NYU Langone specialists offer a range of nonsurgical options for treating meniscus tears. When diagnosing a meniscus tear, your doctor uses imaging exams to help assess the tear pattern and whether it may respond to nonsurgical approaches.
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For older people the injury may be the result of degenerative meniscus tissue due to general wear and tear, which your doctor sees using imaging tests. Treatments for these tears begin with conservative measures and include rest, ice, compression, and elevation; medications to relieve pain; physical therapy; corticosteroid injections; and biologic injections.
Your doctor may recommend the RICE regimen—rest, ice, compression, and elevation—to treat a meniscus tear.
Resting your knee can help relieve your symptoms. Your doctor may suggest using a cane for a few weeks to keep weight off your knee and to stay away from physical activity that may have contributed to the injury.
During the first few days after you’ve torn your meniscus, applying ice to the injury and elevating your knee periodically can reduce swelling. Wearing a compression bandage may also reduce swelling.
Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help to reduce inflammation and pain caused by a meniscus tear. Acetaminophen can also help to manage pain but does not reduce inflammation. Your doctor discusses over-the-counter or prescription options with you.
After the inflammation in the joint has subsided and you can stand and walk without significant pain, doctors may recommend physical therapy to rebuild strength and flexibility in the injured knee. Physical therapists can create a personalized treatment plan that enables you to return to your everyday activities.
Strengthening the thigh and leg muscles and stretching the knee, thigh, and leg can help to restore the full range of motion to the knee. Low-impact exercises such as stationary biking may reduce your level of pain, improve mobility, and restore function to the area around the meniscus tear. As your knee and muscles grow stronger, your physical therapist guides you in returning to more vigorous activity.
The duration of physical therapy depends on the extent of the meniscus tear. For a small tear, a doctor may recommend four to eight weeks of physical therapy. For a more serious tear, physical therapy may continue for eight weeks or longer. Your doctor evaluates your progress every four weeks to determine whether further rehabilitation is necessary.
Corticosteroids are powerful anti-inflammatory medications that can alleviate knee pain. Although corticosteroids injected directly into the knee do not heal a meniscus tear, they may reduce swelling and discomfort. Some people may experience long-lasting relief.
Your doctor may inject a small amount of anesthetic into the knee along with corticosteroids. The anesthetic provides immediate pain relief that wears off after a few hours, at which time knee pain may return. The corticosteroid begins to work two to three days later. You can return home or go to work immediately after the injection.
Doctors typically do not recommend multiple corticosteroid injections within a short period of time. If used too often, corticosteroids may cause side effects, including the weakening of soft tissue in the knee and deterioration of the cartilage. Corticosteroids may also increase blood sugar levels and may not be an option for people with diabetes or other metabolic conditions.
Biologics, medicines derived from biological sources such blood, bone marrow, and fat cells, are an emerging technology that your doctor may discuss with you as a possible complement to other nonsurgical approaches to care. These medicines may help tissue to heal and decrease inflammation in your knee.
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