Why Am I Still Having Knee Pain If Injections No Longer Work?

(A Patient Friendly Guide + When Genicular Artery Embolization Procedure May Help)

Still having knee pain even after steroid or gel injections? Learn why injections stop working, what causes persistent knee pain, and how genicular artery embolization (GAE) may help when surgery isn’t an option.

Understanding Why Knee Pain Continues After Injections

Knee pain caused by osteoarthritis (OA) can be incredibly frustrating, especially when treatments that used to help stop working. Steroid injections, gel (Visco supplement) injections, or even platelet-rich plasma (PRP) can provide temporary relief. But many patients reach a point where the pain returns or never fully improves.  If this sounds familiar, you are not along. Up to 40-50% of patients eventually stop responding to injections over time. Let’s understand why this happens and wat options may still help, even if surgery isn’t possible.

Why Injections Stop Working

  1. Osteoarthritis continues to progress
    1. Injections help calm inflammation or lubricate the join, ut they cannot stop cartilage loss.
    2. As knee OA worsens:
      1. Inflammation inside the joint becomes chronic
      2. Bone spurs may form
      3. Nerves around the joint become hypersensitive
    3. Eventually, injections don’t provide enough benefit
  2. Steroid injections have diminishing returns
    1. Steroids reduce inflammation, but:
      1. The effect becomes shorter over time
      2. Steroids can weaken cartilage if used too frequently
      3. Guidelines limit them to 3-4 injections per year
    2. So for may patients, pain relief slowly fades.
  3. Gel injections don’t work well in advanced OA
    1. Hyaluronic acid injections act like lubrication, but in sever arthritis, the join is to damaged for them to be helpful.
    2. Studies show they work best in mild-moderate OA, not bone on bone disease.
  4. Pain may not be coming only from the joint
    1. OA affects the entire knee system:
    2. This explains why some patients still have pain even if imagining doesn’t look “terrible.”

If Surgery Isn’t an Option- You Still Have Options

Some patients cannot undergo knee replacement due to:

  • Medical conditions
  • Age
  • Personal preference
  • Fear of recovery
  • Prior poor surgical outcomes
  • Wanting a less invasive option

Fortunately, there is a safe and minimally invasive alternative, Genicular Artery Embolization (GAE). 

What is Genicular Artery Embolization?

Genicular Artery Embolization is non -surgical, image guided procedure performed by an interventional radiologist. Instead of treating the joint directly, GAE targets the inflammation source.

How it works:

  • Tiny particles are injected into the genicular arteries (vessels around the knee)
  • These particles reduce abnormal blood flow that drives inflammation
  • This decrease in inflammation reduces nerve irritation and pain

Most patients have not incisions, only a small pinhole in the wrist or groin.

Who is a Good Candidate?

GAE may help if you:

  • Have knee pain from osteoarthritis
  • Are not getting relief from injections
  • Are not ready or cannot have knee replacement
  • Want a procedure with minimal downtime

Studies show 60-80% of patients experience significant long term pain improvement after GAE.

What to Expect Durin the Procedure

Before:

  • You will meet with an interventional radiologist for evaluation
  • Imaging (like X-ray or MRI) confirms OA severity
  • You may undergo diagnostic testing to pinpoint pain sources

During:

  • Local numbing + light sedation
  • Catheter inserted through a tiny puncture
  • Embolization particles placed

After:

  • Same day or next-day discharge
  • Most patients walk immediately
  • Full recovery in a few days

Pain relief often improves steadily over weeks.

Frequently Asked Questions

“Will GAE fix my arthritis?”   

  • No, it reduces inflammation and pain but does not rebuild cartilage.

“How long does the relief last?”

  • Studies show improvement for 1-2 years, sometimes longer.

“Can I still get other treatments later?”

  • Yes, GAE does not prevent future surgery or injections.

When Should you Consider a Consultation?

