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If you’re waking up with achy knees or cringing every time you bend down the stairs, you’re not alone. Knee pain can be frustrating and limiting – whether it’s keeping you from your morning run or making it hard to get off the couch. In this blog, we’ll explore knee pain causes and what your knee might be trying to tell you about your overall body mechanics. The good news is that knee pain is not just an inevitable part of aging or “wear and tear” you have to live with. Often, it’s your body’s way of signaling an underlying imbalance that can be addressed with the right approach. We’ll break down why your knee hurts, what science says about treating it, and how a whole-body, compassionate approach at Unpain Clinic can help you find relief.
Pain is your body’s alarm system. When it comes to the knee – a joint that basically acts as the hinge between your hip and ankle – that alarm often means something elsewhere is off. Instead of simply silencing the alarm with another pill or brace, this article will help you understand the message behind the pain so you can fix the root cause. Let’s dive into why that knee is hurting and how to get you moving freely again.
Knee pain can come from many sources, and understanding the cause of your knee pain is the first step toward relief. Sometimes the cause is obvious – for example, a sudden sports injury or twisting your knee can tear a ligament or meniscus. In these traumatic injuries, pain happens immediately and you often know exactly when it started (you might even recall a “pop” at the time of injury). Other times, knee pain creeps in gradually with no single incident. This non-traumatic knee pain can be more puzzling: you didn’t fall or get injured, yet your knee starts hurting during daily activities like walking, bending, or going downstairs. What’s going on here?
Common knee pain causes include well-known diagnoses like osteoarthritis (wear-and-tear arthritis in the joint), tendinitis (such as patellar tendinitis or “jumper’s knee”), bursitis, or conditions like patellofemoral pain syndrome (pain around the kneecap often due to tracking issues). These diagnoses describe what tissue is irritated (e.g. cartilage in arthritis, tendon in tendinitis) – but they don’t always explain why the problem started. For instance, many people are told their knee pain is due to “arthritis” or age. Yet studies have shown that structural changes on X-ray often don’t match up with who feels pain. In fact, radiographic knee osteoarthritis changes are poorly correlated with pain and function – meaning some people with scary-looking knees on X-ray have little pain, while others with severe pain show only mild changes on imaging. One 2020 study found that even among people with advanced arthritis, a considerable number had no knee pain at all. If a knee is bone-on-bone on an X-ray but doesn’t hurt, while another knee aches without major imaging findings, clearly there’s more to the story than just worn cartilage.
So why does knee pain persist in so many people? Often, it’s because the true root cause isn’t being addressed. The knee is a relatively simple hinge joint – it bends and straightens – and it relies on the proper function of the joints above and below it (the hip and ankle) for healthy movement. If those other areas aren’t doing their job, the knee ends up taking on extra stress. Think of your body as an interconnected chain: weakness or stiffness in your hips, ankles, or even lower back can throw that chain out of balance. Your poor knee then becomes the overworked link, leading to pain. As Unpain Clinic founder Uran Berisha explains, the pain you feel in your knee is often a symptom of dysfunction elsewhere – most commonly in the hip, ankle, or lower back. Over time, those imbalances cause uneven wear-and-tear on the knee joint.
Unfortunately, many standard knee treatments focus only on the knee itself. Have you ever been told to just rest and ice it, wear a brace, or take anti-inflammatories? These can help temporarily, but if you stop there, the real problem (say, weak glute muscles or a tight IT band pulling on the knee) remains unsolved. That’s why people get caught in a cycle of pain returning or even worsening. Cortisone injections or painkillers may provide short-term relief, but they only mask symptoms and don’t fix the underlying issue. In fact, cortisone can weaken soft tissues over time, potentially making matters worse. Even surgery isn’t a guaranteed fix if the mechanical causes of your knee stress aren’t corrected – many patients continue to have pain after a knee replacement because the dysfunctional movement patterns that led to the damage are still there. The key takeaway: your knee pain is often a messenger, not the ultimate source of the problem. To truly resolve it, we have to listen to what that pain is “telling us” about the rest of your body.
Let’s step back and see what scientific research reveals about knee pain and effective relief. A growing body of evidence supports the idea that treating knee pain requires a holistic view. Here are some important research-backed insights to understand:
Hip Strength Matters for Knee Pain: If your knees ache, you may need to strengthen your hips! Multiple studies on patellofemoral pain (a common knee pain condition) have shown that strengthening the hip muscles can reduce knee pain and improve function more than knee exercises alone. In a 2025 meta-analysis of 12 studies (over 1,000 patients), adding hip-focused exercises led to significantly greater pain reduction in chronic kneecap pain compared to just doing knee exercises. In simpler terms, building up your glutes and hip stabilizers can take pressure off the knee. This supports the idea that knee pain often has origins “upstream” in the kinetic chain – a weak hip or poor core stability can make your knee work overtime.
