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It’s easy to dismiss knee pain. Perhaps you overdid it at last weekend’s Parkrun. Maybe you’ve been struggling with joint issues for a while and have simply put them down to getting older.

But what if there’s no clear reason for the pain you’re experiencing? That’s to say: no injury, no over-exercising and no obvious incident that triggered it?

These are the kinds of questions that could point towards rheumatoid arthritis, a painful and frustrating condition that affects about 700,000 people in the UK.

Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system mistakenly attacks the lining of its own joints (the synovium), causing inflammation, pain and – if left untreated – lasting damage. Though most often associated with smaller joints like the knuckles and fingers, it can affect other larger joints like the knees, too.

So what are the hallmarks of rheumatoid arthritis in the knee joints – as opposed to, say, osteoarthritis? RA has certain characteristics that distinguish it from other painful knee conditions. Here are six potential indicators…

Rheumatoid arthritis: 7 signs to look out for

Swelling but no injury

This is the symptom we hinted at above. If you hurt your knee badly in a fall, you might expect to see some swelling over the next few days. If it’s swollen but you haven’t hurt it, something else is going on. Rheumatoid arthritis essentially attacks the synovial lining of the knees, causing it to become inflamed. The synovial tissues thicken (“pannus”) and release excess synovial fluid (the lubricating liquid that helps the joint to move smoothly and comfortably).

Warm and red

A swollen knee that’s also hot and red is another potential sign of rheumatoid arthritis. In RA, the soft tissues go into protection mode to fend off the “attack”, releasing inflammatory cells into the joint as well as extra fluid. The blood vessels also widen to increase blood flow to the area. This makes the knee feel hot and tender to the touch. (It’s worth noting that heat and redness are also symptoms of infection; it’s very important to rule this out if you do experience these symptoms.)

Pain in both knees

The most common type of arthritis – osteoarthritis (OA) – is a wear-and-tear condition, where the cartilage on bone endings becomes depleted, increasing friction within the joint. That kind of damage rarely occurs in equal measure. Usually, it affects one of your knees first, especially if the alignment of your leg is putting extra strain on that knee. Since RA is an autoimmune problem, the damage can happen simultaneously. So pain and swelling that is “symmetrical” – ie affects both knees at once – is another red flag for rheumatoid arthritis.

Worse in the mornings

When we see patients with rheumatoid arthritis, they often tell us the pain and stiffness is worse in the mornings, right after they get out of bed. Typically, the stiffness lingers for at least half and hour. That contrasts with osteoarthritis, where the symptoms tend to disappear more rapidly. “Morning stiffness that is a symptom of osteoarthritis usually wears off within 30 minutes of getting up,” explains the NHS, “but morning stiffness in rheumatoid arthritis often lasts longer than this.”

Worse after rest (not just after activity)

For similar reasons, activity doesn’t necessarily trigger rheumatoid stiffness in the same way as osteoarthritis. In OA, activity increases friction, which increases pain. By contrast, in rheumatoid arthritis, inflammatory cells and fluid accumulate within the joint space even as you rest. So when you get up (or wake up) and start moving again, the pain and stiffness can actually feel worse than it did while you were active.

Involving other joints too

Again, it’s helpful here to contrast rheumatoid arthritis with the wear-and-tear type. Osteoarthritis damage has a focal point – a specific joint or portion of the joint where the cartilage has worn away and left the bone ending exposed, triggering your symptoms. Because rheumatoid arthritis is a systemic (body-wide) condition, it can flare up in multiple places at once, in potentially wide-ranging ways. The symptoms can include more general problems like sweating, high temperature, dry eyes and lack of energy. On which note…

Feeling tired and unwell

A general feeling of fatigue and unwellness is another potential sign of rheumatoid arthritis. Patients often liken it to having the flu; you feel exhausted, your limbs feel heavy and hard to move, you lack energy even if you seemed to sleep well the night before. The reasons why this happens can be varied and complex: everything from anaemia and certain medicines to missed meals, stress and the constant grind of living with ongoing pain may be involved. But if you’re feeling fatigue alongside any of the other symptoms above, it’s another good reason to seek advice from an expert.

Support for rheumatoid arthritis

The number of people in the UK who suffer from rheumatoid arthritis has been increasing in recent years. Fortunately, there’s a lot we can do to manage the situation. If you’re concerned that your knees are being affected by RA, it’s a good idea to get yourself checked out. We can take a look at the problem, organise tests and scans to rule out other conditions, and refer you to a rheumatology specialist if necessary. To book an appointment, hop to our Contact page – or you can call or email the team and they’ll help you take the next steps.

