Knee Arthritis Treatment Adelaide
When sore knees start running your day
For many people in their 50s, 60s and beyond, knee arthritis doesn’t arrive all at once. It creeps in. Getting out of the car takes a second longer. Stairs feel different. There’s a stiffness in the morning that didn’t used to be there, and a deep ache by the end of the day.
Eventually, the knees start making decisions for you. You stop offering to help with the shopping. You park closer. You skip the walk you used to enjoy because you know what it’ll feel like tomorrow.
If this sounds familiar, you’re not alone — and you’re not stuck with it. Knee arthritis is one of the most common conditions we treat at Adelaide Podiatry Centres, and most patients have more options than they’ve been told.
Gap Free Knee Pain Assessments*
We offer a GAP FREE ASSESSMENT* for knee pain under your health insurance.
What knee arthritis actually is
Knee arthritis — most commonly osteoarthritis — is wear-related change inside the knee joint. The smooth cartilage that lines the bones gradually thins, the joint becomes less cushioned, and inflammation builds up in response. Over time this leads to the familiar pattern of stiffness, ache, swelling, and reduced movement.
It’s the most common form of arthritis in Australia. Around 1 in 5 adults over 45 have it to some degree. The reason it’s so common is that it has many contributing causes, not just one:
• Age-related changes to cartilage and joint tissues
• Body weight placing extra load through the knees
• Previous injuries — old meniscus tears, ligament damage, fractures
• Foot and leg alignment that increases pressure on one side of the knee
• Reduced muscle strength around the hip and thigh
• Long-term occupational load from standing, kneeling or heavy lifting
Most patients we see have a combination of several. The good news is that most of these are things we can influence — even when the cartilage itself is not.
What knee arthritis feels like
Symptoms vary, but the pattern is recognisable:
• Morning stiffness that eases after 15 to 30 minutes of moving
• Pain getting out of a chair, the car, or bed
• Aching after walking, even short distances
• Difficulty with stairs, especially going down
• Swelling around the knee, sometimes warm to touch
• Grating, clicking or crunching sensations with movement
• A feeling of the knee giving way or being unreliable
• Knees looking larger or more lumpy than they used to
Pain often comes and goes in flares. A bad week followed by a better week is normal. But the longterm direction, without treatment, tends to be downward — which is why early management matters.
Why “wait until it’s bad enough for surgery” isn’t your only option
A lot of people are told, sometimes quite directly, that there’s nothing much to do for knee arthritis until it’s bad enough for a knee replacement. That advice is decades out of date.
Knee replacements work well for the right patient at the right time, but they aren’t the first step. The current international consensus — including guidelines from the Royal Australian College of General Practitioners — is that conservative, non-surgical treatment should be tried first for most people, and continued alongside any eventual surgical plan.
The reasons matter:
• Knee replacements are major surgery, with a real recovery cost and a finite lifespan
• Many people get years of comfortable function with non-surgical care alone
• Patients who go into surgery stronger and better-prepared have better outcomes
• For mild-to-moderate arthritis, surgery is often not needed at all
We work with many patients who came to us assuming surgery was inevitable, and who now manage their knees comfortably with the right combination of treatments.
How we assess your knees
A thorough assessment is where good treatment starts. Your first visit includes:
A detailed history. What hurts, when it started, what makes it worse, what you’ve tried, what you’d like to be able to do again. The goals matter — getting back to the garden looks different from getting through a 12-hour shift on your feet.
A physical examination of the knee, including movement range, swelling, tenderness, stability, and the way the knee tracks during simple movements.
A computerised gait analysis. We watch how your knee actually loads with each step — alignment, joint angles, weight distribution. This is one of the most useful pieces of information in the entire assessment, because it shows exactly where the load is going wrong.
A broader lower-limb review of your hips, ankles and feet, since knee load is influenced from above and below. Foot posture, in particular, has a significant effect on which part of the knee takes the brunt of each step.
A review of any prior imaging if you’ve had X-rays or scans.
By the end of the visit, you’ll have a clear explanation of what’s happening, why, and what we recommend doing about it.
How we treat knee arthritis
Treatment is matched to your stage of arthritis, your goals, and what your knee actually needs. We rarely use just one approach — combinations work better than single treatments for almost every patient.
