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What Can You Do for Severe Osteoarthritis of the Knee?

Just when I was finally gaining muscle and losing weight, my right knee went into a total meltdown. While my knee screamed with osteoarthritis pain, the red light therapy scientists were making amazing discoveries in the lab. They were reducing pain, increasing tissue (growing tissue!), and getting knee osteoarthritis patients exercising again. Red light therapy is the treatment we have been waiting for.

Red light therapy significantly reduces knee osteoarthritis pain. Red light therapy grows connective tissue that osteoarthritis wears away. Multiple studies show that red light therapy significantly improves even severe osteoarthritis of the knee.

I would love to get back to the way I exercised in 2012. I had more muscle than ever, and less fat than I had had in years. With eight years of physical therapy, and more cortisone shots, I still cannot exercise the way I once did.

I was frustrated and defeated, but now I am excited and hopeful. Red light therapy decreases pain and triggers a tissue building response. The treatment is painless, has no side effects, and you can do it at home.

What is Knee Osteoarthritis?

Knee osteoarthritis is a joint disease that worsens with age.

Normal bones end in protective cartilage. The tissue cushions the bones, and prevents them from touching.

When wear and tear destroys the cartilage, the knee goes into a painful downward spiral.

The range of motion decreases, the pain increases, and the knee audibly cries out with crackling, grating, and rubbing noises.

Walking becomes difficult, the knee can be tender to the touch, and it swells up like a balloon at the slightest insult of movement.

A protective cartilage sheaths normal bones, preventing them from touching one another.

As that protection wears away and the pain increases, the patient suffers more and exercises less.

The knee requires strong leg muscles to function. As the patient gets weaker, the knee gets less support.

Red light therapy decreases the pain enough for the patient to start physical therapy.

The light triggers tissue growth to protect the bones again.

The treatment creates a positive cycle of tissue construction and muscle building.

Is Light as Effective as Traditional OA Knee Treatments?

OA knee patients take Tylenol, Ibuprofen, or Cymbalta to control pain.

They do physical therapy when possible, to get the swelling down and the strength up.

They get cortisone or lubrication injections to cushion the space between the bones.

They get their knees replaced with joints created in the lab.

As an OA knee patient myself, I am grateful that these treatments exist.

That does not mean I like the side effects.

I do not find that Tylenol works for me.

Ibuprofen can hurt the kidneys.

I have not tried Cymbalta, but it does have a long list of side effects.

I have had a few cortisone shots. While it helps in the short term, cortisone is a destructive force over time. That is why doctors limit the number of doses you can have in a year.

Physical therapy was fantastic for me. The massage, exercise and ice got my knee swelling and pain under control.

Not everyone is as lucky as I was to have a good physical therapy experience.

I like using emu-oil based creams to reduce pain. It used to be Blue Stuff until copycats took over the market.

My physical therapist told me to use my knee cream whether I needed it or not. “Slather that stuff on there every day,” she said.

Can You Reverse the Knee Cartilage Damage?

Yes, knee cartilage tissue can grow back.

Treatments that activate tissue generation include red light therapy, Prolotherapy, and glucosamine and chondroitin supplementation.

Prolotherapy is a method of injuring the joint just enough to invoke a healing response.

Glucoasamine and chondroitin help some patients activate a tissue growth response.

Red light therapy is a painless, side-effect free way to trigger the body’s ability to grow knee cartilage.

Red light therapy can heal through multiple biological pathways:

“PBM mechanisms: mitochondria, membrane ion channels, reactive oxygen species, nitric oxide (NO), adenosine triphosphate (ATP), and cyclic-AMP in the activation of signaling pathways and cellular transcription factors.” (source)

Experts in light therapy research say that red light therapy can promote tissue healing, and can prevent further destruction.

They found that red light therapy

  • decreases pain through both hormonal and opioid mechanisms
  • synthesizes collagen
  • increases fibroblast proliferation
  • regenerates bone

Use 808 nm on the Quadriceps to Increase Strength and Reduce Pain

Researchers set out to find the effect of red light therapy on the quadriceps of OA knee patients.

Strong quadriceps support the knee. They tested if quadricep red light therapy treatment decreased knee pain or increased functionality.

They tested the patients for pain, walking speed, timed five-chair stands, and isokinetic strength.

Then they treated half the group with 808 nm light with a dose of 180 J to each thigh (50 mW for 30 minutes).

Patients receiving the red light therapy significantly improved on all fronts.

The knee joint pain went down by 54%. They were able to walk and exercise faster than before treatment. Their isokinetic strength improved.

With only one 180 J 808 nm session to both legs, pain reduction decreased, and functionality significantly improved.

Combine Light Therapy with Exercise to Reduce Osteoarthritis Knee Pain

In one study, the subjects had one bad knee and one good one.

They were in the 40 to 80 year old age group.

Half the group exercised without light therapy.

The other half got two treatments per week for 5 weeks, and they exercised.

Treatment: nine-diode cluster device; one 905 nm super pulsed diode laser; four 875 nm LED and four 640 nm LED; energy per quadrant 7.85 J; total energy 23.55 J per session.

The treated and placebo subjects gained the same strength over 5 weeks.

However, the treated group had significantly less pain than the untreated group.

