Villanueva Institute of Pain and Spine
Knee Pain Treatment in Burbank, CA
For some patients, knee pain starts after a fall, twist, sports injury, or sudden pop. For others, it builds slowly. The knee may ache after activity, feel stiff in the morning, swell by the end of the day, or feel unreliable when walking downhill, climbing stairs, or getting in and out of a car. Fortunately, there are a variety of treatment options available to help you reclaim your days without worrying about chronic knee pain.
I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). When I evaluate knee pain, I look at how the pain started, where it is located, how the knee moves, whether swelling or weakness is present, what imaging shows when needed, and how much the pain affects your daily life.
Knee pain can come from the joint itself, cartilage, meniscus, ligaments, tendons, bursa, nerves, muscles, hip, low back, or more than one source at the same time. The treatment plan should match the actual pain pattern, whether that means rehabilitation, medication management, knee joint injections, bursa injections, PRP, genicular nerve blocks, genicular radiofrequency ablation, or referral to an orthopedic surgeon when that is the right next step.
If you are looking for knee pain treatment in Burbank, CA, call VIPS at (818) 669-8895 or request an appointment online. We are located in Burbank and see patients from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
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What Is Knee Pain?
Knee pain is discomfort in or around the knee joint. It may be felt in the front of the knee, inside of the knee, outside of the knee, behind the knee, under the kneecap, or deep inside the joint.
The knee carries your body weight while bending, straightening, twisting slightly, absorbing impact, and helping you balance. Because it works so hard, pain can come from several structures. Cartilage, bone, ligaments, tendons, bursae, nerves, muscles, and the kneecap can all be involved.
Some knee pain is short-term and improves with rest, activity changes, or therapy. Other knee pain becomes chronic, especially when arthritis, inflammation, nerve irritation, prior injury, or altered walking mechanics keep stressing the joint.
Pain location is useful, but it is only one part of the diagnosis. I also want to know what brings it on, what relieves it, whether the knee swells, whether it catches or gives way, and what the pain is keeping you from doing.
What Knee Pain Can Feel Like
Knee pain does not feel the same for every patient. Some people have sharp pain with one movement. Others have a deep ache that gets worse the longer they are on their feet.
Patients often describe:
- Pain going up or down stairs
- Pain getting out of a chair or car
- Pain with walking, squatting, kneeling, or standing
- Swelling, warmth, or stiffness
- Grinding, clicking, catching, locking, or popping
- Pain under or around the kneecap
- Pain on the inside or outside of the knee
- Pain behind the knee
- Weakness or a feeling that the knee may buckle
- Pain after a fall, twist, workout, or sports injury
- Pain after knee surgery or knee replacement
- Burning, tingling, numbness, or nerve-like pain around the knee
- Trouble sleeping because the knee aches or throbs
Knee symptoms can also change how the rest of the body moves. When you protect one knee, you may shift weight into the other leg, tighten your hip, change your stride, or irritate the low back. That is one reason I look beyond the painful spot and evaluate how the knee is affecting your whole movement pattern.
Common Causes of Knee Pain
Knee pain can come from injury, arthritis, inflammation, overuse, nerve irritation, or pain referred from another area. A careful exam helps narrow the source.
Knee Arthritis
Knee arthritis is one of the most common causes of chronic knee pain. Osteoarthritis can cause cartilage loss, joint irritation, bone changes, stiffness, swelling, and pain with walking, stairs, standing, or getting up after sitting.
Some patients feel arthritis pain mostly on the inside of the knee. Others feel it behind the kneecap, throughout the joint, or along the outside of the knee. The knee may grind, swell, or feel stiff after rest.
Arthritis treatment depends on how advanced the joint changes are, how much function is affected, and whether nonsurgical care is still helping.
Meniscus Tears
The meniscus is a cartilage cushion inside the knee. A tear can happen after a twist, squat, pivot, fall, or sports injury. Meniscus changes can also develop gradually as the knee ages.
Meniscus pain may be felt along the joint line, often on the inside or outside of the knee. Some patients notice catching, swelling, clicking, locking, or pain with twisting and squatting.
A meniscus tear does not always require surgery, but the treatment plan depends on the tear pattern, symptoms, age, activity level, arthritis, and whether the knee is mechanically locking.
Ligament Sprains and Knee Instability
Ligaments help stabilize the knee. Injuries to the ACL, MCL, LCL, or PCL can cause pain, swelling, bruising, instability, or a feeling that the knee cannot be trusted.
A ligament injury often happens after a twist, fall, collision, or sudden change in direction. Significant swelling, difficulty bearing weight, or a sense that the knee gives way should be evaluated carefully.
Patellofemoral Pain
Patellofemoral pain is often felt around or behind the kneecap. It may worsen with stairs, squatting, lunging, running, sitting with the knee bent, or getting up from a chair.