Knee Pain Isn’t Just About “Bad Knees”: As mentioned earlier, research confirms that you can’t judge knee pain severity by an X-ray alone. One analysis noted that radiographic arthritis changes often do not correspond to how much the knee actually hurts. About a quarter of people with very advanced arthritis (Grade 4, the worst on scans) reported no pain in one study. And vice-versa, some folks with lots of pain have only mild imaging changes. What does this mean? Pain is influenced by many factors – including muscle tightness, inflammation, nerve sensitivity, and biomechanics – not just cartilage damage. So, if you’ve been told “it’s just arthritis, nothing can be done,” don’t lose hope. Your pain could be stemming from treatable issues like soft tissue restrictions or alignment problems that a comprehensive approach can improve.
Shockwave Therapy Shows Promise: One exciting area of research for stubborn knee pain (especially in conditions like osteoarthritis and chronic tendinopathies) is extracorporeal shockwave therapy (ESWT). Shockwave is a non-invasive treatment that uses acoustic waves to stimulate healing in tissues. A systematic review published in 2024 analyzed 24 studies on shockwave for knee osteoarthritis and found that patients who received shockwave had better pain relief and function than those who got placebo (“sham”) treatments. In mild-to-moderate knee arthritis, shockwave therapy significantly improved symptoms, whereas it was less effective for very severe bone-on-bone cases. Interestingly, the review noted that adding shockwave to an exercise program was more effective than exercise alone, and that shockwave outperformed several standard treatments – including steroid injections, physiotherapy exercises, and even some joint lubricant injections – in improving knee pain and mobility. In short, studies suggest shockwave can kick-start tissue repair and reduce pain in degenerative knee conditions where traditional therapies fall short. (We’ll discuss more on how shockwave works and why it’s different soon.)
Exercise and “Whole-Body” Rehab are Key: Decades of research support exercise as a cornerstone for knee pain relief, particularly for osteoarthritis. Strengthening the quadriceps (thigh muscles) and improving joint flexibility can significantly decrease pain and improve function. Guidelines worldwide recommend exercise therapy as first-line treatment for knee osteoarthritis because it can reduce pain, improve walking ability, and delay the need for surgery. Importantly, the best outcomes seem to come from programs that don’t just target the knee in isolation, but also address adjacent areas – for example, combining knee strengthening with hip and core exercises, balance training, and manual therapy for tight muscles. One clinical trial found that patients with knee pain who received a combo of exercise + manual therapy (hands-on techniques to improve joint and muscle function) had better short-term pain relief than those doing exercise alone. This reinforces that a multimodal approach (exercise + hands-on treatment + corrective strategies) can yield superior results. Your knee exists in a network – fixing knee pain often means fixing the whole network.
In summary, science is telling us that to tame knee pain, we need to treat the person, not just the knee. By strengthening weak links (like the hips), correcting movement patterns, and using regenerative therapies like shockwave, we address the reasons the knee was hurting in the first place. Now, let’s see how we apply these insights at Unpain Clinic.
At Unpain Clinic, we have one core philosophy for knee pain (or any chronic pain): don’t just chase the symptoms – find and fix the root cause. We take a whole-body, integrative approach to treatment. What does that mean for you? It means that when you come in with knee pain, we’re not only going to examine your knee, but also look at how your ankles, hips, pelvis, and even your posture might be contributing to the problem. Based on a thorough assessment, we create a personalized plan that may include a combination of advanced therapies and traditional hands-on care. Here are the key treatment modalities we use to address knee pain and why each is important:
If knee pain is the fire, think of shockwave therapy as one of our strongest “firefighters.” Shockwave therapy (ESWT) uses focused sound waves delivered to the painful area to stimulate your body’s natural healing processes. It increases local blood flow, encourages new blood vessel formation, breaks down scar tissue, and can even promote regeneration of cartilage and tendons. Unlike cortisone injections which merely reduce inflammation (while potentially weakening tissues), shockwave aims to strengthen and rebuild tissues. In an Unpain Clinic podcast episode, Uran Berisha described shockwave like this: it “uses sound waves to regenerate soft tissue, improve blood flow, and stimulate the body’s natural healing response.” Unlike cortisone, which can weaken tissues over time, shockwave therapy actually helps fortify the knee and surrounding structures.
