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Four Arthritis Knee Pain Alternatives to Cortizone Shots

My knee collapsed under the weight of arthritis and “synovial bodies” when I was 50. My orthopedist did not want to replace my knee at that time. He said I was too young. I have seen hip replacement recipients dancing a week after surgery. I have never seen a happy knee replacement patient until at least a year after surgery. I want to avoid a knee replacement, so I researched new devices that help with knee arthritis pain.

Here are four devices that use electromagnetic fields (EMF) to ease arthritis problems. COOLIEF* is implanted at the doctor’s office. The TENS, Red Light Therapy, and PEMF devices are consumer treatments that you use at home without a prescription.

  • COOLIEF* is an injectable radiofrequency device that modifies the tissues inside the knee. The result is a blocked pain signal.
  • TENS is a proven electrical signal device that resonates with nerves to slow the pain signal.
  • Red Light Therapy is an extraordinarily powerful, non-invasive, drug free use of light to stimulate the body’s energy. Multiple studies show that red light therapy can significantly ease arthritic knee pain.
  • PEMF is a pulsed electronic field therapy similar to TENS. The method is different than TENS, but the body’s response to them is similar.

We are no longer stuck with just ice and compression, but these are still helpful. I put a list below of the conventional therapies you can consider for knee pain.

I am not a doctor. This article reflects my research and opinions. You are responsible for your medical decisions.

Always talk to your doctor about using any electricomagnetic device. This is only a partial list of caution triggers. Be careful if you:

  • have a pacemaker
  • have a deep brain stimulation device
  • have a spinal cord stimulator
  • have neurlogical deficits
  • have epilepsy
  • have heart problems
  • have blood clotting issues
  • take anti-coagulants
  • are pregnant

The Knee Joint

Knee anatomyThe knee is the largest joint in the body.

It sits where the femur and tibia (thigh and shin) meet. The patella (kneecap) sits above the joint.

Articular cartilage covers the bone ends. The cartilage is a smooth, slippery cushion between the bones.

The synovial membrane surrounds the knee. It releases cushioning fluid between the bones.

The Three Types of Knee Arthritis

The three types of arthritis that affect the knee are rheumatoid, osteo, and posttraumatic.

Osteoarthritis and posttraumatic arthritis are wear-and-tear diseases.

Rheumatoid arthritis is an immune system disorder.

They all cause knee swelling, inflammation, pain, and stiffness.

They make it hard to get around, walk about the stairs, and to stand still.


Osteoarthritis is the most common of the three types.

Osteoarthritis is a wear-and-tear disease affecting mostly people over the age of 50.

The cartilage wears away, and the bones get closer together.

You might have heard about this as “bone on bone” arthritis. Osteoarthritis wears away the cushion between the thigh and shin.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease that attacks the joints.

It causes the synovial membrane to swell.

The disease usually affects both knees.

Symptoms usually include pain and stiffness.

The immune system attacks the cartilage and ligaments, and softens the bones.

Posttraumatic Arthritis

Posttraumatic arthritis occurs after a knee injury such as a broken bone.

It forms years after damage to the joint surface.

Posttraumatic arthritis causes instability and pain.

Arthritis Symptoms

Your doctor will diagnose the knee issue.

You probably already have a good idea of what is wrong if you have a cluster of these symptoms.

Your knee is:

  • stiff
  • swollen
  • painful to bend and straighten
  • swells after resting
  • hurts when active
  • interferes with your movement
  • sticks or locks
  • creaks, clicks, snaps, or grinds
  • weakens and buckles
  • feels worse in rainy weather
  • feels tender

(source, source)

Traditional Knee Pain Treatments

Once knee arthritis becomes painful, you naturally avoid normal activities.

Impact sports are too painful. Soon just walking up the stairs is too hard.