This pain pattern can involve kneecap tracking, hip strength, thigh strength, foot mechanics, overuse, or irritation under the patella. Treatment often focuses on improving mechanics and reducing irritation.
Tendinitis and Tendon Pain
Tendon pain can affect the patellar tendon below the kneecap, the quadriceps tendon above the kneecap, or tendons around the inner or outer knee. It may develop after running, jumping, squatting, climbing stairs repeatedly, or a sudden increase in activity.
Knee Bursitis
Bursae are small cushions that help reduce friction between tissues. When a bursa becomes irritated, the knee may feel tender, swollen, or painful with kneeling, pressure, stairs, or walking.
Bursitis can occur in front of the kneecap, along the inner knee, or in other bursa-related areas. The location of swelling and tenderness helps guide treatment.
Baker’s Cyst and Pain Behind the Knee
Pain or fullness behind the knee can sometimes come from a Baker’s cyst, which is a fluid-filled swelling that can develop when the knee joint is irritated.
A Baker’s cyst is often related to arthritis, meniscus problems, or other sources of inflammation inside the knee. The treatment usually focuses on the underlying knee problem rather than the cyst alone.
Nerve-Related Knee Pain
Some knee pain has a nerve component. Patients may describe burning, tingling, electric pain, numbness, sensitivity to touch, or pain that does not match the usual joint pattern.
Nerve-related knee pain can occur after surgery, injury, peripheral nerve irritation, CRPS, or pain referred from the low back. Genicular nerve blocks and genicular radiofrequency ablation may be discussed for certain chronic knee pain patterns, especially when arthritis pain or persistent pain after knee replacement has not improved enough with conservative care.
Pain After Knee Surgery or Knee Replacement
Pain after knee surgery deserves a careful review. Some patients have pain from scar tissue, inflammation, nerve irritation, altered mechanics, weakness, stiffness, persistent arthritis, or a separate pain generator.
After knee replacement, ongoing pain may require evaluation by the orthopedic surgeon to rule out implant-related problems, infection, loosening, instability, or other surgical concerns. When those issues have been addressed, and chronic pain persists, pain management options such as genicular nerve blocks or genicular radiofrequency ablation may be considered in selected patients.
Hip or Low Back Pain Referred to the Knee
Pain felt in the knee can sometimes come from the hip, thigh, or low back. Lumbar nerve irritation, hip arthritis, gait changes, or muscle imbalance can all show up as knee-area pain.
This is why I evaluate the larger movement pattern. Treating the knee alone may not help if the main driver is coming from another area.
When Knee Pain Needs Prompt Medical Attention
Some knee symptoms should be evaluated quickly. Seek urgent care if knee pain follows a major injury, you cannot bear weight, the knee looks deformed, swelling develops rapidly, the knee locks and will not move, or you have severe pain with fever, redness, warmth, or concern for infection.
You should also seek prompt medical attention for calf swelling, shortness of breath, chest pain, or sudden severe pain after surgery since those symptoms can point to more serious problems. For ongoing, worsening, or activity-limiting knee pain, a pain management evaluation can help clarify the source and treatment options.
How Knee Pain Is Diagnosed
Diagnosing knee pain starts with the story. I want to know when the pain began, whether there was an injury, where the pain is located, what activities trigger it, and whether the knee swells, catches, locks, buckles, or feels unstable.
During the exam, I may check knee range of motion, tenderness, swelling, strength, gait, balance, hip motion, low back involvement, ligament stability, kneecap tracking, and signs of nerve irritation. How you walk, stand, squat, step, and shift weight can reveal details that don’t show up in a short symptom checklist.
Testing may include X-rays, MRI, ultrasound, or EMG/NCS testing depending on the pattern. X-rays can show arthritis, alignment, bone changes, or joint space narrowing. MRI can help evaluate meniscus tears, ligament injuries, cartilage, tendons, bone bruising, and other soft tissue problems. Ultrasound can be useful for some tendon, bursa, and fluid-related concerns. EMG/NCS testing may be considered when symptoms suggest nerve involvement from the spine or a peripheral nerve.
Whenever possible, I prefer to review the actual images along with the report. Reports are helpful, but the images often give a better sense of how the findings fit your symptoms.
Knee Pain Treatment Options
Arthritis, meniscus irritation, bursitis, tendon pain, nerve pain, and post-surgical pain all require different planning.
Physical Therapy and Rehabilitation
Physical therapy can help improve knee strength, flexibility, balance, walking mechanics, hip control, and confidence with movement. For knee pain, the hip, thigh, calf, foot, and low back often matter more than patients expect.
