research agrees. Other high-quality trials and guidelines have found glucosamine and chondroitin to be no more effective than placebo for many patients. Organizations like the American Academy of Orthopaedic Surgeons and the American College of Rheumatology do not formally recommend them, because results have been so mixed. The bottom line: Glucosamine and chondroitin may help some people (anecdotally many patients swear by them), but they are not a guaranteed fix. If you do try them, give it a 2-3 month trial to see if your pain improves. They are relatively safe (though can be costly). Always buy from a reputable brand, and check with your doctor, especially if you’re on blood thinners (chondroitin can interact with Warfarin).
Turmeric (Curcumin): Turmeric root, or its active component curcumin, has anti-inflammatory properties and has been studied for joint pain. Good news: turmeric does appear to help reduce arthritis pain in many cases. A 2021 systematic review of randomized trials found that turmeric extracts were more effective than placebo and about as effective as NSAIDs (like ibuprofen) in relieving knee OA pain. Another trial showed a specialized turmeric formulation worked as well as acetaminophen (Tylenol) for knee pain. Turmeric is generally safe, with far fewer side effects than daily NSAIDs – the most common issue is some gastrointestinal upset or heartburn in a minority of users. If you try turmeric, note that curcumin isn’t easily absorbed on its own. Look for formulations with black pepper extract (piperine) or “bioavailable” curcumin complexes, and follow dosing instructions. It may take several weeks to notice an effect.
Other Supplements: Numerous other supplements are marketed for knee OA, though with less evidence. Collagen hydrolysate (a form of collagen protein) has some small studies suggesting it might improve joint pain over a few months – collagen provides amino acids that cartilage uses, but research is still emerging. MSM (methylsulfonylmethane), a sulfur compound, has shown mild pain reduction in some trials, especially when combined with glucosamine. Omega-3 fish oil can have general anti-inflammatory benefits, which might help if you have osteoarthritis and other inflammatory issues, but on its own fish oil isn’t a direct pain reliever for OA (it’s more established for rheumatoid arthritis). Vitamin D – if you are deficient, correcting low vitamin D is important for bone health and muscle function, but taking mega-doses of vitamin D doesn’t seem to reduce OA pain unless you have a deficiency. Always discuss supplements with your healthcare provider, especially if you take other medications, to avoid interactions.
Takeaway: No supplement will cure knee osteoarthritis or magically regrow cartilage. But some supplements (glucosamine/chondroitin, turmeric, etc.) may offer pain relief for certain individuals, and they tend to have a good safety profile. Think of them as one piece of the puzzle – potentially useful for symptom management – but not a standalone solution. And keep your expectations realistic: studies that show benefit typically report moderate pain improvement, not complete pain elimination.
If you have knee OA, you’ve likely seen or tried a knee brace or sleeve. Braces range from simple neoprene sleeves (found at any pharmacy) to more complex offloading braces that have hinges and straps to take pressure off one side of the knee. People often wonder: Do knee braces really help osteoarthritis, or just mask the pain?
Evidence shows that braces can indeed help with knee OA symptoms, especially for arthritis on the inner (medial) side of the knee. A comprehensive 2025 network meta-analysis comparing various treatments found that using a knee brace was the #1 most likely therapy to improve knee OA pain and function scores (even above exercise in that analysis). Knee braces showed the highest probability of improving pain, stiffness, and daily function among multiple non-surgical options studied. Another large study reported that people wearing a knee brace had less pain and better mobility, with an increased ability to do daily activities, compared to those without a brace.
How do braces help? For medial (inner knee) OA, an unloader brace applies a gentle valgus force – essentially pushing the knee a bit outward – which relieves pressure on the worn inner compartment. This can reduce pain, especially during weight-bearing activities like walking. Even a simple soft brace or compression sleeve can improve proprioception (your sense of joint position) and give a feeling of support and warmth, which many find reduces pain and “wobbly” feelings. Braces can also give people more confidence to be active, which is crucial.
That said, braces are not a cure and only work when you’re wearing them (they don’t permanently change the joint). Some people find the bulkier unloaders uncomfortable or inconvenient (they can slip or cause skin irritation). It’s important to have a brace properly fitted and to give yourself time to adjust to it. Also, studies vary: some research shows big improvements, others show more modest or no long-term change in pain. Compliance (using it regularly) is key. Bracing may slow structural progression by reducing joint stress, but this isn’t definitively proven.
Our view: a knee brace is a low-risk, non-drug option worth trying for moderate knee OA. It can be particularly helpful if your pain is mostly on one side of the knee or if you need support during certain activities (like a long walk or exercise session). It’s not a substitute for strengthening and therapy, but rather a helpful assistive device. Think of it as a crutch – useful to offload the joint while you work on the underlying issues.
(Quick tip: If you use a cane for severe knee OA, use it in the opposite hand of the bad knee – this reduces knee load. And don’t be shy to use these supports; they’re there to keep you moving!)
If there’s one intervention virtually every doctor and physiotherapist agrees on for knee osteoarthritis, it’s exercise. Staying active and strengthening the muscles around the knee can significantly reduce pain and improve function – yes, even if you have “bone-on-bone” arthritis. It may sound counterintuitive that moving more helps an arthritic joint, but study after study confirms the benefits of exercise for knee OA.
What kinds of improvements are we talking about? A 2024 Cochrane review (139 trials, ~12,000 people) found low- to moderate-certainty evidence that exercise leads to small-to-moderate improvements in knee pain, physical function, and quality of life in the short term. Patients who exercised were more likely to report meaningful pain relief than those who did minimal care. The effects can be comparable to pain medications – without the side effects. In fact, exercise is so effective that all international guidelines strongly recommend exercise as a first-line treatment for knee OA.
Strength Training: Building up the quadriceps muscle at the front of the thigh is crucial – strong quads better absorb forces on the knee. Exercises like leg raises, wall sits, or weight training can strengthen these muscles and reduce pain. Strengthening the hip muscles (glutes) is also important, since weak hips can cause poor knee alignment. A systematic review found all types of resistance training (like standard gym exercises, isometric exercises, etc.) helped knee OA pain, with some evidence that certain routines may be slightly more effective, but overall the key is to do something consistently.