In practice, if you have knee osteoarthritis or a stubborn tendinitis, we often make shockwave a centerpiece of your treatment plan. A typical course involves about 3 sessions of focused shockwave (spaced about a week apart). Many patients start noticing less pain and better knee mobility after a couple of sessions – for example, getting up from a chair might be easier, or that morning stiffness isn’t as bad. By the end of the course, the majority report meaningful relief: they can walk longer, climb stairs, or squat with much less discomfort. It’s important to note, shockwave isn’t a “magic wand” that cures overnight – but by jump-starting tissue repair, it sets the stage for lasting healing when combined with the other steps below. (As evidence, recall that 2024 review: shockwave improved knee pain and function and even outshined steroid injections and other therapies in clinical trials.) If you’re considering a knee injection or even surgery, exploring shockwave first is a smart move, as it may help you heal without more invasive measures. (We even wrote a whole blog on why to try shockwave before cortisone – check out “Why Shockwave Therapy Might Be the Answer Before You Turn to Cortisone Shots” for more on that.)
During a shockwave treatment at Unpain Clinic, your physiotherapist or chiropractor will use a handheld device to deliver pulses to specific spots around your knee (for example, along the patellar tendon, quad tendon, or joint line). It’s done in-office, with no needles and no anesthesia needed. Most people find it quite tolerable – you might feel a tapping or pressure sensation, and occasionally a brief twinge on a very sore spot, but we adjust the intensity to keep you comfortable. The treatment usually lasts only 5-10 minutes per knee. Afterward, you can resume normal activities (no downtime). And don’t worry – shockwave therapy is very safe. Aside from maybe some temporary soreness, it has minimal side effects, especially compared to medications or injections. It’s a powerful tool in helping your knee heal naturally.
In addition to shockwave, Unpain Clinic is proud to offer some of the latest technologies for pain relief, including EMTT (Extracorporeal Magnetotransduction Therapy) and other gentle neuromodulation techniques. These might sound high-tech, but they play an important supporting role in our knee pain treatments, especially for chronic or hard-to-treat cases.
What is EMTT? It’s a non-invasive therapy that uses high-frequency electromagnetic pulses to target inflammation and pain at the cellular level. Think of it as a very strong magnet field that pulses on and off extremely fast over the area of pain. You don’t feel any electric shock or pain during EMTT – at most a mild warmth – yet it works behind the scenes to reduce inflammation and modulate pain signals in the tissues. We often pair EMTT with shockwave in knee pain patients who have a lot of swelling or nerve sensitivity. The shockwave works on the “hardware” (the tissue structures), while EMTT tells the nerves and inflammatory cells to “calm down.” In Uran’s words, it’s like shockwave tells your tissues “time to rebuild,” while EMTT tells your nerves “shhh, quiet down.” This one-two punch can speed up recovery significantly. Since EMTT is painless and has no known side effects, there’s really no downside to using it – it’s just another way we try to help your knee feel better faster.
Neuromodulation techniques refer to various methods we use to “reset” an irritated nervous system. Chronic knee pain can make your nerves super sensitized – so even if the tissue damage is healing, the nerves might still be over-firing and telling you you’re in pain. To address this “software” aspect of pain, we might use low-level laser therapy or mild electrical stimulation around the knee or in the nerve pathways of the leg. These therapies are gentle (patients often report just a warm or tingling sensation) and they aim to normalize how your nerves are processing pain signals. We may also teach you nerve gliding exercises (“flossing” the nerves) if a nerve is entrapped or irritated. By calming down overactive nerves, neuromodulation helps break the cycle of pain. This means when you start moving normally again, your knee won’t “scream” at you unnecessarily. It’s another layer of ensuring that we fix why it hurts, not just where it hurts.
No comprehensive knee pain treatment plan would be complete without some good old-fashioned hands-on care. Our skilled physiotherapists and chiropractors at Unpain Clinic use manual therapy to address the joint misalignments, muscle tightness, and soft tissue restrictions that contribute to knee pain. Remember, if your knee is hurting because, say, your ankle is stiff or your hip is out of alignment, we need to work on those areas too.
