How is patellofemoral pain syndrome treated?

Patellofemoral syndrome is most commonly a result of improper tracking of the patella in the femoral groove. Depending on whether this improper tracking has caused chondromalacia patella or patellofemoral stress syndrome, the treatment may vary with different health care practitioners. Assessment of what is causing the improper tracking is a first step towards proper treatment and corrective exercise. Treatments in the form of different modalities are sometimes transient when it comes to long term relief from this type of pain. Identification of kinetic chain segments to correct patellar tracking
should be part of any treatment plan.

Scott D. Martin, MD
Orthopedic Surgery
Surgical treatment for patellofemoral pain syndrome is rarely recommended. If you are experiencing knee pain, rest your knee, apply ice packs, and keep your knee elevated. Take acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve pain. A rehabilitation plan will be important to regaining strength and range of motion. Substitute low-impact activities—such as swimming, bicycling, and the use of elliptical trainers—for high-impact activities. After activity, ice the knee for 10 to 20 minutes. Exercise to strengthen your quadriceps muscles, adding small ankle weights after two weeks. Stretch to increase the flexibility of your hamstrings, calves, and hip muscles. Your physical therapist can identify which areas need the most attention. Arch supports or better-fitting athletic shoes may be helpful as well.

It may take six weeks or more to notice an improvement. After you feel better, you may be able to gradually return to higher-impact activities. You should continue to do the exercises you learned during rehabilitation even after your condition improves.
F H. Selesnick, MD
Orthopedic Surgery
Nonsurgical treatment includes rest, anti-inflammatory drugs, physical therapy, ultrasound and injection of corticosteroids. Minimally invasive surgical procedures such as arthroscopic removal of the bursa can allow your doctor to inspect the shoulder structures, remove bone spurs and repair tears.
Your doctor will examine your shoulder to assess range of motion, stability and strength. Although soft tissues cannot be seen on X-rays, X-rays can help eliminate other possible causes of your pain, such as bone spurs and arthritis. MRI imaging can reveal fluid accumulation in the bursa and assess adjacent structures. Ultrasound studies are also useful in identifying bursitis.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.