Aerobic Exercise: Activities that get you moving and your heart rate up – like walking, cycling, swimming, or using an elliptical – are beneficial for knee OA. Aerobic exercise helps with weight control, circulation, and cartilage nutrition (motion nourishes cartilage). A network meta-analysis in the BMJ found that aerobic exercise (like walking programs) was likely the most beneficial exercise modality for knee OA pain and function improvement. Even walking 30 minutes a day (in short bouts if needed) can significantly improve pain over time. If impact is an issue, cycling or pool exercise are great low-impact choices.
Flexibility and Range of Motion: Gentle stretching and range-of-motion exercises help maintain or improve knee mobility. For example, stretches for the hamstrings, calves, and quadriceps can reduce stiffness and improve your ability to straighten and bend the knee. Yoga or Tai Chi have also shown benefits in some studies for knee OA – likely through improving flexibility, strength, and mind-body awareness (plus they can reduce pain perception).
Balance and Neuromuscular Training: Knee OA can affect your balance and how your joints sense movement. Exercises that work on balance (using a balance board or single-leg standing exercises) can improve stability and may reduce fall risk. Some physiotherapy programs include neuromuscular training – basically retraining how you move and improving the control of muscles around the knee.
One of the best things about exercise is that it addresses multiple problems: it strengthens muscles, reduces stiffness, can help with weight management, and even has an anti-inflammatory effect (exercise releases chemicals that fight inflammation). It’s like a powerful medicine with mostly positive side effects.
The challenge: When your knee hurts, exercise can be hard to start. The key is finding the right exercises (often with the help of a physiotherapist) and starting slowly. Even a few minutes a day, consistently, can build up your tolerance. It’s normal for some discomfort to occur when you begin – but pain should remain in a safe range (a good rule: mild to moderate pain that settles within 24 hours is acceptable; sharp or severe pain is not). If you’re not sure what to do, supervised exercise programs or classes (like the GLA:D program for arthritis, available in Canada) can guide you safely.
Fun fact: Exercising and strengthening one leg can even help the other leg – so if one knee is worse, working on your better side or your hips still has benefits for overall function. The body is interconnected!
Finally, don’t fear exercise. Some patients worry that if it hurts, they’re “wearing out” the knee more. Generally, that’s not true for the controlled therapeutic exercises we recommend. Inactivity can be more harmful – it leads to weaker muscles, stiffer joints, and weight gain, all of which worsen knee OA. As one study put it, motion is lotion for the arthritic knee.
Beyond braces, a variety of devices and therapies have been tried for knee osteoarthritis. These include things like TENS units (transcutaneous electrical nerve stimulation), therapeutic ultrasound, low-level laser therapy, shock-absorbing insoles, and hydrotherapy pools. The science here is a bit of a mixed bag – some devices can help with symptom relief, others show minimal benefit. Let’s highlight a few:
TENS (Electrical Stimulation): TENS is a small device that delivers mild electrical currents through sticky pads on your skin. It “tingles” the area and can interfere with pain signals. People can use TENS at home to manage pain episodes. Does it work for knee OA? Some people do report temporary pain relief while the device is on (it’s thought to stimulate nerve fibers that modulate pain). However, clinical trials show mixed results, and any benefit tends to be short-lived (the pain often returns once you turn it off). In the big 2025 analysis we mentioned, TENS was not among the top performers and ranked lower in effectiveness for pain relief. Still, since it’s safe and drug-free, TENS can be a useful tool for short-term relief (for example, before an exercise session to ease pain, or at the end of a long day). Think of it as akin to using ice or heat – it can help symptoms but isn’t disease-modifying.
Ultrasound Therapy: Therapeutic ultrasound (not to be confused with diagnostic ultrasound imaging) uses sound waves to warm deep tissues. It’s commonly used in physical therapy sessions. Unfortunately, research doesn’t show much long-term benefit of ultrasound for knee OA. In fact, that network meta-analysis found ultrasound ranked the worst among treatments for pain and function outcomes. Most guidelines do not recommend routine ultrasound for knee OA because the evidence for pain relief is weak. It likely doesn’t hurt, but time might be better spent on active treatments.
Low-Level Laser (LLLT) and High-Intensity Laser: Laser therapy uses specific wavelengths of light to purportedly reduce inflammation and pain. Some studies on knee OA have shown LLLT can reduce pain and improve function modestly, and high-intensity laser therapy as well. In the 2025 review, HILT (high-intensity laser) was one of the higher-ranked modalities for pain relief (after braces and exercise), and LLLT also showed some benefit especially for pain during activity. These therapies might work by stimulating cellular activity and circulation. The downside is they usually require special equipment and multiple sessions at a clinic, and not all clinics have them. They’re also not a stand-alone solution, but could be a useful adjunct if available.
Hydrotherapy: This simply means exercise or therapy in water (like pool exercise classes). Water’s buoyancy can take load off the knees while still allowing you to move and strengthen. Warm water can also soothe pain. The network analysis found hydrotherapy to be excellent for knee OA – in fact, it had the highest probability of improving overall WOMAC scores (a composite of pain, stiffness, function). This makes sense: many people find they can do exercises in the pool that they struggle with on land. If you have access to a community pool or physiotherapy pool, it’s worth trying aquatic exercise for knee OA, especially if land exercise is too painful.
Insoles and Footwear: What about shoe inserts or specialized footwear? One common idea is using a lateral wedge insole for medial knee OA – this is an insole that’s thicker on the outer edge of your foot, tilting your knee outward slightly to unload the inner knee. Studies on lateral wedges have been surprisingly underwhelming: they do change forces a bit, but haven’t shown significant pain reduction compared to neutral insoles. Some patients feel better with wedges, some don’t – overall they’re not strongly recommended in guidelines. On the other hand, just wearing good, cushioned shoes (or adding shock-absorbing insoles) can make a difference in comfort. Avoiding high heels (which increase knee load) is important. There are also newer “biomechanical” shoes (like those with a slight wobble board built into the sole) that claim to reduce knee pain; evidence is limited, but some individuals report benefit. The key is comfort and support – wear shoes that feel good and stable for you.