Typical treatments include:

  • cycling, swimming, and other low-impact activities
  • muscle strengthening exercises from the physical therapist. The CDC recommends 150 minutes of exercise per week.
  • crutches, canes, scooters, walkers, and rollators
  • the “lose weight” message is the hardest to hear because exercise is restricted.
  • you can take Tylenol or aspirin for pain.
  • Ibuprofen and Aleve reduce inflammation and pain
  • your doctor can give you a COX 2 Inhibitor, which is in the same class of drugs as Ibuprofen.
  • you might get cortisone shots. You are limited to how many of these you can get in a lifetime, because cortisone negatively affects the area.
  • untraditional doctors might advocate for glucosamine and chondroitin supplements. Just know that if the supplements are going to help, it will take many months to feel a difference.
  • arthritis surgery can include grafting cartilage from the healthy knee to the unhealthy one. This is a surgery for younger patients.
  • Rheumatoid patients sometimes get a synovectomy, which removes the synovial membrane. While it cannot swell anymore, it also cannot produce synovial fluid to lubricate the knee joint.
  • an osteotomy is a cut in the tibia or femur to relieve pressure.
  • An arthoplasty is a knee replacement. The surgery removes cartilage and bone and replaces it with a metal or plastic joint.
  • icing and compression can relieve the swelling and pain

The CDC’s arthritis-friendly-exercise web page lists organizations that will help you get more active.

You can look at it here: CDC Physical Activity Programs.

Four Electrical Knee Pain Treatments

We are fortunate to live in a time when scientists are effectively harnessing electromagnetic frequencies for health.

We now have radio and light (both electromagnetic fields) solutions to arthritic knee pain that did not exist even a few years ago.

Halyard COOLIEF* Radiofrequency Ablation

The knee tibia, femur and patellaHave you ever wondered why pain relief is not as simple as turning off the pain nerve signal?

I have wondered about this.

Pain is in the brain, not the knee.

Stop the brain from receiving the signal. Pain problem solved.

This is the goal of Radiofrequency Ablation (RFA).

Ablation is the act of killing tissue and removing it.

Radiofrequency Ablation of the knee removes knee tissue to stop the pain signals from reaching the brain.

COOLIEF* (the asterisk appears to be part of the name) is a radiofrequency pain treatment sold as a better alternative to steroid injections.

COOLIEF* knee injection of radiofrequency ablation device

The COOLIEF* website claims that COOLIEF is the only FDA cleared radiofrequency treatment to relieve moderate to severe osteoarthritis pain.

The treatment is a minimally invasive procedure.

The doctor puts a “water cooled electrode” in the knee tissue.

The electrode emits a frequency that kills off some of the knee tissue. This turns off the knee’s pain signals.

COOLIEF* says their device yields a 93% pain reduction for at least 6 months.

The technique should provide pain relief for a year.

Most people need only aspirin for post-injection pain.

Pain relief starts one to two weeks after the procedure.

COOLIEF* say that Medicare and private insurance often cover the procedure.

Cleveland Clinic published an information article about Radiofrequency Ablation (opens in new window).

(source, source)

Transcutaneous Electrical Nerve Stimulation (TENS) Pain Relief

Knee brace with TENS unit

A Transcutaneous Electrical Nerve Stimulation (TENS) device sends electricity into the body through the skin.

On one end is the controller. A wire attaches the device to two electrode pads that you place on your body near the pain site.

The device sends electricity to the electrodes and then into your body.

The electric fields resonate with the body’s nerves to change how the nerves communicate.

The result is a reduction in pain.

The Difference Between TENS and EMS

TENS devices have been around a long time. Their use is not always supported in scientific studies. However, people swear by them to relieve their pain. So perhaps the studies not finding them useful are poorly designed.

TENS devices look like electro muscle stimulators (EMS) devices, so it helps to know the difference.

A TENS device uses two sets of frequencies to communicate with your body’s nerves. The TENS device power is too low to affect the muscles under the electrode pad.