For example, let’s say you have knee pain due to IT band syndrome (pain on the outer knee). We might find that your hip on that side is weak and your thigh muscles are very tight. Through manual therapy, we’ll work on loosening up the tight iliotibial band and quadriceps with targeted massage or myofascial release. We’ll also check your joint mobility – perhaps your ankle or hip isn’t moving freely, which is altering your knee mechanics. If your ankle lacks dorsiflexion (the ability to bend upward), it could be forcing your knee to compensate and causing strain. In that case, we’ll do joint mobilizations to improve your ankle movement, or maybe adjust your foot and ankle if we find any alignment issues. Similarly, if your pelvis is rotated or your lower back is stiff, we’ll gently adjust and mobilize those areas so that your leg is operating on a stable, neutral base.
The goal of manual therapy is to restore proper movement patterns and eliminate those hidden dysfunctions contributing to knee stress. Often, after a session of hands-on work, patients feel an immediate difference – perhaps the knee feels looser, walking is smoother, or they notice better balance. One happy patient noted in a review that our therapists not only provide shockwave “with every visit” but also “treat secondary problem areas (i.e. a sore foot can affect your knees, etc.), because they look at the whole chain.” This “whole-chain” approach means we’re not going to just rub your knee and call it a day – we’ll work on any tight, weak, or misaligned areas from your spine to your toes that are relevant. By improving your overall alignment and flexibility, we take excess load off the knee so it can finally heal. Many patients report that alongside knee pain relief, they experience nice “bonus” benefits like improved posture or fewer aches elsewhere, simply because everything is moving better in unison.
Last but absolutely not least, exercise therapy is a pillar of our approach to knee pain. While technologies like shockwave and skilled manual therapy can do wonders, true long-term success also relies on you actively strengthening and retraining your body. Don’t worry – we’re not going to throw a million exercises at you or ask you to join a gym if you don’t want to. We will, however, craft a simple, tailored exercise program that you can do at home (or at your gym if you prefer) to reinforce the improvements from your treatments.
For knee pain, knee joint strengthening exercises usually focus on the surrounding muscle groups: the quadriceps in the front of your thigh, the hamstrings in the back, your calves, and importantly, your glutes/hip abductors. Strengthening these areas helps absorb shock and stabilize the knee. We’ll also include stretching or mobility drills for any tight areas – common ones are the calf (to improve ankle flexion), hamstrings, and hip flexors. If balance or foot mechanics are an issue, we incorporate exercises for those too. For example, a typical at-home plan for knee pain might include:
Quadriceps sets or straight-leg raises: Simple moves to activate and strengthen the quads without straining the knee joint. These help support the knee cap and improve stability.
Glute bridges or clamshells: Exercises to strengthen your glutes and outer hips. Strong glutes reduce the load on your knees during activities like climbing stairs or running.
Hamstring and calf stretches: Gentle stretches to the back of the thigh and lower leg can relieve tension that might be pulling on the knee. Improving calf flexibility, for instance, can help if you have knee pain when bending deeply or squatting.
Balance and control drills: For some, we might add single-leg balance exercises or step-down drills to retrain proper knee alignment (ensuring your knee tracks correctly over your foot). This is especially useful post-injury or if you’ve developed a habit of favoring one leg.
We will coach you on proper form and ensure the exercises are safe and appropriate for your condition. A key point we emphasize is to listen to your body – a bit of muscle soreness as you strengthen is okay, but sharp pain is not. Our motto is “move, but don’t martyr.” We also provide guidance on things like pacing your activity, using ice or heat if needed, and even footwear advice (e.g. wearing supportive shoes if you have knee arthritis to cushion impact). By diligently doing your home exercises, you’re essentially helping “future-proof” your knee: once our therapies calm down the pain and jump-start healing, the exercises build strength and resilience so the pain doesn’t just come back. This active participation is what really solidifies the gains. Studies back this up – one review found that exercise programs significantly improved outcomes once pain levels were managed, versus passive treatment alone. We often tell patients: our treatments get you out of the hole, and the exercises keep you out. Together, it’s a winning combination.
To illustrate how all these pieces come together, let’s look at a real-world example (name changed for privacy). Meet “Nancy” – a 45-year-old avid runner and busy mom from Edmonton. Nancy wasn’t a stranger to knee pain; for about 5 years she had been battling pain on the outside of her right knee that flared up whenever she tried to run more than 30–40 minutes. Doctors told her it was likely “runner’s knee” or IT band syndrome. She diligently tried everything: physiotherapy exercises, acupuncture, foam rolling, kinesiology taping, expensive running shoes – you name it. Yet every time she ramped up her mileage, the sharp pain would return and force her to stop. Frustrated and running out of options (no pun intended), Nancy came to Unpain Clinic on a friend’s recommendation.