If movement were a pill, it would be the most powerful drug on the planet…
Dr Davina Deniszczyc, charity and medical director of Nuffield Health

About 3.7 million people in the UK are currently suffering from sore joints. If you’re one of them, the idea of a world-beating pain-relief medicine probably sounds highly appealing.

Could exercise be that pill? A major new study says we might have underestimated the sheer scale of its benefits.

A team of researchers from Nuffield Health, Manchester Metropolitan University and Frontier Economics offered 40,000 joint pain sufferers the chance to take part in free, weekly gym classes. After 12 weeks, the results were genuinely dramatic.

What did the study involve?

The research centred on people with pain in their knees, hip or back. Each participant was given access to two one-hour classes per week, led by a rehabilitation specialist, at one of Nuffield Health’s 110 private UK gyms. The classes provided structured exercise to help improve the patients’ mobility, stability, strength, and overall cardiovascular health. After 12 weeks, the research team dived into the data to see how the participants had fared and whether they’d seen any benefits.

What did the research discover?

The data revealed a big improvement, right across the board. As the Guardian reported, at the end of 12 weeks the patients who took part:

• had on average 35% less pain
• went to see their GP 29% less often
• took almost half as many sick days from work
• needed their family to look after them 21% less.

It’s worth noting that many of the participants felt unable to work because of their joint pain – about 25% of the total. By the end of the trial, however, almost 10% of those people were able to return to work. In public health terms, that’s a significant outcome.

How have experts reacted to the study?

The research team say the findings are so strong that the government should be taking note and considering a similar programme for the NHS. “Tailored, structured exercise is one of the most effective treatments for people with long-term conditions,” explains Dr Davina Deniszczyc, charity and medical director at Nuffield Health. “If movement were a pill, it would be the most powerful drug on the planet, yet it remains under-prescribed. Integrating it as a treatment into mainstream healthcare would transform lives on a scale no drug could.”

Do you have knee joint pain? 3 takeaways from the study

Like the research participants, you may be struggling with knee pain yourself. Maybe you’re managing arthritis-related joint pain and finding it tough going. Perhaps you’re waiting for a knee replacement and trying not to think about exercise right now. What can you take from this research? We think the study actually has a lot of positives for patients in your position. Here are three thoughts:

Reinforce the benefits

This study is a timely reminder of how important exercise is to recovery and rehab. We’ve known for years that regular movement improves almost every area of joint health. To take just a few examples, it: stimulates bone strengthening, improves blood flow, reduces joint strain by reducing excess weight and increases muscle strength (which means more support for the knee joint). The new research shows how that translates into reduced pain too. Indeed, other studies have demonstrated that regular exercise can boost the brain’s pain tolerance to an even greater degree than massage or stress management. Participants in this new study also reported an average “13-point rise in their quality of life scores.”

Keep doing what you can do

Knowing exercise is good for chronic knee pain is one thing. Actually building it into your routine when you feel rubbish is something else entirely. After all, this programme involved two hours of guided exercise every week – that’s a significant amount, and more than some will be able to manage. Yet the truth is that regular, gentle exercise of almost any kind is better than no exercise at all. The key is to keep doing what you feel able to do. And, secondly, to consider switching into lower-impact activities that might keep you moving when other exercise feels too much – things like swimming or hydrotherapy, or even cycling. On which note…

Consider group exercise

The less obvious aspect of this study is that the exercise happened in a group setting. The sessions weren’t carried out in isolation. They were guided by experts, in rooms full of other people facing very similar issues. Numerous studies have found that group-based exercise seems to have a significant impact on chronic pain relief (here’s one recent example). The reasons are likely social and psychological: being around others makes us feel better; sharing the same challenges and goals helps us to feel less isolated and encouraged to keep going. This is the principle behind ESCAPE-pain, a group-based rehab programme that has been doing some great work with patients who are struggling with long-term joint pain. It’s worth checking out if you haven’t come across it before.

Ready to read more?

You may find these articles helpful…

• Read the official report about the study – A new deal for long-term conditions (Frontier Economics)
• Learn more about Nuffield Health’s free Joint Pain Programme (Nuffield Health)
• Find out more about ESCAPE-pain: A course to help you manage knee pain (blog)
• Read more about exercise and pain relief: Why is exercise good for arthritis knee pain? (blog)

If you’re having a knee replacement, how disruptive might it be for your sleep?