Other Modalities: You might encounter or read about other treatments like pulsed electromagnetic field (PEMF) mats, microcurrent stimulation, or even acupuncture. Some people find acupuncture helpful for knee OA pain, and there is evidence it can outperform placebo for short-term relief – however, results vary and it’s typically an adjunct to exercise rather than a replacement. PEMF devices (cousin to EMTT, which we’ll talk about below) deliver electromagnetic waves and some studies show pain improvements, but it’s still a developing area. Overall, these “device-based” therapies can provide additional pain relief for some patients, but the core of managing knee OA remains exercise, weight management, and addressing biomechanical issues.
Important: Many patients ask about injections (like cortisone or viscosupplementation) – while these are medical treatments beyond the scope of this article, we’ll note that cortisone (steroid) injections can provide short-term relief but may have downsides with repeated use (potentially hastening cartilage loss). Gel (hyaluronic acid) injections have mixed evidence; some get relief, others do not – they’re considered “conditional” options by guidelines. Newer injections like PRP (platelet-rich plasma) are being researched, with some promising results, but more evidence is needed and it’s not covered by insurance generally.
In summary, research supports a combination of approaches for knee osteoarthritis. There is no single miracle cure (no, sadly, we can’t fully regrow your knee cartilage yet), but you can achieve significant relief by integrating therapies. Supplements might help pain a bit, braces can offload the joint, exercises are foundational (improving strength and mobility), and various devices or modalities can add extra pain control. And this is exactly what we do at Unpain Clinic: combine the best of each category into a personalized plan. In the next section, we’ll explain those treatment options – including some advanced therapies like shockwave and EMTT that you may not have tried yet – and how they fit into a comprehensive knee osteoarthritis treatment strategy.
At Unpain Clinic, we believe that treating knee osteoarthritis effectively means looking at the whole person – not just the deteriorating joint, but all the factors causing it to hurt. Our approach is rooted in understanding that the knee is often an innocent victim: issues in your foot, hip, lower back, or general health may be the true culprits driving knee pain. We focus on uncovering those root causes. Below are the key modalities we use for knee OA relief, especially when standard treatments (like pills or basic physio exercises) haven’t given you the results you want.
1. Initial Assessment
Before diving into treatment, we start with a thorough Initial Assessment. This is a 60-minute comprehensive evaluation where a licensed physiotherapist or chiropractor will really get to know your case. We take a detailed history (your pain pattern, lifestyle, goals), and then perform a head-to-toe examination – not just your knee, but also your posture, gait, hip and ankle mobility, muscle strength, and functional movementsunpainclinic.com. We might do orthopedic tests to check your ligaments/meniscus, measure your knee range of motion, and assess swelling or tender points. If you have past imaging (X-ray/MRI), we review those; if not and if it’s indicated, we may refer you for imaging.
Our motto during the assessment is: “Don’t just ask where it hurts – find out why it hurts.” For knee OA, that means we might discover, for example, that your right knee pain is worsened by a left hip that’s very stiff, causing you to shift weight onto the right. Or maybe your arches have fallen, making your knee angle inward. Perhaps you have significant muscle imbalances (e.g., quads vs hamstrings) or even distant factors like poor core stability contributing to gait changes. We also consider systemic factors – like if you have diabetes or inflammatory diet, which can affect pain levels. This Initial Assessment ensures that when we start treatment, we’re targeting the right problems and not just chasing knee symptoms.
(Note: In this visit, we focus on assessment and planning – we typically don’t do treatment on day one, so we can take the time to analyze your condition thoroughly. By the end, you’ll know what’s causing your knee pain and have a clear plan.)
2. Shockwave Therapy
One of our signature treatment tools for knee osteoarthritis is Extracorporeal Shockwave Therapy (ESWT). Don’t let the name intimidate you – “shockwave” refers to high-energy acoustic waves. This advanced therapy stimulates your body’s natural healing in a way that standard physio techniques often can’t. We use both radial and focal shockwave devices (as well as an electrohydraulic type), allowing us to target tissues at different depths.
How does shockwave help a knee with arthritis? Research and our clinical experience show several benefits:
Pain Relief: Shockwave has an analgesic effect – it can reduce pain signaling. Patients often report less pain after a session, sometimes immediately. It’s thought to overwhelm nerves in a helpful way and trigger release of growth factors.
Tissue Regeneration: Unlike a cortisone injection which masks pain (but can weaken tissue), shockwave stimulates tissue repair. It promotes blood flow and can encourage cartilage cells and bone cells to regenerate. In fact, scientific studies suggest ESWT has modifying effects on cartilage and subchondral bone, potentially slowing OA progression. While it won’t regrow lost cartilage overnight, it may help preserve what you have and improve the health of the bone under the cartilage.
Breaking Scar Tissue and Calcium Deposits: If you have any calcifications or old scar tissue around the knee (for example, from previous injuries or quad/patellar tendonitis), shockwave can help break those down. This improves tissue flexibility and function.
Strengthening Tissues: Shockwave causes controlled micro-trauma that actually stimulates new collagen production. Think of it like aerating a lawn so that healthier grass can grow. One of our patients likened shockwave to a “deep tissue reboot” for her knee.
Whole-Chain Effects: We often not only treat the knee joint, but also related structures – for instance, tight thigh muscles, trigger points in the calf, or scar tissue in the IT band. By addressing these, we reduce abnormal pull on the knee. Shockwave is great for treating the muscle-tendon unit dysfunctions that often accompany knee OA (like quad or hamstring tendinopathies).
In our experience, shockwave therapy can provide lasting relief for knee OA sufferers where other treatments failed. In an Unpain Clinic podcast episode (Episode #5: “Eliminate the cause of your knee pain with True Shockwave therapy”), I discussed why many knee pain treatments don’t work – they focus only on the knee – and how shockwave fits into fixing the root causes. By improving the surrounding tissues and not just numbing the pain, shockwave aims to strengthen the knee and its support system. One analogy I use: cortisone is like temporarily turning off a fire alarm (pain) without putting out the fire, whereas shockwave is like helping douse the flames and rebuild the weakened structure.