In her first assessment, we quickly noticed a few things: her right hip muscles (especially the glutes) were significantly weaker than her left, and her IT band and lateral quad were extremely tight – likely tugging on that knee with each stride. Her knee pain was stemming from an imbalance in her hip and thigh, not a “mystery” knee problem at all. We explained to Nancy that to fix her knee, we needed to address those root issues. We started a focused treatment plan: shockwave therapy to the fibrous trigger points along her IT band and the insertion points around the knee (to stimulate healing in the irritated tissues), plus some shockwave to her gluteus medius muscle to help it activate better. We also used EMTT to reduce inflammation along the irritated tract. Our manual therapy included deep tissue release for her tight TFL (hip muscle) and quads, and mobilizations of her hip joint to ensure it had full mobility. Crucially, we prescribed just a couple of key exercises: side-lying leg lifts and band walks to strengthen her glutes, and a daily IT band stretch.
The results? After one treatment, Nancy reported she was able to run longer without the familiar pain creeping in – the first time in months. After the full course of three shockwave sessions over three weeks, plus her at-home exercises, she was back to training for her half-marathon, running stronger and pain-free. In her own words, “after five years of trying everything… after the full three treatments I am back to training for my half-marathons and feel stronger than ever.” Her knee wasn’t holding her back anymore. What made the difference was identifying that the knee pain was a symptom of hip weakness and tight fascia – once we fixed those and helped the tissue heal (with the aid of shockwave), her knee could finally recover. Stories like Nancy’s are exactly why we’re so passionate about what we do. Seeing a patient who thought they’d “just have to live with it” get back to the activities they love – that’s the best reward.
(We have many similar success stories. One client in her late 60s had bone-on-bone knee arthritis and was scheduled for a second knee replacement. After a series of shockwave treatments and whole-body therapy at Unpain Clinic, she not only postponed the surgery – she was walking without a cane, golfing, and living with much less pain, to the point where she decided she might not need that new knee at all. As she put it, “the pain in both knees has appreciably declined and the mobility in my left (replaced) knee has increased… I increased my walking routine… back to (before surgery) distance… Life is much more enjoyable!”.)
While professional treatment can accelerate your healing, there’s also a lot you can do at home to manage and prevent knee pain. Here are some simple, safe at-home guidance tips to support your knees between visits:
Keep Moving (Gently): It might seem counterintuitive, but rest in moderation is good – total immobilization is not. Gentle motion nourishes the knee joint with synovial fluid and prevents stiffness. If your knee is feeling stiff, try low-impact activities like stationary cycling, swimming, or simply going for a light walk. These can help keep blood flowing without pounding your joints. (Always stay within a pain-free range – if an activity sharply hurts, stop.)
Strengthen Your Support Muscles: Incorporate a few knee strengthening exercises into your daily routine. A great starter exercise is the straight-leg raise: lie on your back, one leg bent and the other leg straight; tighten the thigh of the straight leg and lift it about 12 inches, hold for 3-5 seconds, then slowly lower. This strengthens the quads without stressing the knee joint. Aim for 2 sets of 10–15 lifts per leg. Another excellent move is glute bridges: lie on your back with knees bent, lift your buttocks off the floor by squeezing your glutes, hold 2 seconds, lower down. Strong glutes will take pressure off your knees during day-to-day activities.
Stretch Tight Muscles: To relieve tension on the knee, gently stretch the muscles that attach to it. Two big ones to focus on are your hamstrings (back of thigh) and calves. For a hamstring stretch, sit on the edge of a chair and straighten one leg forward with your heel on the ground, then lean forward at the hips until you feel a stretch in the back of the thigh. Hold ~30 seconds, no bouncing. For calves, stand facing a wall, step one foot back and press that heel down while leaning forward until you feel the calf stretch, hold 30 seconds. Flexible calves and hamstrings help your knee move through its range without tug-of-war from tight tissues.
Use Ice or Heat Appropriately: For sharp or recent knee pain (especially if there’s swelling), icing the knee for 15 minutes after activity can reduce inflammation and numb pain. Wrap a cold pack in a thin towel – never place ice directly on skin – and elevate your leg while icing. For stiff, achy knees (often arthritic knee pain or chronic issues), heat can be soothing. A warm compress or heating pad for 15-20 minutes can loosen muscles and increase circulation. Some people alternate heat and ice, known as contrast therapy, to get the best of both – just be sure to end with ice if there’s any swelling.