Like all major operations, the answer really varies from person to person. Some knee replacement patients find their sleeping patterns normalise quite quickly after surgery. For others, it can take weeks, even months, before they feel completely comfortable in bed.

That needn’t be taken as a reason not to have the operation. After all, most people opt for a, replacement because the daily and nightly pain has already become unbearable. And the encouraging thing is that post-surgery satisfaction rates for knee replacement are very high: some 75% of patients say they feel much better after the operation compared to before (NHS Digital, 2020).

But the bottom line is that almost everybody faces some sleep disturbance in the early days after knee replacement. Knowing that from the outset can help you prepare ahead – and make some simple tweaks that will give you the best chance of a good night’s rest and a steady recovery.

Grab sleep where you can

In the very early days after surgery, overnight sleep often comes in waves rather than consistent cycles. So taking naps during the day can be helpful – when, wherever and however feels most comfortable to you. Mix resting on a bed during the day with your feet elevated (it reduces swelling in your legs and feet) with gentle mobility and exercise to encourage muscle strength and good circulation.

Experiment with sleep positions

The standard advice after knee replacement surgery is to sleep on your back. Sleeping on your back helps keep your leg straight, which enables good blood flow while you rest and avoids putting stress on the new joint. But that isn’t a hard-and-fast rule. Indeed you may find it quite challenging if you’re usually a front or side sleeper. If sleeping on your side, doctors usually recommend keeping the operated knee on top. Others, though, find it more comfortable the other way round.

Use a pillow if comfortable

If you need more support in bed, try placing a flattish pillow between your knee and upper leg. Or even two, one on either side of the operated joint. Another option is a knee wedge (or form wedge), a memory foam cushion that elevates your leg while providing good support to the knee. Or you could just use an ordinary, firm pillow that extends up past the knee down to your calf (see Knee Replacement Aftercare: Tips for Patients and Caregivers, Arthritis Foundation). It’s not advisable to place a pillow directly under your knee, though – this can cause stiffness and restrict blood flow behind the joint.

Consider a recliner

Some people find they get better sleep in a reclining chair than in bed, at least in the short term. Recliners give you more control over your elevation and are easier to get in and out of, particularly if your bed is set quite high or low. You can of course buy your own, but it’s possible to rent them too. Search “medical recliner chair” or “riser recliner” online. Bear in mind, though, that reclining chairs aren’t recommended as a long-term sleep replacement for a bed.

Go easy on the drinks

It’s very important to keep well hydrated after surgery. But tea, coffee and alcoholic drinks (alcohol especially) are diuretics that will make your night-time bathroom visits more frequent. Alcohol is best avoided completely – it interferes with sleep cycles, making wakeups more likely. As for tea and coffee, timing is key. You may have heard that caffeine has a “half-life” of around six hours, meaning 50% of it is still in your system six hours later. So, in the short term, it may be better to restrict your caffeine intake to the mornings rather than the afternoons.

Be “wakeup-ready”

Accepting that you may sleep fitfully at first can, paradoxically, remove the pressure to sleep perfectly through the night. Instead, focus on making your periods of wakefulness as pleasant as possible. Have everything to hand: books and magazines, a tablet or phone for listening to audiobooks, as well as your medicines and painkillers. Here’s how one reader on an online knee forum describes their routine. “If I woke up at say 3 am and just couldn’t get back to sleep, I would just sit up in bed, prop up my surgery leg with pillows, and have a snack. I kept water and a small ziplock bag of [crisps] and nuts on my nightstand and that seemed to help.”

Keep the routines going

Before leaving hospital, the nurses or therapists will take you through some of the key exercises and activities you’ll need to do as you recover. It’s really important to keep going with these as much as you can. Regular mobility helps to improve the strength and flexibility of your new knee, reduce swelling, and build better stability over the long term. Always follow your therapist’s guidance for your own rehab, but you can get an idea of the types of exercise in this helpful Patient Information guide from University Hospital Southampton.

Keep the end in mind

If sleep becomes a struggle after surgery, keep focusing on the end goal. Your knee will get stronger and more comfortable over time, life will return to normal, and your sleep disruption won’t last forever (even if it sometimes feels like it in the wee small hours). As one reader on the above-mentioned forum puts it: “If your recovery is anything like mine, one morning you’ll wake up and feel almost normal. And here’s some similar reassurance from one of our own knee replacement patients: “I now look forward to having a life without continual pain, especially at night, which is worth remembering when you have the odd “taking a step back” day of overdoing things! I will very soon be able to join in my fitness activities again that I’d previously missed due to the knee pain. I can now get back to normality again. Life is good!”