Focused shockwave therapy
Unlike the more common radial shockwave, focused (focal) shockwave delivers a precise, deeper wave that targets joint structures directly. At Adelaide Podiatry Centres, our capability goes beyond standard podiatric care. We are one of only a handful of clinics in Australia — let alone Adelaide — equipped with focused (focal) shockwave technology. A 2024 umbrella review of systematic reviews concluded that extracorporeal shockwave therapy is effective and safe for reducing pain and improving function in knee osteoarthritis,² with multiple meta-analyses showing significant improvements on standard pain (VAS) and function (WOMAC) measures at 4, 8 and 12 weeks following treatment.³ Sessions are quick, non-invasive, and well-tolerated.
Prolotherapy (dextrose) injections
Prolotherapy is a dextrose-based injection that stimulates the body’s natural repair response in the soft tissues that support and stabilise the knee. It is steroid-free and medication-free, which makes it a useful option for patients who prefer to avoid cortisone. We are also one of a small number of Adelaide clinics able to offer prolotherapy injections. Prolotherapy can only be performed by specially trained regenerative medicine doctors and podiatrists who have completed additional credentialing in regenerative injection therapies, and our team is qualified to deliver these safe, low-pain injections in-house.
Published randomised controlled trials — including the landmark Rabago study in Annals of Family Medicine — have shown significant and sustained improvements in pain, stiffness and function in patients with knee osteoarthritis treated with dextrose prolotherapy compared with saline injection or exercise alone.⁴ A 2016 meta-analysis published in Scientific Reports concluded that prolotherapy conferred a positive and significant beneficial effect in the treatment of knee osteoarthritis,⁵ and a 2019 systematic review found it more effective than local anaesthetic injection and as effective as hyaluronic acid injection for pain and function.⁶ Larger high-quality trials are still being called for, but the current evidence supports prolotherapy as a reasonable option for selected patients — particularly those wanting to avoid steroids or surgery.
High-level cold laser therapy
Painless light-based therapy that helps reduce inflammation and supports tissue repair at a cellular level via photobiomodulation. A 2024 network meta-analysis published in Aging Clinical and Experimental Research found that low-level laser therapy produced statistically significant reductions in pain and improvements in function in knee osteoarthritis compared with sham treatment,⁷ with effects amplified when combined with structured exercise therapy.⁸ Many patients describe a gentle warmth during treatment, or feel nothing at all.
Custom orthotic therapy
For many patients, redistributing pressure through the foot can reduce the load on the painful part of the knee. Using the data from your gait analysis and a 3D laser scan, we design orthotics that gently shift load away from the worn compartment and improve overall alignment. Research has shown that orthotic devices can reduce the knee adduction moment — the mechanical force driving medial compartment wear — by between 4% and 12% during walking,¹ which is why orthotic therapy is included as a recommended non-pharmacological option in international knee osteoarthritis guidelines. Importantly, response varies between patients; the highest-yield results come from custom, gait-informed devices fitted to your specific biomechanics rather than generic off-the-shelf wedges.
Footwear advice
The wrong shoe can undo everything else. We review your everyday footwear — slippers and house shoes included — and give clear, practical recommendations for what to wear for walking, errands, and around the home. This is one of the lowest-cost, highest-yield changes available.
Strength and rehabilitation programs
Stronger muscles around the knee — particularly the quadriceps, glutes, and calves — directly reduce pain and improve function in arthritic knees. We use the AxIT muscle strength testing system to measure where you actually are (often quite different from where people assume), and build a program you can realistically do at home, suited to your starting point. For patients who’d benefit from supervised group exercise, we’ll refer to physiotherapy or exercise physiology partners who run programs like GLA:D.
What outcomes can you realistically expect?
Most patients we see can expect:
• Noticeable pain reduction within 6 to 12 weeks of starting a structured plan
• Easier daily movement — getting up from chairs, walking, stairs, standing for longer
• Better sleep, since night-time knee ache often improves alongside daytime symptoms
• Less reliance on pain medication
• Delay or avoidance of surgery in many mild-to-moderate cases
• Better preparation for surgery if it does become the right step
We won’t promise to reverse the arthritis — no one honestly can. But the gap between what your knees feel like now and what they could feel like is usually much wider than people expect.
