Why do your knees hurt? If you have knee osteoarthritis, part of the answer is that the cartilage that cushions your knee can thin out, and the joint can become irritated and inflamed. That irritation can cause pain, stiffness, and swelling. But knee pain can also come from other problems, which is why an evaluation matters.
You may have seen articles that rank the top causes of knee pain. This one takes a different approach. It focuses on the cause our medical source explains well, osteoarthritis, and on how a clinician checks whether that explanation fits you.
Understanding what is happening inside your knee will not fix it on its own. It can, however, make your next appointment more useful and help you ask better questions.
What happens inside a knee with osteoarthritis?
Knee osteoarthritis is the most common “wear and tear” arthritis. Think of the cartilage in your knee as a cushion. Over time, that cushion can thin out, and the joint can get irritated and inflamed.
According to our source, that irritation can lead to chronic knee pain, stiffness, swelling, and popping or grinding sounds. If you have noticed any of these, you are not imagining things. They are the kinds of symptoms osteoarthritis is known for.
Put simply, the cushion gets thinner, the joint gets irritated, and your knee tells you about it through pain, stiffness, swelling, and noise. That is a plain-English picture of what the source describes, not a full medical explanation, so your own evaluation matters.
It is also worth knowing how much this can affect daily life. Chronic knee osteoarthritis pain can shrink your world fast, with fewer walks, less sleep, and more time spent just putting up with it.
Because the cartilage is part of the story, it is fair to ask whether a treatment can bring it back. Our source is clear on one point: GAE is designed to reduce pain and inflammation, not rebuild cartilage. Setting that expectation early can save you from disappointment later.
How can inflammation and extra blood vessels add to the pain?
Pain from osteoarthritis is not only about the cushion. In many people with osteoarthritis, parts of the knee lining, called the synovium, can become inflamed and develop extra small blood vessels. Those vessels can help feed ongoing inflammation and pain.
This idea is the reason some treatments focus on the blood vessels around the knee. For example, genicular artery embolization (GAE) is a minimally invasive procedure that targets tiny blood vessels around the knee called the genicular arteries. By blocking some of the extra tiny vessels with very small particles, the goal is to calm inflammation and reduce pain over time.
GAE is not right for everyone, and it is not the focus of this article. It is mentioned here because it shows how understanding the cause of pain can shape the options a clinician discusses with you.
Could something other than osteoarthritis be causing your knee pain?
Yes, it could. Our source notes that GAE might not be the best fit for people whose knee pain is mainly caused by a different problem. Examples include a fracture, a major ligament injury, or another inflammatory arthritis.
That is exactly why guessing at the cause is risky. Two people can both say “my knee hurts” and have very different problems underneath. The first step with any knee pain is usually a focused evaluation to confirm that osteoarthritis is the main driver of your pain.
A sore knee is a symptom, not a diagnosis. Bringing notes on where it hurts, what triggers it, and what you have already tried gives your clinician the details they need to sort out the cause with you.
Imaging plays a role here too. One of the things a provider looks for is imaging that supports osteoarthritis as a main pain source. If the picture and the symptoms do not match, that is useful information, and it can point toward another approach.
What does a knee pain evaluation involve?
Our source describes a typical evaluation in three parts.
- A detailed symptom review. Where it hurts, what triggers it, and what you have tried.
- A review of imaging. Often an X-ray, and sometimes an MRI, depending on your situation.
- A discussion of options. This can include nonsurgical care, injections, nerve-based treatments, and when knee replacement may be more appropriate.
The goal is clarity, not hype. If a treatment is a fit, you should understand what success looks like, what timelines are realistic, and what the alternatives are.
Do not be shy about asking questions during this visit. If you are told that osteoarthritis is the main driver of your pain, ask what that means for your options. If something else is suspected, ask how it will be confirmed.
If you are asking about next steps, it helps to know what conservative care is. It usually means exercise-based physical therapy, weight management if needed, and medications or injections when appropriate. If you have already tried some of these, tell your clinician so they can see the full picture.
When should you see a vascular specialist?
Consider an evaluation if you have chronic knee pain that limits your daily activities, or if your symptoms have not improved enough with conservative treatments. At VidaVascular, the team can review your symptoms and history and help you understand whether genicular artery embolization makes sense in your situation, or whether another approach is more likely to help.
You can also read about other conditions VidaVascular evaluates and treats. Whatever the cause of your knee pain turns out to be, getting a clear answer is the best starting point.
Ready to talk it through? Call VidaVascular at (866) 800-2346 or request an appointment. We see patients at our offices in Oxon Hill and White Plains, MD and Springfield, VA. You can find all of our locations here.
References
- Bagla, S., Piechowiak, R., Sajan, A., Orlando, J., Hartman, T., & Isaacson, A. (2022). Multicenter randomized sham controlled study of genicular artery embolization for knee pain secondary to osteoarthritis. Journal of Vascular and Interventional Radiology, 33(1), 2-10.e12. https://doi.org/10.1016/j.jvir.2021.09.019
- Landers, S., Hely, R., Hely, A., Harrison, B., Page, R. S., Maister, N., Gwini, S. M., & Gill, S. D. (2023). Genicular artery embolization for early-stage knee osteoarthritis: Results from a triple-blind single-centre randomized controlled trial. Bone & Joint Open, 4(3), 158-167. https://doi.org/10.1302/2633-1462.43.BJO-2022-0161.R2
- van Zadelhoff, T. A., et al. (2024). Genicular artery embolisation versus sham embolisation for symptomatic osteoarthritis of the knee: A randomised controlled trial. BMJ Open. https://doi.org/10.1136/bmjopen-2024-087047
- Okuno, Y., Korchi, A. M., Shinjo, T., & Kato, S. (2017). Midterm clinical outcomes and MR imaging changes after transcatheter arterial embolization as a treatment for mild to moderate radiographic knee osteoarthritis resistant to conservative treatment. Journal of Vascular and Interventional Radiology, 28(7), 995-1002.
- Taslakian, B., Miller, L. E., Mabud, T. S., Macaulay, W., Samuels, J., Attur, M., Alaia, E. F., Kijowski, R., Hickey, R., & Sista, A. K. (2023). Genicular artery embolization for treatment of knee osteoarthritis pain: Systematic review and meta-analysis. Osteoarthritis and Cartilage Open, 5(2), 100342. https://doi.org/10.1016/j.ocarto.2023.100342
- Bannuru, R. R., Osani, M. C., Vaysbrot, E. E., Arden, N. K., Bennell, K., Bierma-Zeinstra, S. M. A., Kraus, V. B., Lohmander, L. S., Abbott, J. H., Bhandari, M., et al. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage, 27(11), 1578-1589.
- Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., et al. (2020). 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis & Rheumatology, 72(2), 220-233.