You may benefit from evaluation if your knee pain:

  • Interferes with walking or sleep
  • Limits daily activities
  • No longer responds to steroid or gel injections
  • Prevents you from exercising
  • Affects quality of life

GAE may offer meaningful relief without major surgery.

Citations

  1. Altman RD, et al. “Recommendations for the Use or Intra-Articular Therapies in the Management of Osteoarthritis.” Osteoarthritis and Cartilage. 2015.
  2. Bagla S, et al. “Genicular Artery Embolization for the Treatment of Knee Pain Secondary to Osteoarthritis.”  Journal of Vascular and Interventional Radiology. 2020.
  3. Little MW, et at. “Genicular Artery Embolization for Osteoarthritis-Related Knee Pain: Clinical Results.” Cardiovascular and Interventional Radiology. 2021.
  4. American College of Rheumatology. “Guidelines for Management of Osteoarthritis of the Knee.” 2019.

Top 10 Knee Exercises for Pain: How to Keep Moving Without Making It Worse

Key Takeaways:

  • Knee exercises for pain help strengthen the knee joint, improve range of motion, and reduce discomfort.
  • Stretching exercises, like hamstring stretch and quadriceps stretch, loosen tight muscles and prevent stiffness.
  • Knee strengthening exercises, such as straight leg raises and calf raises, support stability without causing pain.
  • Low-impact activities, including water aerobics and cycling on a stationary bike, keep you active without putting excess strain on the knees.
  • When knee pain persists despite exercise, Genicular Artery Embolization (GAE) is a non-surgical option that reduces inflammation and improves mobility.
  •  

Best Knee Exercises for Pain Relief and Strength

Knee pain can come from overuse, injury, arthritis, or weak muscles around the knee joint. While resting might seem like the best option, staying still often leads to tight muscles, stiffness, and reduced range of motion—making the pain worse over time.

Knee exercises for pain, like gentle stretching and strengthening movements, can help relieve knee pain and improve flexibility. Movements such as straight leg raises, hamstring stretches, and calf raises support the knee joint and surrounding muscles. 

Before beginning any exercise program, it is strongly recommended to consult with a healthcare professional or physical therapist to ensure the exercises are appropriate for your condition.

A. Lower-Body Stretches to Loosen Tight Muscles

Stretching can help loosen tight muscles, improve range of motion, and keep the knee joint moving smoothly. This can make daily activities easier and reduce discomfort over time.

Before starting, spend 5 to 10 minutes warming up with light movement. Walking, cycling on a stationary bike, or using an elliptical machine can help get blood flowing and prepare your thigh muscles, calf muscles, and knee joint for stretching.

After warming up, go through these gentle stretching exercises before and after knee strengthening exercises. Aim to do them four to five times a week for the best results.

1. Calf Stretch Against a Wall

Tight calf muscles can put extra strain on the knee joint, making it harder to move without causing pain. Stretching the calves regularly can help improve range of motion and reduce pressure on the knees.

Wall Calf Stretch

  1. Stand shoulder width apart facing a wall, placing one foot about a step behind the other leg.
  2. Keep your back leg straight and your front knee bent, pressing your hands against the wall.
  3. Slowly lower your back heel toward the floor until you feel a stretch in your calf muscles.
  4. Hold for 20–30 seconds, then switch legs.
  5. Repeat two to three times per leg.

2. Standing Quadriceps Stretch

Stretching the quadriceps muscles can help keep the knee joint stable and improve range of motion, especially if you have sore knees or tight muscles. This stretch is simple but effective.

Standing Quadriceps Stretch

  1. Stand shoulder width apart, using a wall or chair for balance if needed.
  2. Bend your left leg, bringing your left foot toward your glutes.
  3. Grab your left foot with your left hand, keeping your knee bent and thigh muscles engaged.
  4. Slowly raise your foot until you feel a gentle stretch in your quadriceps muscles.
  5. Hold for 20–30 seconds, then switch legs.
  6. Repeat two to three times per leg.