For further reading

You may find these blogs helpful…

6 simple sleep tips for arthritic knee pain
Sleep and knee surgery: how to plan around the disruption
ESCAPE-pain review: a course to help you manage knee pain

Are you worried about sleep after surgery? It’s a common question and we’re always very happy to chat and offer advice about this and any other concerns you have. Call the team on 01962 826107 – or book an appointment with Mr Bailey through the website. We’ll be glad to get you the help you need.

If you google the phrase MPFL, you’ll find it often pops up alongside the words “dislocation” and “kneecap”.

That’s because the MPFL (medial patellofemoral ligament) plays a critical role in protecting the kneecap from becoming dislocated. And when things go wrong with this particular ligament, recurrent dislocations often follow.

If this does happen to your knee, one of the potential solutions is MPFL reconstruction – a type of surgery that doctors generally turn to when other treatments haven’t worked. Let’s explore this operation in a bit more detail, why you might have it, and what it entails…

Where and what is the MPFL?

The medial patellofemoral ligament is the key ligament on the inside of your kneecap (the patella). You can think of it as a “guy rope” between your thighbone and kneecap, pulling the two bones together and keeping everything taut and strong. (The other guy rope is the lateral patellofemoral ligament, which does a similar job on the outer side of the knee.) Without the MPFL, your kneecap wouldn’t sit firmly in place within your joint.

How do dislocations happen?

There are several reasons why MPFL-related dislocations happen. Two important causes are:

• Trauma – if you damage (tear) the ligament during an accident, usually a sporting injury or a bad fall
• Hyperlaxity – when your joints are more flexible than most people’s, making them less supportive of your kneecap

Hyperlaxity – also known as joint hypermobility or double-jointedness – can run in families and is most common in children and teenagers. Although it usually gets better with age, some patients experience ongoing problems with dislocation or subluxation (partial dislocation): the kneecap keeps popping out of the joint, causing pain and considerable distress.

What’s the treatment for kneecap dislocation?

In most cases – especially if it’s a first-time dislocation – your doctor will recommend non-surgical treatment. That means relieving the immediate pain with painkillers or NSAIDs, using the RICE protocol (rest, ice, compression, elevation), possibly immobilising your knee with a brace or splint, and potentially working on exercises with a physiotherapist. One issue with kneecap dislocations, however, is that once they’ve happened once, they are prone to recur. In over 90% of first-time dislocations, the MPFL suffers damage or gets stretched in the process – which, unfortunately, increases the risk of further dislocations. The good news is that many MPFL tears can heal naturally over time. But this doesn’t always happen.

When would you recommend MPFL reconstruction?

MPFL reconstruction is what we call an operation of last resort. It’s a very effective procedure, but really only one to consider when other avenues haven’t worked, if you have severe MPFL damage, or your kneecap keeps on dislocating (“recurrent patella dislocation”). The aim of the operation is to restore stability to your kneecap and stop it from popping out of the joint. We would normally assess your knee with an x-ray, CT scan and / or MRI to determine this.

What happens in an MPFL reconstruction?

Reconstruction basically involves replacing the damaged ligament with a new one. The traditional way to do this is with a piece of your hamstring (known as an autograft, since it comes from your own body). But we use a synthetic version made from a highly durable polyester material. This synthetic tape, about 1cm wide, is passed through an incision in your kneecap, looped back on itself to create a kind of sling for the knee joint, and secured into place on your thighbone. We do this with a modern technique called interference screw fixation, which creates a smoother fixation than traditional titanium staples. (You can read more about how it works in this blog: A new technique for dislocated kneecaps.)

How long does it take to recover from MPFL reconstruction?

For most young people – who make up the bulk of our cases – the recovery journey is fairly straightforward. It takes about six weeks get back to everyday activities, and a few months to resume sport if you feel able to. It’s important to keep up with rehabilitation exercises to give yourself the best opportunity for a strong recovery. This is something you’ll work on with a physiotherapist in the weeks following your operation. It’s worth adding that a reconstructed MPFL can feel unusual at first and may take some getting used to. But, overall, as a solution for the pain and frustration of recurring dislocations, we find most patients are very happy with the results and are able to get back to a good level of activity.