Shockwave treatments for knee OA are usually done once a week for a series of sessions (often about 3–6 sessions, depending on the case). The treatment itself involves moving a probe around the knee area that delivers pulses – it’s a bit uncomfortable (feels like rapid tapping), but not unbearable (we adjust intensity to your tolerance). There’s no needles or surgery – it’s non-invasive. Afterward, you might feel sore for a day (like you had a deep massage), but then many feel an improvement in pain and mobility.
Evidence backs this up: a 2025 analysis of therapies found shockwave (ESWT) was among the top few interventions improving knee function. Other studies show shockwave improves pain and walking ability in knee OA, and can even reduce inflammatory markers in the joint. We stay on the cutting edge of this research to refine our protocols.
3. Extracorporeal Magnetotransduction Therapy (EMTT) & Neuromodulation
Knee osteoarthritis isn’t only about bones and cartilage – the nervous system plays a big role in pain. Over time, chronic pain can cause your nerves to become oversensitive (a phenomenon called central sensitization). Also, if you have nerve impingement (like a bit of sciatica or a past injury affecting nerve supply to the muscles), that can complicate knee rehab. That’s why we incorporate EMTT and neuromodulation techniques to address the neuro aspect of knee OA pain.
EMTT (Extracorporeal Magnetotransduction Therapy) is a state-of-the-art therapy that uses high-frequency pulsed electromagnetic fields to stimulate healing. Think of it as a cousin to MRI technology, but used therapeutically. What can EMTT do for a knee? It penetrates deep into the joint and surrounding tissues (deeper than shockwave in some respects) and has been shown to reduce inflammation and modulate pain at the cellular level. It’s great for calming irritated nerves and promoting circulation in areas that are hard to reach. We often pair EMTT with shockwave in the same session – while shockwave provides a mechanical stimulus, EMTT provides an electromagnetic stimulus. This one-two punch can accelerate relief. And good news: EMTT is gentle and painless – you typically just lie there with a loop or paddle over your knee; you might feel a mild tapping or warmth, but it’s very comfortable. Many knee OA patients love it because they can relax during the treatment.
Neuromodulation, more broadly, refers to techniques that alter nerve activity. This could include things like electrical stimulation of nerves or muscles (for example, activating your quads with NMES – neuromuscular electrical stimulation – to improve muscle firing patterns) or using specific frequency currents to decrease pain. At Unpain Clinic, we have specialized devices and protocols to “reset” abnormal pain patterns. We might stimulate a nerve pathway to encourage normal signaling or use biofeedback to help you activate certain muscles. The idea is to break the cycle of pain reinforcement in the nervous system. In diabetic patients with pain, we’ve used this approach to great effect; in knee OA, it can help if you have areas of numbness, tingling, or muscle inhibition around the knee.
In short, EMTT and neuromodulation aim to reboot the nervous system’s response to your knee. By doing so, we can decrease pain sensitivity and improve the muscle support to the joint. As one patient described after a few sessions: “My knee just feels calmer and more responsive – like it’s not yelling at me with pain every step, and my leg feels ‘connected’ again.”
4. Manual Therapy & Movement Retraining
Mechanical problems require mechanical solutions. Manual therapy means hands-on techniques provided by our physiotherapists or chiropractors to improve joint and soft tissue function. For a knee with osteoarthritis, manual therapy can be very useful to address stiffness and alignment issues. For example:
We might perform patellar mobilizations – gently moving your kneecap if it’s sticking due to tightness or scar tissue, which can relieve pain and improve range.
Soft tissue release for tight muscles or fascia around the knee (quads, IT band, calves) can reduce abnormal pulling on the joint.
If your tibia (shin bone) or fibula head is a bit restricted, specific mobilizations can improve how forces transmit through the knee.
Manual stretching or traction of the knee can give a short-term relief in pain and feeling of more space in the joint.
We don’t stop at the knee – often manual therapy is directed at the hips, pelvis, or ankle because if those are tight, the knee suffers. For instance, improving hip rotation or loosening an ankle with poor dorsiflexion can translate into better knee mechanics when you walk.
We always combine this with movement retraining. What does that mean? Basically, teaching your body better ways to move. If you’ve been limping or avoiding using one leg, you develop compensations. We’ll work on retraining proper gait (sometimes even using video analysis), correcting posture (for example, leaning less on one side), and exercises to activate the right muscles in the right sequence. Common areas of focus are: learning to hip hinge (so you use your powerful glutes to squat down rather than putting pressure on your knees), improving your balance on the affected leg, and core stabilization so that your pelvis and knee alignment improve.
Manual therapy and exercise go hand-in-hand. As we often say, manual therapy can open a window of opportunity (e.g., more range of motion, less pain), and exercise/movement is what solidifies the improvement. By ensuring your body moves with better mechanics rather than in compensation mode, we help reduce undue stress on the knee. This is especially important if you’ve had chronic knee pain – your movement patterns may have adapted in an unhealthy way, and we need to unlearn those.
One more aspect: we’ll coach you on activity modification – not to stop moving (quite the opposite, we want you active), but to adjust how you do things. For example, teaching a proper technique for stairs (like the “up with the good, down with the bad” trick if needed temporarily), or using trekking poles for hiking to offload knees, etc. Little changes can make a big difference in pain over the day.
5. Exercise Prescription & Self-Management Support
Last but absolutely not least, we emphasize exercise prescription tailored to you. This is the cornerstone of long-term knee OA management. After we’ve done some sessions of shockwave, EMTT, manual therapy, etc., you will find you can do exercises more effectively because it hurts less and you have better mobility. Our team will create a custom exercise program for your needs – targeting your specific weaknesses and limitations.
For example, your plan might include: specific quadriceps strengthening (if squats hurt, maybe start with isometric quad sets or straight leg raises), glute medius strengthening (to help knee alignment, e.g., side-lying leg lifts or band walks), gentle knee range-of-motion drills (stationary cycling with low resistance to lubricate the joint), and stretches for any tight muscles found on assessment (often hamstrings or calves in knee OA patients). We also incorporate balance exercises if needed, and low-impact cardio guidance (like a walking schedule or pool exercises).
We’ll also advise on lifestyle factors – because knee osteoarthritis is not just a knee problem, it’s a whole-body condition. If appropriate, we provide coaching or referrals for:
Weight management: Even a modest weight loss (5-10% of body weight) can lead to significant pain reduction in knee OA. We can guide you on safe ways to stay active and refer to nutrition support if needed.