As a PM&R physician, I pay close attention to function. The plan may include strengthening, mobility work, gait training, balance exercises, activity modification, home exercise, or gradual return to walking, stairs, work, and exercise.
Medication Management
Medication can be useful when knee pain is making it difficult to sleep, walk, work, exercise, or participate in therapy. Depending on the diagnosis, we may discuss options to calm inflammation, reduce nerve-related symptoms, ease muscle guarding, or help you move with less discomfort.
I choose medication carefully based on your diagnosis, health history, current prescriptions, and prior response. Medication works best when it supports a larger plan rather than becoming the entire plan.
Knee Joint Injections
A knee joint injection places medication into the knee joint. This may be discussed when arthritis, inflammation, swelling, or joint irritation is contributing to pain.
A joint injection can provide relief, and it can also give useful information. If numbing medication improves your usual pain, that response supports the knee joint as a meaningful pain source.
Bursa Injections
A bursa injection may help when knee bursitis is contributing to pain. This can be useful when a tender, inflamed bursa is making kneeling, stairs, walking, or pressure on the knee difficult.
The injection has to match the location and exam findings. Pain near the knee is not always bursitis, so I evaluate the joint, tendons, ligaments, muscles, nerves, and nearby structures before choosing a target.
PRP and Regenerative Medicine
PRP and other regenerative medicine options may be discussed for certain knee pain patterns, including select cases of mild to moderate arthritis, tendon irritation, ligament-related pain, or soft tissue injury.
Whether regenerative medicine makes sense depends on your diagnosis, imaging, severity, prior treatments, activity goals, and expectations. I will explain when PRP is worth discussing and when another option is more appropriate.
Genicular Nerve Blocks
Genicular nerves carry pain signals from the knee. A genicular nerve block places numbing medication near selected nerves around the knee to see whether those nerves are contributing to the pain.
This can be useful for certain patients with chronic knee arthritis pain or persistent knee pain after surgery when the orthopedic evaluation does not show a problem that needs revision surgery. If the block provides meaningful temporary relief, genicular radiofrequency ablation may be discussed.
Genicular Radiofrequency Ablation
Genicular radiofrequency ablation, often called genicular RFA, uses controlled heat to quiet selected pain-carrying nerves around the knee.
This treatment may be considered for chronic knee osteoarthritis pain or selected post-surgical knee pain when conservative care has not helped enough, and the diagnostic process supports the target. It does not repair cartilage, reverse arthritis, or replace the need for surgery when surgery is clearly indicated. It can, however, help reduce pain signals for properly selected patients.
Treatment for Nerve-Related Knee Pain
When knee pain feels burning, electric, numb, tingling, hypersensitive, or out of proportion to the joint findings, I evaluate whether a nerve pathway may be involved.
Depending on the pattern, care may include medication management, EMG/NCS testing, peripheral nerve evaluation, lumbar spine evaluation, nerve blocks, CRPS evaluation, or coordination with another specialist.
Bracing, Activity Changes, and Supportive Care
Some patients benefit from bracing, shoe changes, activity pacing, weight-bearing adjustments, or changes in training. These choices depend on the diagnosis and should be specific to the way your knee hurts.
Our goal is to help you keep moving with less irritation while the rest of the treatment plan takes effect.
Orthopedic Referral When Appropriate
Some knee problems need orthopedic evaluation. This may apply when there is a significant ligament tear, locked knee, displaced meniscus tear, fracture, advanced arthritis, failed knee replacement concern, infection concern, severe instability, or pain that continues despite appropriate nonsurgical care.
If your exam or imaging suggests surgery should be considered, I will explain why and help guide the next step.
Good Candidates for Knee Pain Treatment
You may benefit from a knee pain evaluation if pain is limiting how you walk, stand, work, exercise, or move through the day. You do not need to know the exact cause before coming in. The consultation is where we connect your symptoms, exam, imaging, and goals.
Patients often come in with:
- Knee pain with stairs, walking, standing, squatting, or kneeling
- Pain getting out of a chair or car
- Swelling, stiffness, grinding, clicking, catching, or popping
- Knee arthritis pain
- Meniscus-related pain
- Tendon or bursa pain
- Pain after a sports injury, fall, twist, or accident
- Knee pain after surgery or knee replacement
- Burning, tingling, numbness, or nerve-like pain near the knee
- Pain that has not improved enough with rest, medication, therapy, or prior injections
- Interest in nonsurgical options before considering surgery
Why Choose VIPS for Knee Pain Treatment?
Double board-certified expertise
I am double board-certified in PM&R and interventional pain management. My PM&R training helps me evaluate movement, strength, gait, rehabilitation, nerve symptoms, and function. My interventional training allows me to perform targeted procedures when they fit the diagnosis. In addition to being double board-certified, I am a Certified Life Care Planner with advanced specialized training in assessing the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities. This additional expertise further strengthens my work as a medical-legal consultant and expert medical witness.
