Patellofemoral Pain is a Multifactorial Complex Condition; Are We Missing a Multidisciplinary Approach to its Management? Time for a Paradigm Shift.

Abstract

Background: Patellofemoral pain is a prevalent musculoskeletal condition characterized by persistent anterior knee pain, often exacerbated by activities that increase patellofemoral joint stress. The aetiology of patellofemoral pain is multifactorial, involving biomechanical, muscular, and psychological factors. Altered movement patterns and muscle weaknesses, particularly in the hip and knee regions, are commonly observed in people with patellofemoral pain. These impairments can either contribute to or result from the condition. Psychological factors, such as kinesiophobia and pain catastrophizing, also play a significant role in the persistence and severity of patellofemoral pain, highlighting the need for a comprehensive treatment approach.

The problem: Patellofemoral pain imposes a considerable burden on those who leave with the condition, leading to high pain levels, impaired physical function, and reduced quality of life. The condition's persistent nature and potential progression to patellofemoral osteoarthritis underscore the critical need for effective management strategies. Current best practices include exercise therapy and adjunct treatments, but adherence and long-term effectiveness remain challenges.

Take-home message: Emerging evidence suggests that addressing obesity and incorporating patient education and self-management strategies could enhance outcomes. Additionally, integrating dietary interventions targeting systemic inflammation presents a promising avenue for reducing pain and improving function. A multidisciplinary approach, involving various health professionals, is advocated to provide holistic and patient-centered care for those affected by patellofemoral pain.