Are you or a family member thinking about surgery for repeated dislocation? We would be happy to have a look at your knee and discuss the potential options. Please call the team on 01962 826107, or fill out a quick form online, and we’ll book you an appointment with Mr Bailey.

When arthritis wears away the knee cartilage and the pain becomes unbearable, it could be time to consider joint replacement. In practice, that often means TKA (total knee arthroplasty) – an operation that swaps out the whole of the damaged joint for a new, artificial implant.

But a patellofemoral knee replacement? That’s a slightly different operation. As the name suggests, this type of replacement surgery focuses on a very specific part of the knee – the patella, or kneecap.

So how does the procedure work – and who would it be appropriate for?

How does patellofemoral arthritis affect the knee?

As you probably know, osteoarthritis is what happens when the smooth cartilage on our joints breaks up or wears away, either through injury or long-term wear-and-tear. Quite often, the damage is spread across the knee. But sometimes – in about 10% of cases or fewer – it’s concentrated in the front ‘compartment’ of the knee: the patellofemoral joint. This is where you lose cartilage on the underside of your kneecap and along the trochlea, a groove in the thighbone that allows your knee to flex and extend smoothly.

What does patellofemoral arthritis feel like?

Patellofemoral osteoarthritis tends to cause isolated pain at the front of the knee, especially when crouching, walking up or down stairs and slopes, or after sitting or lying down for an extended period of time, or getting up from a low chair. It can also cause swelling, stiffness and instability, where the knee gives out during activity. Patellofemoral arthritis often has its origins in a previous injury (such as in a high-impact car crash), a naturally unstable kneecap, or because of malalignment in your leg.

How does patellofemoral knee replacement work?

A patellofemoral prosthesis is much smaller than a TKA implant. It comes in two parts: a shiny metal component that sits against the thighbone (femur) and a polyethylene (high-density plastic) button that covers the rear surface of the kneecap. To place the implant, the surgeon removes small sections of cartilage damage from both bones before fixing it in place with cement. The operation happens under a general anaesthetic and usually takes about 40-60 minutes.

What are the advantages of a patellofemoral knee replacement?

A patellofemoral implant is a type of partial (or unicompartmental) knee replacement. Partial knee replacements have a number of benefits. Firstly, they’re less invasive, because we’re removing less material from the knee and resurfacing a smaller section of the joint. That generally means less time in hospital, a shorter recovery time and, potentially, the ability to return to a wider range of activities when everything has healed. This is one reason why patellofemoral replacements are popular among younger, very active patients. (You can find out more about partial versus total surgery in this article: Partial or total knee replacement? Understanding the differences.)

Is a patellofemoral replacement right for me?

The time to seriously consider knee joint replacement, whether partial or total, is only when alternative treatments – such as painkillers, anti-inflammatory injections, cartilage repair, and activity modification – have been exhausted. If we suspect you have significant osteoarthritis damage in your kneecap, we can confirm it using X-ray or MRI scans. This will also tell us if the rest of your knee is well preserved – ie, there’s little or no cartilage damage in the inner and outer compartments of your joint. If you’re otherwise fit, healthy and active – and want to remain as active as possible in the years to come – you could be a good candidate for the implant. Patellofemoral knee replacement may be a relatively uncommon procedure but, in the right circumstances, it can be a very effective solution to painful knee arthritis.

Further reading on knee replacement surgery

Looking into the options and alternatives? You may find these articles helpful

What causes a painful kneecap?

Case study: Ed’s partial knee replacement with robotic surgery

Knee resurfacing or partial replacement – what’s the difference?

The extraordinary Lindsey Vonn: Pro skiing… after a knee replacement

Why robotic surgery can be a good option for partial knee replacements

A new study from China has some encouraging news about hydrotherapy and knee pain.

Researchers from a hospital in Neijiang, central China, recently examined 12 non-drug therapies to see how well they reduced pain and stiffness in patients with knee osteoarthritis. After trawling through 139 trials involving nearly 10,000 patients, they found that hydrotherapy was one of the most effective treatments – second only to knee braces overall.

“For the reduction of pain, this study demonstrates that aquatic therapy is particularly effective,” they concluded. “Aquatic therapy stands out in pain management, possibly due to the reduced impact and increased comfort of exercising in water compared to land.”

The good news is that water-based therapies – and pools – are becoming more and more available in clinics and hospitals around the UK. So how does hydrotherapy work – and who is it useful for?

What is hydrotherapy?