An EMS device uses a different set of frequencies to send electricity to the electrode pads. The signal is strong enough to force the muscle under the pad to clench, and then let go.

This contraction and relaxation happens thousands of times per session. Muscle knots and cramps automatically let go because the contractions tire it out.

Features Common to TENS Devices

You will find all kinds of gadgets, bells, and whistles in TENS devices. The purpose is to relieve pain, and in that, all TENS devices have the following in common:

  • their purpose is to relieve chronic pain
  • they are usually battery operated
  • they available without a prescription
  • they are drug free
  • they consist of a control unit, wires, and electrode pads
  • they are safe for most people to use
  • they work best when used daily
  • they might stop working when you turn them off

The TENS Electrical Frequencies

A TENS device communicates with the nerves using electric fields in two sets of frequencies.

Muscle contraction in an EMS device occurs between 10 Hz and 50 Hz. The TENS units uses frequencies below and above the muscle contraction range. It uses less than 10 Hz and greater than 50 Hz frequency electric waves.

(source, source )

How TENS Works

TENS kit

People have successfully used TENS devices to relieve pain for 60 years.

Despite this long track record, the TENS mechanism for relieving pain is still not 100% known.

What is clear is that different frequencies stimulate different biological responses.

Low frequency stimulation increases endorphin production. Endorphins are the body’s natural painkillers.

High frequency stimulation increases enkephalins, a less well known but an important pain relief molecule.

(source, source, source, source, source)

Red Light Therapy for Knee Arthritis

Dyago knee red light wrap
Dyago knee red light wrap


Red light therapy (RLT) is the use of red and infrared light to heal the body.

I suspect it is not as popular as it could be because big medical companies cannot make a fortune on it. Because this thing is amazing, and everyone should be doing it.

Studies have shown red light to be effective in resolving stroke symptoms, quelling epilepsy, calming autistic children, healing wounds, healing broken bones, decreasing depression.

Studies have shown success in all of these areas:

  • reducing anxiety and depression
  • reducing arthritis inflammation
  • reducing irritation in autistic children
  • relief from carpal tunnel syndrome
  • decrease in cellulitis, dermatitis and rosacea symptoms
  • increased circulation and decreased cholesterol
  • recovery from dementia symptoms
  • increased ability to exercise and quicker exercise recovery
  • fat reduction!
  • hair growth!
  • increased motor function in cerebral palsy
  • reduced blood pressure
  • reduced neuralgia
  • pain reduction in general
  • better sleep and melatonin levels
  • better mouth movement with TMJ (jaw lock)
  • increased skin collagen

Many studies back the use of red light therapy for arthritis relief.

The “Red” in Red Light Therapy

The term “red light” refers to both red light and to infrared energy.

Other types of light have beneficial value. Red and infrared are very effective. Hundreds of scientific studies show that this therapy is effective and has almost no negative effects.

The Short Story on Red Light Therapy Dosing

The Photonic Red Plus red light therapy torch
The Photonic Red Plus red light therapy torch

Red light therapy dosing is complicated.

I have built some tools to make it easy for you.

Even with the tools, you still need to understand some concepts.

Some people just want the thing to work without a learning curve.

This section is for you.

For arthritis knee pain, get a red light device with light in the 830 nm or higher range (infrared).

Some devices put out energy in the red as well as the infrared range.

Get an LED light. Do not get fluorescent.

Do not get a light for growing plants. These have wavelengths of energy that will not help you.

If you get a light like this, then you need to double your session times.

This is because you want a full dose of infrared energy. The dose is based on the light’s power. In a dual red/infrared light, half the energy is devoted to infrared. The other half is going into your skin, not your body.

Put the light 6 inches from your knee for 25 minutes every day.

That’s it. Just do that every day.

These are the simple instructions.

I’m not tweaking anything.

I do not know your light’s stated power.

I do not know the light’s real power (since vendor’s always overstate their device’s power).

