Physical examination

A healthcare professional will assess joint alignment, swelling, tenderness, muscle strength, and range of motion. Special tests may be used to identify signs of meniscal tears, ligament instability, or alignment issues.

This hands-on assessment also helps determine how the knee responds under pressure or during certain movements, such as bending, squatting, or stepping. The goal is to rule out referred pain from the hip or lower spine and to assess for patterns consistent with arthritis or soft tissue involvement. Sometimes discomfort in the knee can actually originate from the hip, making it important to consider the hip-knee pain connection during a thorough diagnostic process.

Imaging tests

• X-ray imaging is often used to check for signs of osteoarthritis, narrowed joint spaces or the development of bony spurs.
• If soft tissue injuries are suspected, such as damage to the meniscus or tendons, an MRI scan may be recommended.
• Ultrasound can also help visualise bursitis or fluid accumulation.

Depending on symptoms, your doctor may also review gait (how you walk), perform balance tests, or refer you to a physiotherapist or rheumatologist for a more detailed assessment. In some cases, blood tests may be done to rule out inflammatory arthritis or infection.

Conservative Management

In many cases, knee pain in older adults can be managed successfully without surgery. Let’s explore some of the most evidence-backed and age-appropriate strategies available.

Physiotherapy and joint-friendly exercises

Tailored physiotherapy can help build strength in the surrounding muscles, especially the quadriceps, glutes, and calves. Low-impact exercises, such as walking, swimming or cycling, are often recommended to maintain joint movement without causing further strain. A physiotherapist can also provide education on pacing, posture, and movement strategies.

Structured strength programs can also delay the progression of arthritis by improving load distribution across the knee. Even simple routines, such as seated leg raises or resistance band work, can build resilience and reduce joint pain over time.

Walking aids and home modifications

Using a walking stick or frame can reduce pressure on the knees during walking, especially on uneven ground or stairs. Handrails, non-slip mats, raised seating, and accessible bathrooms are simple yet highly effective ways to reduce strain and prevent falls in daily life.

Occupational therapists can assess your home environment to identify subtle hazards, such as poor lighting or cluttered pathways, that may increase the risk of falls. These assessments are especially helpful for people living alone or recovering from injury.

Medication options

Paracetamol is often used for mild to moderate knee pain, while topical anti-inflammatories (such as diclofenac gel) can target local inflammation with fewer systemic side effects. Oral NSAIDs may be prescribed short-term, but are used carefully in older adults because they can affect the stomach, kidneys, or blood pressure.

Other options may include capsaicin creams, short-term corticosteroid injections (for inflammation), or targeted treatments based on the cause. Always follow your doctor’s guidance and avoid self-medicating with over-the-counter options long-term without review.

Weight management and joint unloading

Carrying extra weight puts added pressure on the knees, especially during activities such as walking or climbing stairs. Even modest weight loss may help ease knee symptoms and reduce joint strain. Joint unloading braces may also be recommended to support alignment and reduce pressure on affected areas of the joint.

Weight loss doesn’t need to be extreme. Losing even 5 to 10 percent of your body weight can ease joint strain. A dietitian or GP can support safe, age-appropriate strategies that consider other health conditions, like diabetes or heart disease.

Surgical Referrals

Sometimes, conservative care isn’t enough. In this section, we’ll look at when a surgical opinion might be appropriate and what types of procedures may be considered.

When surgery is considered

Surgical options are typically explored when:

• Pain persists despite physiotherapy, medication, and lifestyle changes
• Mobility is significantly limited
• Joint damage is visible on imaging and correlates with symptoms

Your GP may also refer you for an orthopaedic knee surgeon input if symptoms are rapidly worsening or if the pain significantly interferes with your independence and ability to participate in daily life. Importantly, the decision to proceed with surgery is always personalised and made in consultation with your medical team.

Types of procedures

• Arthroscopy may be used in selected cases to remove loose fragments or smooth rough cartilage
• Osteotomy is sometimes recommended to shift weight-bearing forces in cases of malalignment
• Joint replacement may be discussed if the joint is severely damaged, although this is typically explored in a separate consultation

Not all procedures are suitable for every patient. Your surgeon will consider factors like age, bone quality, general health, and goals for recovery. Prehabilitation (physio before surgery) is often advised to optimise outcomes.

Daily Living Tips for Knee Health

Small, proactive changes can make a big difference to your comfort and confidence. Here’s how to protect your knees while staying engaged in the life you love.

Falls prevention strategies

Falls are a major concern for many older adults who experience knee pain. To reduce your risk:

• Keep walkways clear and well-lit
• Wear supportive, non-slip footwear
• Consider an in-home assessment by an occupational therapist
• Use mobility aids confidently when needed

Many falls happen not because of weakness alone, but because of distraction, poor lighting, or rushed movement. Slow, deliberate movement and proper footwear can help minimise risk.

Joint-friendly nutrition

Eating foods that contain omega-3s, antioxidants, and vitamin D may be helpful for keeping your joints healthy. Eating enough protein helps maintain muscle mass, which is important for joint stability.

Hydration is also important, as dehydrated tissues may be more prone to stiffness. For some, addressing vitamin D deficiency (especially in winter) may improve joint and muscle function.

Stay active, but within your limits

Staying active can support joint mobility, even if you have some pain. Gentle activities like tai chi, water-based classes, or slow bushwalks can be easier on the knees and still highly beneficial. Avoid sudden increases in activity, and don’t hesitate to rest when needed.

Activity shouldn’t leave you limping. A good rule of thumb is: if the pain lingers more than two hours after exercise, it may have been too much. A physiotherapist can help tailor a plan that suits your body and pace.

Warmth, pacing, and self-care

Using heat packs, pacing your activities throughout the day, and scheduling breaks can all help manage discomfort. Simple rituals, such as stretching in the morning or wearing supportive shoes, can provide steady, low-effort relief.

Even how you plan your day matters. Try to alternate tasks that use your knees with ones that don’t, and listen to your body’s cues. Energy conservation strategies can help maintain function without causing setbacks.

When to Seek Help

You don’t need to wait for the pain to become severe before speaking with a knee specialist like Dr. Negus or consulting a physiotherapist. Early management often leads to better outcomes, whether through strengthening, joint protection strategies, or further referral. If you notice increasing stiffness, reduced function, or feel uncertain about your knee health, a timely assessment can help you stay ahead of any problems.

You’re not alone. Many older adults face these challenges. With the right knee care for older adults, including education, support, and tailored strategies, it’s entirely possible to move forward with confidence.

Disclaimer: This content is intended for informational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a registered health practitioner before beginning any treatment or making decisions about your healthcare. You can verify registration at AHPRA’s public register. Individual outcomes may vary depending on personal health circumstances and the nature of the injury.

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