Nutrition and supplements: We’ll discuss anti-inflammatory diet principles (like reducing excess sugar and processed foods that can worsen inflammation) and advise on any supplements that might complement your treatment (for instance, if you’re keen on trying turmeric or collagen, we’ll ensure it fits in safely).
Pain coping strategies: Chronic pain has mental/emotional aspects. We encourage techniques like mindfulness, relaxation, or gentle yoga – these can help reduce the brain’s amplification of pain signals.
Home adjustments: Tips like using heat packs to warm up a stiff knee in the morning, or installing a shower chair or rail if needed for safety, etc., especially for our older clients.
Collaboration with your doctor: If there’s a need for medication optimization or further investigations (like if we suspect something beyond typical OA), we communicate with your family doctor or specialist.
Our goal is to empower you with things you can do at home and long-term. Knee osteoarthritis tends to be a chronic condition – so instead of a quick fix, think of it as managing a chronic disease. But with the right tools, many of our patients essentially “forget” about their knee during daily life because it improves so much.
(On a side note: We sometimes integrate our treatments with your existing care. For example, if you’ve had PRP injections or are considering them, our therapies like shockwave can actually complement those by enhancing the regenerative environment. We stay flexible to adapt to each patient’s situation.)
Why this integrated approach matters:
We don’t rely on just one modality. By combining mechanical treatments (shockwave, manual therapy, exercise) with neurological modulation (EMTT, nerve work) and metabolic/lifestyle support, we aim to cover all bases. We emphasize non-invasive treatment first – avoiding surgery or heavy medications unless absolutely necessary. And we always set realistic expectations: nothing is guaranteed (remember, knee OA is a degenerative process), but evidence-informed care offers far better chances of meaningful improvement than a do-nothing or wait-for-surgery approach. Our patients often say they appreciate this honesty and thoroughness.
In the next section, let’s look at a real-world example of how these treatments can come together to change someone’s life.
To illustrate how these treatments can help, here’s an example (name changed for privacy):
Meet John: a 68-year-old retired teacher from Edmonton who loves hiking and gardening. John has osteoarthritis in his right knee from years of sports and a past meniscus surgery. By the time he came to us, he described his knee pain as a constant 6/10 ache, often spiking to 8/10 when going down stairs or walking more than 15 minutes. His knee also felt unstable at times (“like it might give out”) and would swell noticeably after any longer activity. He had tried the usual avenues: physiotherapy exercises (which helped a bit but plateaued), yearly cortisone shots (which only gave him 1-2 months of relief), and he wore a basic sleeve brace. He was starting to avoid hobbies he loved, fearing his knee would flare up. His doctor told him, “Eventually you’ll need a knee replacement, maybe in a couple of years when you’re ready.”
John wasn’t satisfied with waiting for surgery. He wanted to live now, not just sit on the couch. So he came to Unpain Clinic seeking a second chance at pain-free movement.
Assessment findings: In John’s Initial Assessment, we found some interesting things. Yes, his right knee was stiff (he was lacking about 10 degrees of full straightening) and had tenderness along the joint line. But we also discovered big weaknesses and tightness elsewhere: his right hip abductor strength was poor (likely due to limping), his left pelvis was rotated (a compensation from offloading the right knee), and his ankle mobility on the right was limited (from an old sprain he forgot about). His right quadriceps was visibly smaller than the left – indicating long-term disuse atrophy. We also noted scar tissue around his old surgery incisions. When we watched him squat, he would barely bend the right knee and instead excessively bent his back – a strategy to avoid knee strain that unfortunately put more pressure on his spine.
We discussed a plan with John, setting realistic goals: reduce pain to manageable levels (e.g., from 6/10 down to 2-3/10), improve his walking endurance from 15 minutes to at least 45 minutes, and increase knee range of motion and confidence so he could do stairs foot-over-foot again. Importantly, John’s ultimate goal was to delay or avoid knee replacement if possible, by improving his knee function now.
Treatment implemented: Over the next 12 weeks, we employed a multimodal treatment:
Shockwave Therapy: We did weekly shockwave sessions targeting John’s right knee and surrounding tissues. We focused on his quad tendon and patellar tendon (to stimulate healing in those tissues and improve knee extension ability), the pes anserine area (inside of knee, where tendons were tight), and even his right hip muscles (to address referred tightness). After 3 sessions, John noted his knee felt “looser” and he could bend it a bit more without pain.
EMTT and Neuromodulation: Starting session 3, we added EMTT treatments for his knee joint to reduce inflammation. John loved these – he said it felt relaxing and his knee “buzzed with warmth” after. We also used some neuromuscular stimulation on his quads to help wake them up, since the shockwave had started to break down the inhibition. This helped him feel more confident to engage the muscle.
Manual Therapy: We performed mobilizations to his patella (kneecap) which was rather stuck, and after a couple of sessions he noticed less of that grinding sensation. We also did deep tissue release on his right IT band and calf – areas that were like concrete. This hands-on work increased his knee flexibility and reduced some trigger points that were referring pain.
Movement Retraining: We spent time teaching John how to move differently. We practiced a pain-free squat by focusing on hinging at the hips and not letting his knee collapse inward. We used a mirror for feedback. At first he could only do a mini-squat; by week 8 he was doing half-squats holding onto a counter with minimal pain. We also trained stair climbing: initially, we taught him to lead with the good leg going up and the bad leg going down (classic technique), but later as his strength improved, we re-trained him to alternate legs normally, focusing on knee alignment and glute activation. He was ecstatic the first time he went up a flight of stairs normally in over a year.
Exercise Program: John’s program included daily at-home exercises: gentle quad sets and straight leg raises (with a small ankle weight as he got stronger), glute bridges for hip strength, and calf stretches. In clinic, we did step-ups on a low step and balance drills (standing on a foam pad). We also used the stationary bike each visit for 10 minutes to improve his knee motion; at first, we had to raise the seat high and he still struggled with a full rotation, but by week 4 he could pedal comfortably and even bought a recumbent bike for home use.
