How to Treat a Popping Knee

Recognizing the Symptoms of Osteoarthritis. Unlike the typical "clicking" sound that doesn't cause pain when extending the leg, a popping knee due to osteoarthritis is usually accompanied by significant pain. Fortunately, there are several ways to identify osteoarthritis:

• Look for signs like pain, redness, swelling, and stiffness when walking. The most common area where the popping sound is heard is on the inside of the knee.
• Try to locate the sound by gently pressing the upper part of the knee while bending and stretching the joint. Typically, when this sound occurs, you may also feel a soft and brittle sensation in the knee.

Reduce localized swelling. If you experience popping in your knee along with pain and swelling, applying an ice pack (wrapped in a towel) to the knee can help. Cold compresses are effective for reducing inflammation and soothing the pain.

• You may also take small doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as Alaxan (ibuprofen) or Ameproxen (naproxen) to relieve pain temporarily. However, these medications should not be used long-term as they can harm the kidneys and digestive system.
• The benefit of NSAIDs is that they not only reduce pain but also decrease inflammation.
• You may combine an NSAID with an over-the-counter pain reliever like Panadol (acetaminophen). While pain relievers cannot treat inflammation, they can significantly alleviate pain, and the combination of these two medications (an NSAID and Panadol) is particularly effective in enabling you to carry out daily activities without discomfort.

Purchase prescription anti-inflammatory medications. Prescription NSAIDs include brands like Indocin, Daypro, Relafen, and many others. These medications are stronger than over-the-counter options, making them more effective in treating pain and inflammation associated with knee popping. However, you need a doctor's prescription to obtain them, which means your knee must be examined first.

• Prescription NSAIDs may cause side effects, with the most common being stomach discomfort. In severe cases (such as when overdosed), they can lead to stomach ulcers and kidney damage. Always follow the doctor's instructions and never exceed the recommended dosage.

Cortisone injections. Cortisone is a steroid hormone produced by the body during stress. (Note: this is not the type of steroid often used or abused by athletes.) Cortisone suppresses the immune system and significantly reduces inflammation. For knee pain accompanied by popping, your doctor may choose to inject cortisone directly into the knee joint to alleviate pain and inflammation.

• Cortisone injections have proven to be effective in treating intermittent knee popping. However, frequent cortisone injections into the knee can actually lead to cartilage degeneration, making the knee pain worse. For this reason, cortisone injections are not a long-term solution.
• It is recommended not to have more than one cortisone injection every three months, although you can continue receiving them as long as they remain effective, and some cases may see relief lasting for years.

Treatment with "lubrication supplements". Synovial fluid within the knee joint serves as a lubricant and helps stabilize joint movement. In individuals with arthritis, this synovial fluid becomes "thinner" or less viscous, increasing friction and disrupting normal joint motion. In such cases, doctors may suggest a treatment known as "lubrication supplementation," which involves injecting new lubricating fluid into the knee joint to restore smooth movement.

• Typically, you'll need three to five injections over several weeks to complete the lubrication supplementation process.
• Note that approximately half of the patients receiving lubrication supplementation experience successful symptom relief.

Wear a knee brace. Knee arthritis patients often need to wear a knee brace. This type of brace helps shift the pressure from the inner part of the knee joint (where the popping occurs) to the rest of the knee. A knee brace also provides stability and support, ensuring that the knee bends in a proper direction and preventing further damage.

• There are affordable knee braces available, but a medically certified brace is custom-made to fit each individual's knee, making it more expensive. Consult your doctor for pricing if you're considering using a knee brace.

Consider surgical options. For cases of knee popping that are severe, and where arthritis is the underlying cause, surgery may be a viable solution. If knee pain significantly impacts your quality of life and non-surgical treatments have been ineffective, surgery might be something to explore.

• Your doctor will provide details on various knee surgery types: total or partial knee replacement, cartilage repair, knee arthroscopy, and osteotomy are commonly used options.
• It’s important to note that while surgery may work well for some patients, it might not be effective for others. Arthritis is notoriously difficult to treat, so it's crucial to explore all available options before making a decision.

Ensure proper diagnosis. Knee pain can stem from several different diagnoses, such as osteoarthritis (caused by mechanical "wear and tear" over time—this is the most common cause), rheumatoid arthritis (due to an autoimmune issue), infectious arthritis, past knee injuries, or patellar dysfunction. It's vital to get a correct diagnosis, as the best treatment methods and knee protection plans depend on what's happening inside the knee.

• Similarly, if diagnosed with osteoarthritis but symptoms don’t improve with treatments, you should ask your doctor to consider other possible diagnoses that might be more appropriate.

Maintain a healthy weight. For every additional kilogram you gain, it puts an extra six kilograms of pressure on your knee joints. Therefore, people who are overweight are more likely to develop arthritis compared to those who maintain a healthy weight. To prevent future knee pain (and alleviate existing symptoms), aim to maintain an appropriate weight by following a balanced diet (since exercising may be challenging with knee pain).

• People with arthritis are advised to avoid processed foods, fried foods, sugar, refined carbohydrates, salt, preservatives, and corn oil, all of which can exacerbate knee inflammation either directly or through weight gain.

Exercise regularly. The muscles surrounding the knee joint serve as shock absorbers, providing support and stability during intense activities (like sports or exercise) and in everyday movements. The stronger the muscles, the better they absorb force. To prevent or alleviate knee popping, try to gradually build muscle strength with targeted strengthening exercises.

• For knee popping, thigh muscle contractions are one of the best exercises. Place a rolled towel under your knee, tighten your thigh muscles, hold for five seconds, then relax. Repeat this 10 times.
• Non-joint moving exercises, such as leg raises (keeping the knee fixed), thigh muscle strengthening, or wall sits, can build strength without aggravating pain or inflammation in the knee.
• Low-impact cardiovascular exercises, like cycling and swimming, are also great for building thigh and calf muscles (aim for at least three times a week). They help reduce weight and ease knee pain.

Try alternating cold and hot compresses. Both of these methods can help alleviate pain related to knee popping. It's worth experimenting with cold and/or hot compresses to see if either works effectively for you.

Consider taking dietary supplements. Certain dietary supplements, such as glucosamine sulfate and chondroitin sulfate, are commonly used by arthritis patients to treat and/or prevent knee popping. However, they are not regulated by the FDA (Food and Drug Administration) and their effectiveness has not been scientifically proven. There is also limited information regarding the long-term side effects of these supplements. Clinical research is currently underway to assess their medical benefits. In the meantime, you may want to consult with your doctor or someone who has used these supplements before deciding to try them yourself.