It’s my opinion that a 25 minute session in front of the average infrared light will get you a sufficient dose of energy to make a difference.

Give the process at least 6 weeks before you decide if it is helping.

The Long Story on Red Light Therapy Dosing

A Dyago red light pad specifically designed for elbows and knees
A Dyago red light pad specifically designed for elbows and knees

Dosage is everything with red light therapy. Too little and too much light are both a waste of time.

Red light dosage has several inputs, but it all boils down to getting:

  • the right wavelength
  • the right amount of energy inside the target

We want the right amount of light at the right wavelength inside our knees.

To get that data, we need to dive deeper into what the light does.

The specs you want to know about in your light are:

  • the healing wavelength for your goal
  • the distance you will hold the light from your target area
  • the light’s power output
  • the light’s REAL power output
  • the amount of energy you seek to input into the target area

From these inputs above, we will calculate your treatment time in seconds per session.

I will walk you through how to figure out your dosage.

The Healing Wavelength for Your Treatment Goal

Light moves in waves, going up and down and up again.

The distance between to wave peaks is a “wavelength.”

In the red and infrared range, the distance between the wave peaks is a few hundredths of a billionth of a meter long. It is tiny.

A billionth of a meter is a nanometer, abbreviated “nm.”

Red light wavelengths range from 600-750 nm.

Infrared ranges from 750-1000 nm.

You will see other wavelength ranges because there is no set standard.

Different treatment goals respond best to different wavelengths.

There is no one “right” wavelength.

The best wavelength for internal wellness applications is wavelengths between 800 nm and 1000 nm.

The average red light device available today will offer both 660 nm and 850 nm wavelengths.

The 660 nm is red, which helps with the skin.

There is some evidence that it helps with arthritis, but most successful studies use the 850 nm range.

Since 660 nm is good for skin, people like having both wavelengths at once.

If you buy a device like this, recognize that you are getting half power in 850 nm, so you will need to double your treatment time to get 100% of the 850 nm dose.

If you get a device with an output between 800 nm and 100 nm, you do not need to double the treatment time. These values are near the ideal for your goal. The fact is that we do not know what the ideal is, so you are spreading the love around in the right range.

As long as your device is infrared, you do not need to double the treatment time we calculate.

Determine the Light’s Power at 6 Inches

A light’s energy is powerful at the face of the device, and weaker as you get farther away from the device.

The power drops off sharply with every inch you move from the device.

Therefore, it is important to pick a distance you will put the light from your knee, and then stick with that decision.

If you move the light closer, you will get a higher dose. If you move it away, you will get a lower dose.

If the dose is too low or too high, it will not stimulate the body’s energy to help heal the arthritis.

For the sake of this example, we are going to say that you will put the light at a 6 inch distance from your knee.

The vendor should publish a power output rating for your light at 6 inches. Go get this value from their website or advertisement.

It will look something like this:

100 mW/cm^2 at 6 inches

Most vendors say their lights put out 100 milliwatts of energy if you are at about 6 inches away.

Almost none of them meet their stated specifications.

If you trust your vendor’s specs, use the stated power at 6 inches.

If you do not, use one third of the stated value.

In our example, they said 100 mW/cm^2 at 6 inches.

Divide 100 by 0.33 and use that for your power.

100 mW/cm^2 x 0.33 = 33 mW/cm^2

Therefore, our power in milliwatts we will enter into the dose calculator is 33.

Get 42 Joules Into Your Knee Each Day

Next, we are going to use scientific study data to make an educated guess about the amount of energy

Your goal is to get about 42 joules (42 J) of 850 nm energy into your knee each day.

That is my opinion based on the studies I have documented on using infrared to reduce knee arthritis symptoms.

To get this many joules depends on the light’s power at the distance is from your knee, and the treatment time of your session in seconds.

I came up with 42 J using the studies I have documented.

I will walk you through it.