What to Do if PBM is Not Relieving Your Osteoarthritis Knee Pain

Laser light forms a coherent beam. The light travels in a straight line from A to B.

LED light jumps around in the space between A and B. LED is “incoherent” light.

Despite this difference, LED is as effective as laser in creating healthy responses and relieving pain.

If the LED is less powerful than the laser, then the subject needs to spend longer per session to get a proper dose.

6 J (joules) of laser energy is functionally equivalent to 6 J of LED energy.

If they are the same wavelength delivered to the same area on the body, they will have the same effect.

In one study, researchers searched the literature for high-intensity laser therapy (HLT) treatment of knee osteoarthritis.

They found six studies in which the HLT treatment decreased pain and increased functionality in arthritic knees.

In those studies, researchers used lasers to deliver the energy to the knee.

The energy to each knee ranged from 1250 to 3000 J.

The abstract of that study does not tell us the wavelengths used, but we can still learn something about red light therapy and knee osteoarthritis from the data presented.

Most LED devices for sale output a red and an infrared light.

I have looked at many red light therapy lamps. I cannot say I have seen any that had improper wavelengths. Light in the 800+ and 900+-wavelength range is most successful in knee osteoarthritis scientific studies. 600+ and 700+ nm light might work, but it is not as well studied.

Therefore, if we assume you have healing wavelengths coming from your device, we just need to know how much energy the lamp is transmitting to the knee.

For example, let’s say you have a device that claims to emit 100 mW at a 6 inch distance.

Unless you see a third party certification for the irradiance of 100 mW, assume it is really 33 mW to 50 mW.

Consumer devices are notoriously underpowered compared to their stated specs.

If you device delivers 33 mW, you can use that information to calculate the treatment time to get a 1250 to 3000 J dose of energy.

Go to the EMF Channel’s Red Light Therapy Treatment Time Calculator (opens on this site in a new window).

Enter 33 mW and 1250 target joules.

The calculator will tell you to do 631-minute sessions. (Divide by 60 to get 10.5 hours.)

Enter 33 mW and 3000 J.

The calculator will tell you to do 1515-minute sessions. (Divide by 60 to get 25.25 hours.)

You would have to treat yourself with a 33 mW device for 10.5 to 25.25 hours to get the same dose as subjects received in the studies.

The upshot?

It’s hard to overdose on an LED device. When in doubt, up your treatment time until you can feel real results.

Kick Yourself Until You Feel Better

At its worst, osteoarthritis gets to a “bone on bone” state. The cushion between the bones wears away to nothing.

Osteopaths provide a treatment that causes the body to re-grow that tissue.

Prolotherapy is the art of injuring the knee just enough to invoke a healing response.

That response includes the laying down of fresh tissue to protect the body from future injury.

Researchers examined the literature for studies including both Prolotherapy and red light therapy.

They found several successful Prolotherapy studies, and several successful red light therapy studies.

There were no studies testing the use of Prolotherapy and red light therapy at the same time.

The researchers noted that both Prolotherapy and red light therapy invoke the tissue healing response.

They suggested that osteopaths performing Prolotherapy add red light therapy to their practice.

The idea is a theory, not yet tested in formal studies.

Infrared Osteoarthritis Knee Therapy Significantly Reduced Pain Reliever Use

The muscles around the knee have to be strong, or they cannot support the knee joint.

The Arthritis Foundation recommends osteoarthritis knee patients exercise the quadriceps, hamstrings, and glutes.

Researchers set out to study the effect of infrared therapy on exercises supporting the arthritis knee.

They assembled a group of patients who were 50 to 75 years old.

All had osteoarthritis in one or both knees.

The researchers gave infrared therapy to half the subjects.

Each knee was treated with infrared (904 nm) light at three points around the knee.

The researchers thought that the treated group might get stronger than the untreated group.

That did not happen, but something wonderful did happen.

Subjects treated with infrared took significantly fewer pain relievers than the untreated group.

The effect lasted at least 6 months after the study’s main phase ended.


  • 6 Exercises for Knee OA Pain
  • Long-term results of a randomized, controlled, double-blind study of low-level laser therapy before exercises in knee osteoarthritis: laser and exercises in knee osteoarthritis
  • Prolotherapy and Low Level Laser Therapy: A Synergistic Approach to Pain Management in Chronic Osteoarthritis
  • What is Prolotherapy?
  • Efficacy of High-Intensity Laser Therapy in Treating Knee Osteoarthritis: A First Systematic Review
  • Incorporation of photobiomodulation therapy into a therapeutic exercise program for knee osteoarthritis: A placebo-controlled, randomized, clinical trial
  • Immediate responses of multi-focal low level laser therapy on quadriceps in knee osteoarthritis patients
  • Osteoarthritis (Mayo Clinic)
  • Applications of Photobiomodulation Therapy to Musculoskeletal Disorders and Osteoarthritis with Particular Relevance to Canada
  • Effectiveness of phototherapy incorporated into an exercise program for osteoarthritis of the knee: study protocol for a randomized controlled trial
  • Effectiveness of phototherapy incorporated into an exercise program for osteoarthritis of the knee: study protocol for a randomized controlled trial

What Can You Do for Severe Osteoarthritis of the Knee?

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