Hydrotherapy is the use of water in various forms – including warm baths, pools, and sometimes pressurised jets – to treat symptoms like muscle pain and joint stiffness, and often incorporating special exercises from a trained physiotherapist. You might also hear it called water therapy, aquatic therapy and occasionally balneotherapy.

What knee problems does it treat?

Hydrotherapy tends to be recommended for any kind of ongoing swelling, inflammation, bruising, stiffness and pain around the knee joint. Practically, that means things like managing osteoarthritis, relieving the symptoms of fibromyalgia (pain that’s widespread in the body) and for rehab after an injury or an operation – particularly following a knee replacement.

Why is hydrotherapy good for knee problems?

Good question! It has quite a few different benefits:

Temperature

Hydrotherapy pools are usually heated to around 33-36°C (91-97°F), which is warmer than the average swimming pool. The warmth is important because it dilates blood vessels, promotes blood flow, reduces swelling, and encourages the release of endorphins, helping your muscles to relax. By improving circulation, it also helps to clear the lactic acid that builds up after certain types of exercise.

Buoyancy

Water of course reduces gravity and supports weight – which means you can move much more freely than you would be able to on land, and with less pain. This opens up the kind of exercises that are vital for combatting stiffness and improving mobility – whether you’re struggling with arthritis pain or getting back on your feet after a knee replacement.

Coordination

The supportive qualities of water also improve balance and proprioception (the sense that tells your brain where your body is in space, enabling you to move and coordinate your actions). This is one of the reasons why hydrotherapy is often recommended for people with multiple sclerosis and cerebral palsy, or patients who are recovering after a stroke.

Resistance

While water supports mobility it also, paradoxically, provides low-impact resistance. Put simply: it takes more effort to move through water, which means you build up muscle strength – but gently. Strengthening your leg muscles is one of the surest ways to protect your knee health and alleviate pressure on a chronically damaged, swollen or painful joint.

Psychology

As the researchers indicated, being in warm water increases our “comfort”. That’s important too, because the way we think about pain is very closely related to how much pain we experience. Research has shown, for example, that our brains have the ability to tone down how intensely a harmful stimulus is experienced. Merely being in a hydrotherapy pool, in other words, may help people to feel more positive about their injury or pain – and their recovery.

How does a hydrotherapy session work?

Typically, your first hydrotherapy session would be a one-to-one appointment with a specialised aquatic physiotherapist. They’ll ask you about your knee, your medical history, and what you hope to get from the sessions. They’ll then guide you through a series of movements and exercises that are tailored to your knee situation. Hydrotherapy exercises tend to revolve around working with the water or against it (resistance training). Here are some examples:

Water walking – Walking across the pool in waist-high water, swinging your arms naturally and keeping your back straight and abdominal muscles tight

Deep-water walking – Walking in deeper water while swinging your arms and maintaining good posture, using a water noodle (a foam pipe) between your legs or a flotation device for buoyancy if needed

Leg exercise using a noodle – Tying a water noodle around one foot then, supported by the pool wall, repeatedly straightening and flexing the leg

You can read more about these and other exercises in this short guide: Aquatic exercises (Mayo Clinic). Bear in mind that you should always get advice from your doctor or physiotherapist on which exercises to use for your knee.

Length

Your first one-to-one session is likely to last 45 minutes; follow-up sessions are normally 30 minutes. Once you’ve completed your initial hydrotherapy programme, it’s usually possible to sign up for group “splash” sessions to carry on your rehab exercises.

Cost

Depending on where you go, a private hydrotherapy session with a physio is likely to cost between £60-£80 (2025 prices) for the initial assessment. Follow-up sessions are usually around £50-£60, or less for group sessions. If you’ve been signed off by your physio, you can sometimes book independent sessions for as little as £10 for 30 minutes (for instance at the Nuffield Wessex – see below).

Locations

You’ll find good hydrotherapy services right across the UK. Facilities that are popular with our own patients here in Hampshire include:

The Royal Hampshire County Hospital (Winchester) – for NHS referrals by your physio, your doctor or Mr Bailey

Wessex Nuffield Hospital (Chandler’s Ford) – for private physio-led sessions, which you can book on 0345 0454845

Pinder Aquatic Physiotherapy (Winchester Sport and Leisure Park) – for one-to-one private sessions with a physio and, potentially, independent exercise with the hydrotherapy pool and equipment: see their website for more details

Are you interested in finding out more about hydrotherapy for knee pain or as part of your rehab? Drop us a line and we’ll be happy to send you more details or arrange a consultation and referral with Mr Bailey.