Go to my EMF Channel website Light Doses database page (opens in a new window).

Choose the Arthritis button, and look at the results, or click here to see the arthritis doses.

The results are a series of study summaries. All studies in the database used light energy to relieve arthritis issues.

Click each article to get the specs in a table format.

Find the “joules” value for each arthritis study. These are the successful arthritis energy doses in joules:

  • 9 J
  • 1200 J
  • 3 J
  • 1 J
  • 6 J
  • 56 J
  • 85 J
  • 55 J
  • 42 J

The joules range from 0.9 J to 1200 J. that is a huge range.

I think we should assume that the 1200 J is an outlier due to a coding error. It is just way too off the grid to take seriously.

That leaves us with 0.9 J to 56 J.

My rule of thumb, which is my opinion and not medical advice, is to pick a value near the top end of the successful energy range. It is somewhat arbitrary.

I choose the 42 J target for my arthritis treatment.

Calculate Your Treatment Time per Day

We now have everything we need to determine the treatment time per day.

  • the device’s stated power at 6 inches is 100 mW/cm^2. We have handicapped that to 33 mW/cm^2.
  • the target joules for arthritis treatment is 42 J, based on using the top end of the scientific study data

Now go to the EMF Channel Joules Calculator to get your treatment time.

Enter 33 in the Milliwatts box (from our 33 mW/cm^2 at 6 inches).

Enter 42 in the Joules box (from the top end of the study data range).

The calculator tells you to use the red light for 1,272 seconds, or 21 minutes.

Use the light 21 minutes per session.

Some people say to leave as little as four hours per session. My personal belief is to have no more than one session per day. It depends on how fast your body uses the photon energy. You want it used up before taking another treatment.

Just for the geeks, the calculator is dividing the joules by the milliwatts, and multiplying that by 1,000.

s = (J/mW) x 1000

(source, source, source)

Pulsed Electromagnetic Fields for Knee Arthritis

ActiPatch PEMF knee pain device
ActiPatch PEMF knee pain device

Pulsed Electromagnetic Fields (PEMF) therapy uses pulsed electricity to change the way your body behaves.

The pulsing adds to the therapeutic value of the electromagnetic fields (EMF). Pulsing works more effectively than a continuous electricity flow.

PEMF devices range in size from blankets to wearable pads.

PEMF reduces pain by sending signals to pain nerves to slow down.

Differences Between PEMF, TENS, and EMS

Wearable PEMF devices look like TENS and EMS devices.

The crucial difference is that PEMF devices always have a loop creating a closed circuit as part of the device design.

A TENS device uses electrical fields to communicate with nerves. In that way, PEMF and TENS are similar.

You can feel TENS and EMS energy. You do not feel a wearable PEMF pulse.

EMS uses electricity to force the muscle underneath it to contract. The pain relief comes from the muscle letting unclenching after the contractions tire it out. I adore my EMS devices, but they are not appropriate for relieving osteoarthritis knee pain.

ActiPatch PEMF for Knee Arthritis

ActiPatch is a wearable PEMF patch designed to reduce and even eliminate knee pain.

ActiPatch is an FDA cleared PEMF wearable device you attach to your knee for pain relief.

The device is a sticky tab that you attach to your knee. It contains a very small electronic pulsing mechanism that starts when you squeeze it for 3 seconds.

At least one study supports its use as a pain relief device.

Pain relief can occur anywhere from right away to four days from the first treatment.

You wear the device for between eight to 24 hours per day.

ActiPatch is non-invasive, drug-free, and painless.

Some of the reasons not to use the ActiPatch are if you are a child, you have cancer pain, or have any electrical stimulation devices. These include deep brain stimulation, pacemaker, defibrillator, or any device near the painful area. See more about the contraindications below.

ActiPatch comes from BioElectronics Corporation, which you can learn more on their website:

Four Arthritis Knee Pain Alternatives to Cortizone Shots