Mind Your Weight and Footwear: This isn’t a quick “do tonight” tip, but it’s important for long-term knee health. Each extra pound of body weight can load an additional 3-4 pounds of force on your knee when you walk or go down stairs. If you’re carrying a bit of extra weight and have knee arthritis or pain, gradual weight management can significantly reduce strain on your knees (and has been shown to improve pain). Additionally, check your shoes – wearing supportive footwear with good cushioning can absorb shock and correct subtle foot positions that affect your knee alignment. If you have flat feet or high arches, consider being evaluated for proper insoles or orthotics; sometimes supporting your arches can prevent that inward or outward collapse at the knee that causes pain.
These at-home strategies, combined with professional care, can accelerate your progress. Always remember: never push through sharp pain during any exercise – a little discomfort or muscle effort is okay, but pain is your knee’s way of saying “not so fast.” If you’re unsure about any exercise, consult your physiotherapist for guidance. With consistency and attentive care, you’ll be giving your knees the best chance to heal and stay strong.
Knee pain when bending the knee (such as squatting or descending stairs) is a common complaint. It often points to issues with the patellofemoral joint – essentially, how your kneecap glides in its groove. When you bend deeply, the kneecap is under higher pressure. If the muscles around your knee (quads, hamstrings) are imbalanced or your kneecap is slightly misaligned, you’ll feel pain especially during these motions. Conditions like patellofemoral pain syndrome or early arthritis under the kneecap can cause pain with bending. Also, going down stairs puts eccentric load (controlled lowering force) on your quads and knees, which can aggravate things like patellar tendinitis or chondromalacia. The key is to identify if it’s a tracking issue, an inflamed tendon, or something like a meniscus strain. A physio can test this. The good news is that in many cases, targeted exercises (to strengthen your quads and hips) and treatments to reduce inflammation can significantly improve this type of knee pain. For instance, strengthening the inner quad (VMO) and doing hip abductor exercises can help the kneecap track better, alleviating that pain when you bend. If stairs are tough, try using the railing for support and avoid “plopping” down – controlled, muscle-supported movement is easier on the joint.
Absolutely. This surprises many people, but knee pain is often a classic example of referred or biomechanically linked pain. The knee is a middle joint – it’s influenced by the joints above (hip) and below (ankle/foot). If you have a hip imbalance (say one hip is weaker or tighter), it can cause your thigh bone to rotate improperly and put stress on the knee. One common scenario is weak gluteal muscles leading to the knee caving inward during activities – this can cause pain around the kneecap or inner knee. Likewise, issues in the foot or ankle can send pain up to the knee. If you have very flat feet or an old ankle injury, the altered mechanics can strain the knee (for example, overpronation in the foot can twist the knee inward). Even differences in leg length or pelvic alignment can trickle down to knee pain. At Unpain Clinic, it’s routine in our knee assessments to examine your whole lower body movement. Many patients are relieved (and fascinated) when we show them, for example, that their knee stops hurting when we correct their hip position or give the foot more support. In essence, a sore knee can be the victim of a problem elsewhere – that’s why our approach “treats the whole chain, not just the knee”. By fixing those root issues (hip strengthening, orthotics for feet, etc.), the knee pain often resolves.
Managing knee osteoarthritis (arthritis) naturally is very possible and often effective. The goal is to reduce pain and improve function without relying solely on medications. Here are several natural approaches:
Exercise Therapy: It may seem counterintuitive to exercise an arthritic knee, but targeted exercise is the number one recommended treatment. Strengthening the muscles around the knee (quads, hamstrings, calves) and the hips provides support and can markedly reduce painunpainclinic.com. Low-impact activities like cycling, swimming, or tai chi can maintain joint mobility and reduce stiffness.
Weight Management: If you’re overweight, even a modest reduction can ease knee pain – less load on the joint with each step means less pain. Diet and low-impact exercise combined can help achieve this gradually.
Supplements and Diet: Some people find relief with supplements like glucosamine, chondroitin, or anti-inflammatory omega-3 fish oils. While scientific evidence is mixed, they are generally safe to try (check with your doctor). An anti-inflammatory diet rich in vegetables, fruits, whole grains, and omega-3s (and low in processed foods and sugars) may also help by reducing systemic inflammation.
Heat and Topicals: Warm compresses or baths can loosen a stiff arthritic knee. Topical creams with ingredients like capsaicin or arnica may provide temporary pain relief without systemic side effects.