Education and Lifestyle: We discussed weight – John was about 20 lbs overweight. He committed to a nutrition plan (and lost 8 lbs over our 12 weeks, which definitely didn’t hurt the cause!). We also talked about pacing: instead of marathon gardening that would flare him up, we planned 20-minute intervals with breaks. And we updated his knee brace – he got a medical-grade unloader brace. Once he was stronger, he found he needed the brace less often, but it was a good confidence aid initially.
Outcomes: Over 12 weeks, John’s progress was remarkable. His pain levels dropped from constant 6/10 to mostly 2-3/10, and some days he had no pain at all. He reported that he could walk 45 minutes continuously on flat ground with just mild discomfort by the end (previously 15 minutes was his max). Stairs became manageable – he described it as “no longer a dreaded task.” Objective measures improved too: his knee range of motion increased by 5 degrees in extension and 10 degrees in flexion, and his quadriceps strength (measured via single-leg sit-to-stand test) increased significantly – he went from struggling to do 5 partial stands from a chair to doing 12 full stands unassisted. Even his balance on that leg improved (he could stand one-legged for 15 seconds versus 5 seconds initially).
Perhaps most telling: John cancelled his appointment with the orthopedic surgeon. At his last follow-up he said, “I know I might need surgery one day, but it’s no longer on my mind because I’m doing so well. I feel like I have my life back without going under the knife.” He continues maintenance exercises and comes in once in a while for a “tune-up” shockwave session if he overdoes it.
John’s story highlights a key point – treating knee osteoarthritis isn’t about one magic treatment, but about the right combination tailored to the individual. By addressing his whole-body mechanics, his knee got relief. Your story might not be identical, but many patients see similar transformative improvements with a comprehensive approach. (And of course, results may vary: everyone’s starting point is different. But we aim for you to be the best you you can be, knee OA and all!)
Whether or not you become our patient, there are self-care strategies you can start right away to help your knee osteoarthritis. These are evidence-informed tips that, in general, are safe for most people with knee OA. Always check with your healthcare provider before starting new exercises, especially if you have other health conditions. Listen to your body – some discomfort is normal, but sharp pain is a signal to ease off.
Safe Exercises for Knee OA Relief
1. Quad Set (Isometric Knee Press): Sit or lie down with your leg straight. Place a rolled towel under your knee. Gently press the back of your knee down into the towel by tightening your front thigh (quadriceps) muscle. Hold for 5 seconds, then relax. Do 10–15 reps. Why: This activates your quads without moving the joint (great if movement is painful). Strong quads protect your knee.
2. Straight Leg Raise: If quad sets are easy, try this: lie on your back, one knee bent, the affected leg straight. Tighten the thigh of the straight leg and lift it about 12 inches off the ground, keeping the knee straight. Hold 2 seconds, then slowly lower. Do 10 reps × 2 sets. Why: It strengthens the quadriceps and hip flexor without much knee strain.
3. Glute Bridge: Lie on your back with knees bent, feet flat on floor. Tighten your buttocks and lift your hips off the bed/floor until your body forms a straight line from shoulders to knees. Hold for 2–3 seconds, lower down. Do 10 reps × 2 sets. Why: Strengthens glutes and hamstrings. Strong glutes reduce load on the knee by controlling hip and thigh position. John (from our story) found this very helpful for stability.
4. Hamstring Stretch: Sit on the edge of a chair and extend one leg forward, heel on the ground, knee straight (but not locked). Gently lean forward at the hips (keep back straight) until you feel a stretch in the back of your thigh. Hold 20–30 seconds. Do 2–3 times each side. Why: Flexible hamstrings allow easier knee extension and can reduce joint stress. Tight hamstrings are common in knee OA and can pull on the tibia, affecting alignment.
5. Calf Pump (Ankle range): Sit or stand holding a chair back. Rise up on your toes (calf raise), then rock back on your heels lifting toes (careful if balance issues; you can just do toe raises seated by moving ankles). Repeat 15 times. Why: Keeps your ankles mobile and calves loose, aiding better walking mechanics to reduce abnormal forces on the knee.
6.Stationary Cycling or Walking: If you have access to a stationary bike, easy pedaling for 5-10 minutes (with low resistance) is a great warm-up that increases knee joint fluid circulation (synovial fluid). If no bike, a short walk (10 minutes around the block) is good – even if you need a cane or walking poles, staying mobile prevents stiffness. Remember: some movement, even a little, is better than none. Start small and build up. Consistency (daily movement) is more important than intensity for joint health.
Helpful Tips for Managing Knee OA Day-to-Day
1. Watch Your Weight: We say it often because it matters – if you are carrying extra weight, losing even a few pounds can significantly reduce knee pain. One study famously estimated that each pound lost can relieve four pounds of pressure on the knee during steps. Combine exercise with dietary changes for best results; seek guidance if needed.
2. Apply Heat for Stiffness, Ice for Swelling: In the mornings or before exercise, a warm compress or heating pad on the knee for 10 minutes can loosen you up and reduce stiffness. After activity, if your knee is swollen or aching, ice for 10-15 minutes can numb pain and reduce fluid. Always protect your skin (wrap ice pack in cloth).
3. Use Pain Meds Strategically (if you take them): It’s generally fine to use an over-the-counter pain reliever (like acetaminophen or an NSAID) occasionally to push through a needed activity or on a really bad day – just stay within recommended doses and ensure it’s safe for you (check with your doc, especially with NSAIDs if you have blood pressure, kidney, or stomach issues). The goal is not to rely on pills daily, but they’re there as tools. Topical NSAID gels (like diclofenac gel) can also be useful applied to the knee with less systemic effect.
4. Assistive Devices: Don’t hesitate to use a cane, walker, or trekking poles if they help you stay active. A cane should be used in the opposite hand of the bad knee, adjusted to the correct height (elbow slightly bent). Many patients find that using walking poles for outdoor walks relieves knee pressure and improves confidence (plus you get an upper body workout!). These devices can be temporary or permanent allies – the key is to keep you moving safely.
5. Home modifications: Little tweaks at home can reduce knee strain. For example, using a raised toilet seat or armrests can help if sitting and standing are hard. Add a shower chair if you feel unsafe standing long. Install railings or grab bars on stairs. Wear supportive shoes even in the house (those fuzzy slippers might be comfy but offer no support).
