What is the treatment for patellofemoral pain?
In the short term
- Avoid strenuous use of the knee - until the pain eases. Symptoms usually improve in time if the knee is not overused. Aim to keep fit but to reduce the activities which cause the pain.
- Painkillers - paracetamol and/or anti-inflammatory painkillers such as ibuprofen.
- Improving the strength of the muscles around the knee and hip will ease the stress on the knee.
- Specific exercises may help to correct problems with alignment and muscle balance around the knee. For example, you may be taught to do exercises which strengthen the muscles of the hip and buttock.
- The physiotherapist can give advice tailored to your individual situation.
- Taping of the kneecap (patella) - this is a treatment which may reduce pain. It involves adhesive tape being applied over the patella, to alter the alignment or the way the patella moves. Some people find this helpful. Some physiotherapists can offer patellar taping treatment.
In the longer term
- Treatment aims to treat some of the underlying causes - for example, by strengthening hip muscles and helping with foot problems:
- Physiotherapy - a long-term home exercise programme, for at least one year.
- Suitable footwear - for example, arch supports if you have flat feet; suitable shoes if you are running.
Surgery is no longer recommended, as there is no evidence that it is any better than other treatments.
What is the outlook?
The outlook (prognosis) is good. Most people get better with simple treatments such as physiotherapy. However, it may take 4-6 months for full recovery and, meanwhile, you may need to reduce activities such as sports training. Unfortunately symptoms may persist in 25% of people for up to 20 years but patellofemoral pain is an area of active research interest.
Further reading and references
van der Heijden RA, Lankhorst NE, van Linschoten R, et al; Exercise for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015 Jan 201:CD010387. doi: 10.1002/14651858.CD010387.pub2.
Witvrouw E, Callaghan MJ, Stefanik JJ, et al; Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014 Mar48(6):411-4. doi: 10.1136/bjsports-2014-093450.
Callaghan MJ, Selfe J; Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev. 2012 Apr 184:CD006717. doi: 10.1002/14651858.CD006717.pub2.
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