A careful diagnostic process
I review your symptoms, exam findings, imaging, prior care, and daily limitations before recommending treatment.
Image-guided procedures when appropriate
Some knee injections and nerve procedures are performed with ultrasound or fluoroscopy. The guidance method depends on the target, anatomy, safety, and clinical need.
A broad view of knee pain
Knee pain can come from arthritis, meniscus changes, ligaments, tendons, bursae, nerves, the hip, the low back, or several sources at once. I take time to identify which source fits your pattern.
A full treatment toolkit
Care may include rehabilitation, medication management, knee joint injections, bursa injections, PRP, genicular nerve blocks, genicular radiofrequency ablation, EMG/NCS testing, or orthopedic referral.
Function-focused care
I want to know whether knee pain is limiting sleep, stairs, walking, work, exercise, driving, travel, or time with family. Those details help define what success should look like.
A warm, unhurried experience in Burbank
Many patients arrive with knee pain that has been brushed off as age, arthritis, or weight alone. I want you to leave with a clearer understanding of what may be causing the pain and what options are worth considering.
What Happens During Knee Pain Treatment?
Your treatment visit depends on the source of pain and the option chosen:
- For a knee joint injection, medication is placed into the joint.
- For a bursa injection, medication is placed near the inflamed bursa.
- For PRP, blood is drawn and processed so the platelet-rich portion can be placed into the treatment area.
- For a genicular nerve block, numbing medication is placed near selected nerves around the knee.
- For genicular RFA, controlled heat is used to quiet selected pain-carrying nerves after the diagnostic process supports that target.
When image guidance is appropriate, I may use ultrasound or fluoroscopy to guide the procedure. Before any treatment, I explain what we are targeting, why that target fits your symptoms, what to expect afterward, and how we will judge your response.
Some patients need treatment in stages. We may begin by calming the most painful structure, then build the rest of the plan around strength, walking mechanics, activity progression, and longer-term function.
What Should You Expect After Knee Pain Treatment?
Your response depends on the diagnosis, treatment performed, and how long the knee has been painful.
Some injections can provide quick temporary relief because of local anesthetic. Anti-inflammatory medication may take several days to work. PRP and regenerative options usually develop more gradually. Genicular RFA may take days to weeks before the benefit becomes clear.
After treatment, I want you to track practical changes in your life, which help us decide whether to continue the current plan, adjust the target, add rehabilitation, update imaging, or discuss another option.
Knee Pain Treatment in Burbank, CA
VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. The office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.
This is a place where your story has time to be heard. I live and work in Burbank, and I care about building a practice where patients feel known, respected, and well informed.
We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.
Burbank Knee Pain FAQs
To schedule a knee pain consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right care may help you spend less time working around a painful knee and more time moving with comfort and confidence.
When should I see a doctor for knee pain?
You should consider an evaluation if knee pain lasts longer than a short period, keeps returning, causes swelling, limits walking or stairs, affects sleep, follows an injury, or does not improve enough with rest, medication, or physical therapy.
Can knee arthritis be treated without surgery?
Yes. Many patients with knee arthritis begin with nonsurgical care such as physical therapy, medication management, activity changes, joint injections, PRP, genicular nerve blocks, or genicular radiofrequency ablation when appropriate.
Can knee pain come from the back?
Yes. A pinched or irritated nerve in the low back can refer pain toward the knee or leg. Hip problems and gait changes can also contribute to knee-area pain. This is why I evaluate the full pattern, not only the knee.
Are knee injections image guided?
Some knee injections are image-guided. Ultrasound or fluoroscopy may be used when it improves accuracy, safety, or targeting. The choice depends on the diagnosis, anatomy, and procedure.
What is a knee joint injection?
A knee joint injection places medication into the knee joint to help reduce pain and inflammation. It may be discussed for arthritis, swelling, inflammation, or joint irritation when the evaluation supports it.
What is a genicular nerve block?
A genicular nerve block places numbing medication near selected nerves around the knee. It can help determine whether those nerves are carrying a meaningful part of the knee pain. A strong temporary response may lead to a discussion about genicular radiofrequency ablation.
Can genicular RFA help after knee replacement?
Genicular RFA may be considered for selected patients with persistent pain after knee replacement, but the knee replacement should first be evaluated for surgical or mechanical concerns such as infection, loosening, instability, or implant-related problems.
How much does knee pain treatment cost in Burbank, CA?
The cost of knee pain treatment in Burbank can vary depending on the evaluation, imaging, medication plan, physical therapy, injections, regenerative medicine, genicular nerve blocks, radiofrequency ablation, nerve testing, or specialist referral involved. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.