3. Seated Hamstring Stretch

Seated Hamstring Stretch 

Tight hamstrings can pull on the knee joint, making movement uncomfortable. This stretch helps lengthen the hamstring muscles, improving flexibility and reducing tension in the thigh muscles.

B. Strengthening Moves to Support Your Knees

Stretching can help loosen tight muscles, improve range of motion, and keep the knee joint moving smoothly. This can make daily activities easier and reduce discomfort over time.

Before starting, spend 5 to 10 minutes warming up with light movement. Walking, cycling on a stationary bike, or using an elliptical machine can help get blood flowing and prepare your thigh muscles, calf muscles, and knee joint for stretching.

After warming up, go through these gentle stretching exercises before and after knee strengthening exercises. Aim to do them four to five times a week for the best results.

1. Calf Stretch Against a Wall

Tight calf muscles can put extra strain on the knee joint, making it harder to move without causing pain. Stretching the calves regularly can help improve range of motion and reduce pressure on the knees.

Standing Calf Stretch

  1. Stand shoulder width apart facing a wall, placing one foot about a step behind the other leg.
  2. Keep your back leg straight and your front knee bent, pressing your hands against the wall.
  3. Slowly lower your back heel toward the floor until you feel a stretch in your calf muscles.
  4. Hold for 20–30 seconds, then switch legs.
  5. Repeat two to three times per leg.

2. Standing Quadriceps Stretch

Stretching the quadriceps muscles can help keep the knee joint stable and improve range of motion, especially if you have sore knees or tight muscles. This stretch is simple but effective.

One Leg Quadriceps Stretch

  1. Stand shoulder width apart, using a wall or chair for balance if needed.
  2. Bend your left leg, bringing your left foot toward your glutes.
  3. Grab your left foot with your left hand, keeping your knee bent and thigh muscles engaged.
  4. Slowly raise your foot until you feel a gentle stretch in your quadriceps muscles.
  5. Hold for 20–30 seconds, then switch legs.
  6. Repeat two to three times per leg.

3. Seated Hamstring Stretch

Floor Hamstring Stretch 

Tight hamstrings can pull on the knee joint, making movement uncomfortable. This stretch helps lengthen the hamstring muscles, improving flexibility and reducing tension in the thigh muscles.

Weak thigh muscles and calf muscles can put extra strain on the knee joint, leading to knee pain and stiffness. Adding knee strengthening exercises can help relieve knee pain and improve range of motion. Movements like straight leg raises, hamstring curls, and step-ups build strength and stability. Try these strengthening exercises to support your knees.

4. Mini Squats (gentler than full squats but effective)

Strong thigh muscles help stabilize the knee joint and reduce strain during movement. Mini squats are a great way to build strength without causing pain, making them a safer option for sore knees.

Mini Squats

  1. Stand shoulder width apart, keeping your feet flat and toes pointing straight ahead.
  2. Slowly bend your knees and lower your body just a few inches, keeping your back straight.
  3. Hold for a second, then slowly raise yourself back to the starting position.
  4. Make sure your knees stay behind your toes to avoid extra strain.
  5. Repeat 10–15 times, gradually increasing as your strength improves.

5. Toe Raises for Calf Strength

Strong calf muscles help absorb shock and support the knee joint during walking and standing. Toe raises improve stability and reduce the risk of knee pain from weak lower-leg muscles.

Toe Raises for Calf Strength

  1. Stand shoulder width apart, keeping your feet flat on the floor.
  2. Slowly lift your heels off the ground until you’re on your toes.
  3. Pause for a moment, then gently lower your heels back to the ground.
  4. To increase difficulty, try this exercise on one foot at a time.
  5. Repeat 10–15 times, adding more as your leg muscles get stronger.

6. Hamstring Curls for Knee Stability

Hamstring Curls

Weak hamstrings can make the knee joint less stable, increasing the risk of injury and knee pain. Hamstring curls help strengthen these muscles.

