Knee pain and osteoarthritis: who should I see?
Knee osteoarthritis is common and often improves with exercise and weight management. Here's when to see a physio or surgeon.
Osteoarthritis is the most common cause of ongoing knee pain in adults. The smooth cartilage that covers the ends of the bones slowly thins, and the joint can become stiff, sore and sometimes swollen. It often comes on gradually and tends to be worse after activity or first thing in the morning.
Osteoarthritis is not just wear and tear, and it doesn't always get worse. Many people manage it well for years with the right mix of exercise, weight management and pain relief.
What usually helps first
Australian guidelines recommend starting with treatments that don't involve surgery. These include:
- A tailored strengthening and movement program, often guided by Physiotherapy or Exercise physiology
- Losing some weight if you carry extra, which takes load off the knee
- Staying active with low-impact exercise like walking, cycling, swimming or water exercise
- Pain relief and other medicines your GP or pharmacist recommends for you
- Aids such as a walking stick or supportive footwear, which a podiatrist or physio can advise on
You don't need a referral to see a physiotherapist or exercise physiologist privately. If you have a chronic condition, your GP may be able to set up a plan that gives Medicare rebates for some allied health visits. See Do I need a referral for a physio, psychologist or dietitian?.
When to see a specialist
Your GP may refer you to Orthopaedic surgery if pain and stiffness are still severe after a good trial of exercise and other treatment, if the knee keeps locking or giving way, or if pain is affecting your sleep, work or independence. Some people also see Rheumatology if there are signs of an inflammatory arthritis, such as several swollen joints or long morning stiffness.
The surgeon will examine your knee, look at X-rays and talk through options. These might include more targeted rehab, injections in some cases, or a partial or total knee replacement. Arthroscopy (keyhole surgery to clean out the joint) is generally not recommended for osteoarthritis alone. Ask what each option involves, the expected recovery and what happens if you wait.
Referrals and costs
You need a GP referral to claim a Medicare rebate for a specialist visit. Surgeons set their own fees, so ask about the consultation fee, and later any surgery quote, before you book. On Spec Book you can see who has the soonest appointment, and your GP can send the referral with the booking.
When to get urgent help
Go to an emergency department or call 000 if your knee is suddenly hot, red and very swollen with a fever, if you can't put any weight on it after an injury, or if your calf becomes painful and swollen.
Common questions
Will exercise make my arthritis worse?
For most people, no. The right exercise usually reduces pain and improves function over time. Some soreness at first is common, and a physio can adjust the program.
Do I need an MRI for knee osteoarthritis?
Usually not. Osteoarthritis is mostly diagnosed from your symptoms, an examination and sometimes an X-ray. Your doctor will tell you if other scans are needed.
Am I too young for a knee replacement?
There's no fixed age. Surgeons weigh your symptoms, how much the knee limits you and how long a replacement is likely to last.
Can I see a physio without a referral?
Yes. You can book a physiotherapist directly. A referral is only needed if you want to use a GP plan for Medicare rebates.
General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.