Shockwave Therapy and EMTT: These are newer natural (non-pharmaceutical) modalities. As discussed, shockwave can stimulate your body’s own healing in the joint, potentially improving arthritis symptoms. EMTT (pulsed electromagnetic therapy) can reduce inflammation. They are drug-free, injection-free therapies offered at specialized clinics (like ours) that can complement your natural management plan.
Mind-Body Practices: Chronic pain has a mind-body component. Techniques like gentle yoga, meditation, or tai chi can improve pain by promoting relaxation, better movement, and body awareness. They also reduce the stress and frustration that often come with chronic arthritis pain.
Always consult with a healthcare professional before starting supplements or new exercise routines, but these natural strategies can make a world of difference. Many of our patients with knee arthritis manage well without surgery, using a combination of the above therapies and periodic professional treatments to keep pain at bay.
This is a great question, as the word “shockwave” can sound a little intimidating! In reality, shockwave therapy is well-tolerated by most patients and typically does NOT cause significant pain. The treatment involves a hand-held device that delivers acoustic pulses – you will feel something, but it’s usually described as a tapping, thumping, or tingling sensation. Over areas with very tight or sensitive tissue, you might experience a brief spike of discomfort (imagine a deep tissue massage on a knot – a similar “good hurt”), but it lasts only seconds and we can adjust the intensity at any time. Our therapists check in with you continuously and keep the level at a tolerable setting. If you’re nervous, rest assured: we start low and gradually increase as you get used to it. Most clients say it’s surprisingly painless – any odd sensations stop the moment the treatment is over. After a session, it’s not uncommon to have mild soreness or an “achy” feeling in the treated area for a day or two (akin to post-workout soreness). This is a normal part of the healing response and often subsides quickly. In fact, some people feel no soreness afterward and go right back to their activities. Compared to knee surgery or injections, shockwave is a walk in the park sensation-wise. And remember, the potential benefits – pain relief and tissue healing – far outweigh the temporary discomfort of the procedure. Our patients who were apprehensive at first often tell us after the first session, “Oh, that’s it? That wasn’t bad at all!”
It’s not too late! Even if you have a knee replacement surgery on the calendar, there’s a lot that conservative therapies can do – both to possibly improve your condition before surgery and to help in recovery after. In some cases, patients who try shockwave and physiotherapy in the weeks leading up to surgery find their pain improves so much that they choose to postpone or cancel the surgery. Each case is unique, of course, depending on how advanced your joint damage is. But we have helped many clients avoid surgery by addressing the root causes and strengthening the knee’s support system in time. If your knee is truly beyond natural repair, doing therapy before surgery is still extremely valuable: strengthening your muscles (quads, hamstrings, glutes) and improving your range of motion can dramatically improve surgical outcomes. A stronger leg will rehab faster.
Shockwave therapy is even used post-replacement to help the surrounding muscles and to break down scar tissue. It’s safe to use around implants (it won’t harm the metal joint). In fact, patients who receive shockwave and EMTT after joint replacement often report faster reductions in stiffness, better walking ability, and less compensatory pain in other joints. There’s evidence that using these therapies can lower the risk of certain complications by improving circulation and tissue quality. Always coordinate with your surgeon, but integrating physiotherapy, shockwave, or EMTT before and after a knee replacement can enhance your recovery significantly. Bottom line: whether your surgery is next year or next week, it’s never too late to seek a whole-body assessment – you might discover that there are still options to improve your pain or ensure your surgery has the best possible outcome.
Many patients come to us feeling hopeless, saying they’ve tried “everything” – pain meds, cortisone shots, traditional physio, braces, even surgery – and yet they still hurt. First, know that we hear you and empathize deeply. Chronic knee pain can be very stubborn and disheartening. However, in almost all cases, there is something that has been missed or not fully addressed. Our approach is different enough that even those who have seen multiple practitioners often finally get relief with us. We don’t have a magic wand, but we do have: fresh eyes on your problem, advanced tools (like shockwave, EMTT) many clinics don’t offer, and a commitment to find the why of your pain. For example, perhaps previous treatments focused only on your knee arthritis, but no one checked your lower back or hip stability – and it turns out a pinched nerve in the back or a weak hip is keeping the knee in pain. Or maybe you had physio exercise programs, but they never included regenerative therapy to truly heal a damaged tendon – so the underlying issue never healed. By doing a head-to-toe assessment, we often find contributing factors that others overlooked. We also use a combination of treatments in synergy. As we like to say, we leave no stone unturned. Even if your condition is chronic, the body has an amazing capacity to heal and adapt – sometimes it’s about giving it the right stimulus (like shockwave) and removing impediments to healing (like tight fascia or poor alignment). We have had clients who suffered for decades finally experience relief by approaching the problem from a new angle. So, don’t give up. Your knee pain’s “everything” might not include our “everything” – and that can make all the difference. Results may vary, of course, but we will do our utmost to help you break that cycle of pain.