  1. Stand with feet shoulder width apart, using a chair or wall for balance.
  2. Slowly raise one bent knee, bringing your heel toward your glutes.
  3. Hold for a second, keeping your thigh muscles engaged.
  4. Lower your foot slowly until it reaches the starting point.
  5. Repeat 10–15 times per leg, gradually increasing reps as your strength improves.

7. Seated Leg Extensions (great for strengthening the knee joint)

Weak thigh muscles can make everyday movements harder and put extra strain on the knee joint. Seated leg extensions help build strength while keeping knee pain to a minimum.

Seated Leg Extensions

  1. Sit in a sturdy chair with your feet flat on the floor and knees at a 90-degree angle.
  2. Slowly lift one leg straight, keeping your foot flexed.
  3. Hold for a few seconds, then slowly lower back to the starting position.
  4. Switch legs and repeat.
  5. Perform 10–15 reps per leg, gradually increasing as your knee strengthening exercises improve.

8. Straight-Leg Lifts for Quads

Strengthening the quadriceps muscles helps stabilize the knee joint and improve range of motion. Straight-leg raises are a great option for those with sore knees or difficulty bending the knee.

Straight-Leg Lifts

  1. Rest on your back, keeping one leg extended and the other knee bent.
  2. Engage your thigh muscles and slowly lift the straight leg about 12 inches off the ground.
  3. Stay in position for a few seconds, then gently lower it back down.
  4. Repeat on the other leg.
  5. Aim for 10–15 reps per leg, increasing as your leg muscles get stronger.

9. Side-Lying Leg Lifts for Hip and Knee Support

Strong hip and thigh muscles help take pressure off the knee joint. Side-lying leg lifts improve stability and reduce the risk of knee pain from weak supporting muscles.

Side-Lying Leg Lifts 

  1. Lie on your side, keeping your legs straight and stacked on top of each other.
  2. Engage your thigh muscles and slowly raise your top leg about 12 inches.
  3. Stay in place for a second, then lower it back down with control.
  4. Switch sides and repeat.
  5. Perform 10–15 reps per leg, adding more as you build strength.

10. Reverse Leg Raises to Strengthen the Back of Your Legs

The muscles at the back of the thigh and calf help stabilize the knee joint and improve range of motion. Reverse leg raises focus on these muscles while keeping stress off the knees.

Reverse Leg Raises

  1. Lie on your stomach with your legs extended and arms at your sides.
  2. Engage your thigh muscles and slowly lift one leg straight off the ground.
  3. Pause for a few seconds, then gently lower back down.
  4. Repeat with the other leg.
  5. Aim for 10–15 reps per leg, increasing as your knee strengthening exercises progress.

C. Low-Impact Activities to Keep You Moving

Staying active with knee pain can feel challenging, but avoiding movement often makes things worse. Low-impact activities help strengthen the knee joint, improve range of motion, and keep thigh muscles engaged without causing pain. These exercises are easy on sore knees while still keeping the body in motion.

  • Water Aerobics. Exercising in water reduces stress on the knee joint while working all the muscles. The natural resistance of water helps improve range of motion and build strength without excessive strain.
  • Cycling on a Stationary Bike. This movement strengthens leg muscles and improves circulation without putting too much pressure on the knees. Keeping a straight leg during the pedaling motion can help with flexibility and knee stability.
  • Walking on Even Surfaces. Uneven terrain can make knee pain worse, but walking on flat surfaces supports mobility and helps relieve knee pain. Start slowly, keep your feet shoulder width apart, and focus on smooth, controlled steps.

How to Manage Knee Pain While Staying Active

Staying active with knee pain is achievable, but it’s important to know when to modify your routine. Some movements may place excessive strain on the knee joint, resulting in tightness, swelling, or discomfort. If an exercise begins to cause pain, making minor adjustments can help protect your knees while allowing you to remain active.