6. Activity Pacing: Adopt a “little and often” approach. It’s normal to have good and bad days – on good days, don’t do hours of strenuous activity non-stop (tempting as it is to catch up on yard work) because it can flare you up. Break tasks into smaller chunks with breaks. On bad days, don’t completely avoid movement – do gentle range of motion stretches or a short walk to signal to your body that it’s still in use. Avoid the boom-bust cycle.
7.Mind your Mood: Chronic pain can lead to frustration or low mood, which ironically can amplify pain perception. Engaging in enjoyable activities, staying socially connected, and possibly practicing relaxation techniques can help. Sometimes knee OA can push you into a more sedentary lifestyle which affects mental health – be proactive in finding things that bring joy and movement together (maybe a water aerobics class with a friend, or walking the dog in a beautiful park).
8.Track Your Progress: Keep a simple diary or use an app to note your pain levels and activities. This helps you identify patterns (e.g., “my knee hurts more on cold days” or “after I eat a lot of sugar my pain spikes” – yes, some patients notice diet links). It also helps you see improvement over time, which is encouraging.
9. Keep Expectations Realistic: Managing knee OA is a marathon, not a sprint. You might not be pain-free 100% of the time, but maybe you can go from 8/10 pain to 3/10, or from not walking at all to walking 30 minutes. Those are huge wins! Celebrate the small victories – like needing fewer pain pills, or being able to play with grandkids longer. And if you slip (e.g., skipped exercise for a week and feel worse), it’s okay – just restart, it’s never too late.
When to Seek Help Sooner: While knee osteoarthritis is typically a chronic, slowly evolving condition, certain signs should prompt a medical review sooner rather than later:
Sudden severe worsening of knee pain or swelling, especially if the joint becomes red and very warm. Osteoarthritis flares are usually mild; a big sudden flare could indicate something like gout in the knee or an acute injury on top of OA.
Locking or giving way frequently: If your knee starts to lock (get stuck) or you experience frequent falls because it gives out, tell your provider. There may be a treatable mechanical issue (like a loose fragment or meniscus tear) that needs attention.
Pain at rest/night that is unmanageable: OA pain is usually activity-related. If you have constant night pain unrelieved by rest, it could be a sign that your OA is severe or there’s another issue – time to discuss more aggressive treatments or pain management.
Signs of infection (very rare unless you’ve had an injection or surgery): fever with a very painful, hot, red knee – go to emergency, as infected joints need urgent care.
In any of these cases, don’t tough it out – get evaluated. Often there are additional treatments or modifications we can do.
Yes, knee osteoarthritis often causes mild to moderate swelling in the joint. This swelling (an effusion) is due to inflammation in the joint lining and increased fluid production. Many people with knee OA notice their knee looks puffy or feels “full,” especially after being on their feet a lot. The amount of swelling can vary – it’s usually not as extreme as in rheumatoid arthritis, but enough to cause stiffness and discomfort. Managing swelling is important: using ice, compression sleeves, or anti-inflammatory measures can help. If you have significant swelling that came on suddenly, or swelling with a lot of heat/redness, get it checked to rule out other issues.
No, there is currently no outright cure for knee osteoarthritis. Cartilage, once significantly worn, does not typically grow fully back. However – that doesn’t mean you’re destined for misery! Many treatments can manage and greatly improve symptoms. Think of it like diabetes: we can’t cure it, but we can control it. Weight loss, exercise, and therapies like shockwave may slow the disease process and protect the joint you have left, but they won’t give you a brand-new knee cartilage. Some early-stage research is exploring cartilage regeneration (like stem cell injections, etc.), but nothing is yet proven to regrow cartilage reliably. The good news is pain can be reduced to the point that you feel “as good as new” even if an X-ray still shows arthritis. Also, knee replacements are a definitive option if OA becomes end-stage – that “replaces” the joint but is a last resort. Our aim in conservative care is to delay or avoid the need for surgery by keeping your knee as healthy as possible.
The best exercises are those that strengthen the muscles around your knee and improve its range of motion without causing undue pain. Quadriceps strengthening is top of the list – strong quads act like shock absorbers for your knee. Simple exercises like straight leg raises, mini-squats, or leg presses (within pain-free range) are great. Low-impact aerobic exercises such as walking, cycling, or swimming help with endurance and weight control – cycling is particularly knee-friendly. Don’t forget hamstring and calf stretches to keep your knee flexible. Glute and hip strengthening (like side-leg raises, clamshells, or bridges) is crucial too, because better hip control = less knee stress. Balance exercises (standing on one leg, etc.) are useful if you have instability. The key is consistency – doing a bit every day. Aim for at least 150 minutes/week of moderate exercise (guideline for arthritis) in whatever form you enjoy. If you’re unsure, working with a physiotherapist to design a program can be very beneficial. And always warm up before exercise (a 5-minute brisk walk or a warm shower to limber the joints).
For many people, yes, a knee brace can help. As discussed above, knee braces (especially an “unloader” brace for one-compartment OA) can significantly reduce pain and improve function while you wear them. They work by offloading the pressure from the damaged part of your knee or by providing external support and stability. People often report they can walk longer or with less pain when using a brace. Even a simple neoprene sleeve can give a sense of support and keep the joint warm (which can ease stiffness). However, braces are not a cure – they are like a crutch or eyeglasses: they help while on, but your underlying condition remains. Some cons: they can be cumbersome, and an ill-fitting brace may not do much. Our advice: if you have moderate to severe knee OA, especially inner knee (medial) arthritis, consider trying a well-fitted unloading brace. It should be fitted by a professional for best results. Use it during activities that usually hurt (e.g., long walks). If it helps, great – you have another tool in your toolkit. If not, no harm done (other than some cost). Remember, you don’t want to rely solely on the brace – still work on muscle strength so your body’s internal “brace” (your muscles) get stronger.
It depends on the individual, but not everyone with knee OA will need a knee replacement. Knee replacements are typically recommended for end-stage osteoarthritis when pain is severe and unrelenting, and when conservative measures no longer provide relief. If you follow a good management plan (exercise, weight management, etc.), you might slow the progression enough to never reach that point, or perhaps not until very late in life. We have patients in their 70s with knee OA who are still going strong without surgery. That said, some cases do progress despite our best efforts – especially if you have factors like genetics or very advanced degeneration already.