Your knee pain is not a life sentence – it’s more like a wake-up call. By now, you hopefully understand that when your knee hurts, it’s trying to tell you something about your body’s balance and function. Maybe it’s flagging weakness in your hips or ankles, or reminding you of an old injury pattern that never fully healed. The key to conquering knee pain is to listen to those signals and address the true root cause rather than just silencing the pain. Modern evidence-based therapies like shockwave, combined with a holistic rehab approach, make it possible to not only reduce knee pain but also improve how your knee functions. This means not just temporary relief, but getting you back to moving confidently and doing the activities you love – without that constant worry of “will my knee hold up?”
At Unpain Clinic, we don’t just ask “Where does it hurt?” — we dig deeper to find out “Why does it hurt?” Our whole-body methodology has helped countless individuals finally break free from the cycle of chronic knee pain when standard treatments didn’t work. Whether your knee pain comes from arthritis, an old sports injury, or seemingly out of nowhere, there is hope in a tailored approach that treats you as a whole person. We hope this guide has given you clarity on knee pain causes and reassurance that you can get better with the right help.
You don’t have to resign yourself to bad knees or keep spinning your wheels with quick fixes. Real, lasting relief is possible. It starts with understanding the message your knee pain is sending – and we’re here to decipher it with you and map out the fastest path to fix it. If you’re ready to finally address the “why” behind your knee pain, we invite you to take that next step.
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. Ying-Chun Wang, Hsuan-Ti Huang, Peng-Ju Huang, Zi-Miao Liu, Chia-Lung Shih. Efficacy and Safety of Extracorporeal Shockwave Therapy for Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis. Pain Medicine, 2020;21(4):822–835. https://academic.oup.com/painmedicine/article-abstract/21/4/822/5593618 OUP Academic
2. Zeyang Zhang, Zeyi Zhang, Bosong Zheng, Yuhang Yang & Youping Sun. Effects of lower-limb strengthening training on lower-limb biomechanical characteristics and knee pain in patients with patellofemoral pain: a systematic review and meta-analysis. European Journal of Medical Research, 2025;30:90. https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-025-02347-3 BioMed Central
3. M S Rathleff, C R Rathleff, K M Crossley, C J Barton. Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis. British Journal of Sports Medicine, 2014;48(14):1088. https://bjsm.bmj.com/content/48/14/1088 British Journal of Sports Medicine
4. Denisa Manojlović, Žiga Kozinc, Nejc Šarabon. Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis. Journal of Pain Research, 2020;13:983–1001. https://www.tandfonline.com/doi/pdf/10.2147/JPR.S301448 Taylor & Francis Online
5. Juan Avendaño-Coyã, Natalia Comino-Suárez, Jesús Grande-Muñoz, Carlos Avendaño-López, Julio Gómez-Soriano. Extracorporeal shockwave therapy improves pain and function in subjects with knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. (PDF) https://rocklinfamilypractice.info/documents/shockwave/knee/ESWTKneeOsteoarthritis.pdf rocklinfamilypractice.info
6. Yuyan Na, Changxu Han, Yuting Shi, Yong Zhu, Yizhong Ren, Wanlin Liu. Is Isolated Hip Strengthening or Traditional Knee-Based Strengthening More Effective in Patients With Patellofemoral Pain Syndrome? A Systematic Review With Meta-analysis. Orthopaedic Journal of Sports Medicine, 2021;9(7):23259671211017503. https://journals.sagepub.com/doi/full/10.1177/23259671211017503 SAGE Journals
7. “Hip and Knee Strengthening is More Effective Than Knee Strengthening Alone for Reducing Pain and Improving Activity in Individuals with Patellofemoral Pain.” Physio-Pedia. https://www.physio-pedia.com/Patellofemoral_Pain_Syndrome_and_Hip_Strength Physiopedia
8. “A Systematic Review of the Use of Shockwave Therapy for Knee Osteoarthritis.” Europe PMC. https://europepmc.org/article/MED/38765896 Europe PMC