  • Reduce the Range of Motion. If bending too far worsens knee pain, shorten the movement. For example, try mini squats instead of deep squats or keep a leg straight during knee exercises like straight leg raises.
  • Slow Down and Focus on Control. Moving too fast can strain the thigh muscles and increase discomfort. Slowly lift and lower during each movement, keeping the focus on smooth, controlled repetitions.

Use Support When Needed. Holding onto a chair or railing can improve stability during step-ups, leg lifts, or calf raises, reducing the risk of losing balance and putting excess pressure on the knee joint.

When Knee Exercises Aren’t Enough

Knee exercises for pain can help strengthen the knee joint and improve range of motion, but they may not be enough for persistent or severe pain. If discomfort continues despite consistent stretching exercises and knee strengthening exercises, it may be time to seek medical advice.

Here are the signs when to seek professional help:

  • Severe pain that doesn’t improve
  • Swelling that won’t go down
  • Difficulty bearing weight
  • Limited range of motion
  • Clicking, popping, or locking sensation
  • Pain that wakes you up at night

Methods for Treating Chronic Knee Pain

When knee pain affects daily activities and doesn’t improve with exercise programs, medical intervention may be needed. Treatment options range from conservative approaches to advanced procedures for long-term relief.

  • Physical Therapy. A physical therapist can develop a customized exercise program to strengthen the muscles around the knee, improve flexibility, and reduce discomfort.
  • Pain Medications. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve knee pain, but long-term use should be monitored by a doctor.
  • Knee Injections. Corticosteroid injections provide temporary relief by reducing inflammation, while hyaluronic acid injections help lubricate the knee joint for smoother movement.
  • Genicular Artery Embolization (GAE). A non-surgical procedure that reduces knee inflammation by blocking specific arteries responsible for excess blood flow. Many patients turn to GAE when physical therapy and medications no longer work.
  • Arthroscopic Surgery. A minimally invasive surgical option where a doctor uses a small camera to repair cartilage, ligaments, or remove loose fragments inside the knee.
  • Total or Partial Knee Replacement. In severe cases, knee replacement surgery may be recommended to replace damaged parts of the knee joint with artificial components.

If knee pain continues despite strengthening exercises, physical therapy, or conservative treatments, consulting a healthcare professional can help determine the best treatment for long-term relief.

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A Smarter Approach to Chronic Knee Pain Relief

Living with knee pain can make everyday activities more challenging, but there are effective solutions beyond exercise and medication. When traditional methods no longer provide relief, it’s important to explore advanced treatment options that target the root cause of knee joint pain.

At KneePain360, we specialize in innovative, non-surgical solutions like Genicular Artery Embolization (GAE) to help reduce inflammation and improve mobility. Our experienced team is committed to finding the right treatment plan for you, connecting you with top specialists in your area. If you’re ready to take the next step toward lasting relief, we’re here to help you stay active and pain-free.

Exercise for Knee Pain FAQs


Can knee pain go away with exercise?


Yes, the right knee exercises for pain can help relieve knee pain by strengthening the muscles around the knee and improving range of motion. Knee strengthening exercises like straight leg raises and calf raises support the knee joint and reduce strain. However, if knee pain worsens or does not improve, it’s best to consult a healthcare professional for guidance.


Low-impact knee exercises that build strength without causing pain are best, such as straight leg raises, hamstring stretches, and step-ups. Stretching exercises improve flexibility, while strengthening exercises help stabilize the knee joint. A physical therapist can recommend the best treatment based on your specific needs.


Not moving is one of the biggest mistakes when dealing with knee pain, as it can lead to tight muscles and reduced range of motion. Regular knee exercises for pain, like straight leg raises and calf raises, help keep the knee joint mobile and strong. Avoiding movement for too long can make sore knees feel worse over time.


If knee pain persists despite stretching exercises, strengthening exercises, and physical therapy, it may be time to explore other options. Genicular Artery Embolization (GAE) is a non-surgical procedure that helps relieve knee pain by improving blood flow and reducing inflammation. Many patients consider GAE when conservative treatments are no longer effective in managing their symptoms.

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