Our philosophy is: explore all conservative options first, and use surgery as a last resort. Why? Because even after a knee replacement, if you haven’t addressed issues like muscle weakness or poor movement patterns, you might still have pain or difficulties. In fact, some 10-20% of people continue to have chronic knee pain after a “successful” knee replacement (often due to those other factors). So, doing prehab (pre-surgery rehab) can improve outcomes. We often say: “Before you get a knee replacement, do this first.” Strengthen your body and correct dysfunctions – you’ll have a better recovery, and you might even find you don’t need the surgery yet.
If you do end up needing a replacement, we’ll support you both before and after. Shockwave and EMTT can even be used safely after knee replacements to help with scar tissue and muscle recovery (we’ve had patients where it reduced their post-op stiffness). And remember, a replaced knee might remove the arthritic pain, but you want to have the best muscle function around it for it to truly feel good. So, either way, the work you do now is invaluable.
EMTT stands for Extracorporeal Magnetotransduction Therapy. It’s a newer, cutting-edge treatment (the name’s a mouthful, we know!). Essentially, it’s a type of pulsed electromagnetic field therapy. During EMTT, you lie down and a circular device (loop) is placed over the area like your knee. It emits high-frequency magnetic pulses that go through your tissues. You don’t feel much – maybe a slight tapping or warmth – nothing painful. Sessions last around 5-20 minutes. EMTT is very safe; it’s non-invasive, no radiation (it’s magnetic, not X-ray), and typically no side effects apart from rare mild temporary increases in pain (which are actually part of the healing response sometimes). It’s not done if you’re pregnant or have certain implants (active electronic implants like older pacemakers, though most modern pacemakers are fine – we always check compatibility).
EMTT has been used in Europe for a variety of musculoskeletal conditions. It appears to reduce inflammation, improve microcirculation, and promote cell repair. For knee OA, we use it to complement shockwave. It’s especially good if there’s a lot of bone marrow edema or inflammatory aspect to your arthritis (something we might see on an MRI report). In those cases, EMTT can penetrate to the bone level and calm things down. Another perk: you just get to relax during it! Many patients joke it’s their “spa” part of the visit.
Knee osteoarthritis is a journey – but it’s one you don’t have to walk alone, and certainly not one where you should lose hope. We’ve covered a lot: from supplements and knee braces to exercise and advanced therapies. The recurring theme is that an integrative, evidence-based approach yields the best results. There is no single magic cure for knee OA, but by combining modalities, you can achieve life-changing relief. Studies back this up, and we see it in our clinic every day.
In Canada (and worldwide), knee osteoarthritis is a leading cause of pain and disability, but modern pain science and rehabilitation have given us great tools to combat it. You can take control of your knee osteoarthritis with targeted exercise, smart use of supports (like braces or orthotics), and treatments that address the root causes of your pain. It’s not about just numbing the knee, it’s about improving how your knee functions within your whole body. And that’s exactly our philosophy at Unpain Clinic – treat the person, not just the x-ray.
If you’re reading this and feeling overwhelmed by information, just remember this simple plan: Move more, nourish your joints, and seek expert help when you need it. Movement is medicine, food is fuel, and we clinicians are your coaches in this process. There is no “one-size-fits-all” cure, but there is an optimal plan for you – and we’re here to help you find it.
You deserve to walk, bend, and live your life with as little pain as possible. Many patients tell us they wish they hadn’t waited so long to seek comprehensive treatment – they assumed suffering was just their new normal. It doesn’t have to be. Relief is often possible even when you’ve “tried everything.”
Ready to take the next step? The first step (literally and figuratively) is an in-depth evaluation – our Initial Assessment – where we pinpoint why your knee hurts and chart a path forward. We’d love to partner with you on your journey to being active and pain-free. Remember, at Unpain Clinic we don’t just ask “Where does it hurt?” — we dig deep to find “Why does it hurt?” and then work on fixing that. Let’s break the cycle of “try everything, feel nothing.” Real results start with understanding.
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
Important Details
60 minutes, assessment only
No treatment in this visit
Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
1.Chen X, et al. (2025). Clinical efficacy of different therapeutic options for knee osteoarthritis: A network meta-analysis based on randomized clinical trials. PLOS One, 20(6): e0324864journals.plos.orgjournals.plos.org.
2. An S, et al. (2020). Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism. Biosci Rep, 40(11): BSR20200926pubmed.ncbi.nlm.nih.gov.
3. Zeng C, et al. (2015). Effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in knee osteoarthritis. Scientific Reports, 5: 16827nature.comnature.com.
4. Onakpoya IJ, et al. (2021). Efficacy and safety of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials. BMJ Open Sport Exerc Med, 7(1): e000935pubmed.ncbi.nlm.nih.govjournals.lww.com.
5. Campbell TM, et al. (2023). Stretching, bracing, and devices for osteoarthritis-associated joint contractures: A systematic review and meta-analysis. Sports Health, 15(6): 867-
877medicaljournalssweden.se.
6. Lawford BJ, et al. (2023). Exercise for osteoarthritis of the knee: An update of Cochrane systematic review. Cochrane Database Syst Rev (search up to Jan 2024)cochrane.org. (Cochrane summary: exercise improves pain and function in knee OA).
7. Liu X, et al. (2020). Osteoarthritis in Canada: 1 in 8 affected and rising – implications for comorbidity management. BMC Public Health, 20: 1551bmcpublichealth.biomedcentral.com.
8. Unpain Clinic Podcast Episode #5 (2025). Eliminate the cause of your knee pain with True Shockwave therapyunpainclinic.comunpainclinic.com. (Hosted by Uran Berisha – discusses root causes of knee pain and shockwave approach).
9. Unpain Clinic – How Diabetes & Musculoskeletal Pain Are Connected (Blog, Nov 17, 2025)unpainclinic.comunpainclinic.com. (Referenced for integrated modality descriptions).
10. Unpain Clinic – Why Sciatica Pain Flares in Winter (Blog, 2023)unpainclinic.com. (Referenced for EMTT mechanism description).