When you should book an appointment
It’s worth seeing a podiatrist if:
• Knee pain or stiffness is changing how you move through your day
• You’re avoiding activities you used to do without thinking
• You’ve been told you “just have to live with it” but aren’t ready to accept that
• You’ve been told surgery is inevitable but want to explore alternatives first
• You’re on a knee replacement waitlist and want help managing in the meantime
• You’re noticing one knee starting to make the other one work harder
Earlier intervention generally produces better outcomes. Knees that have been compensating for years take longer to retrain.
Frequently asked questions
Can a podiatrist help with knee arthritis?
Yes. While podiatry is best known for foot care, podiatrists with biomechanics training routinely manage knee pain — particularly knee osteoarthritis where foot posture, gait, and load distribution are contributing factors. Many patients are surprised at how much the foot influences knee comfort.
Will I need a knee replacement eventually?
Not necessarily. Many patients with knee arthritis manage well long-term without surgery. Whether you’ll need a replacement depends on the severity of the arthritis, your symptoms, your goals, and how well conservative care manages your knee over time. Surgery is one option among several, not an inevitable destination.
Are cortisone injections a good idea?
Cortisone injections can provide short-term pain relief during a flare, but they don’t change the underlying condition, and repeated use carries documented concerns about cartilage health. We tend to favour treatments that support the knee rather than just temporarily silence it, but cortisone has its place in selected situations.
Is treatment painful?
Most of our treatments are well-tolerated. Shockwave can feel firm but is brief. Cold laser is painless. Prolotherapy involves a small injection with a sting that settles quickly. Orthotic fitting and gait analysis involve no discomfort at all.
How quickly will I notice a difference?
Many patients notice early improvements — particularly in morning stiffness and stair pain — within the first few weeks. More substantial improvement typically builds over 6 to 12 weeks of a structured plan.
Will my private health insurance cover this?
Podiatry consultations and treatments are claimable under most private health funds with extras cover that includes podiatry. We also offer a gap-free initial knee assessment for eligible patients with podiatry cover.
Do I need a GP referral?
No. You can book directly. If you have a chronic disease management plan from your GP, your visits may also be eligible for Medicare rebates.
Book your knee assessment
Two clinics: North Adelaide (62 Melbourne Street) and Eastwood (233 Fullarton Road).
Same-day appointments often available. Gap-free initial knee assessment for eligible private health patients.
References
¹ Reilly KA, Barker KL, Shamley D. A systematic review of lateral wedge orthotics — how useful are they in the management of medial compartment osteoarthritis? The Knee. 2006;13(3):177–183. Biomechanical reduction in knee adduction moment of 4–12% with wedged orthotic devices.
² Tang P, Wen T, Lu W, et al. The efficacy of extracorporeal shock wave therapy for knee osteoarthritis: an umbrella review. International Journal of Surgery. 2024;110(4):2389–2395. doi:10.1097/JS9.0000000000001116
³ Liao CD, Xie GM, Tsauo JY, Chen HC, Liou TH. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-analysis. International Journal of Surgery. 2020;75:24–34. Significant pain reduction at 4, 8 and 12 weeks; significant WOMAC function improvement at all time points; no increased risk of adverse effects compared with controls.
⁴ Rabago D, Patterson JJ, Mundt M, et al. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. Annals of Family Medicine. 2013;11(3):229–237. doi:10.1370/afm.1504
⁵ Sit RWS, Chung VCH, Reeves KD, et al. Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: a systematic review and meta-analysis. Scientific Reports. 2016;6:25247. doi:10.1038/srep25247
⁶ Arias-Vázquez PI, Tovilla-Zárate CA, Bermudez-Ocaña DY, et al. Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials. Advances in Rheumatology. 2019;59:39. doi:10.1186/s42358-019-0083-7
⁷ Wang HK, Lin YC, Liao JD, Lin PH. A systematic review and network meta-analysis on the optimal wavelength of low-level light therapy (LLLT) in treating knee osteoarthritis symptoms. Aging Clinical and Experimental Research. 2024;36:208. doi:10.1007/s40520-024-02853-0
⁸ Ahmad MA, Hamid MSA, Yusof A. Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy. 2022;114:85–95
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