Some back and neck pain needs a doctor today, not a chiropractor. Some back and neck pain is not a case for a chiropractor and needs a doctor the same day. Go to an emergency room, not to us, if you have numbness in the groin or inner thighs, if you have lost control of your bladder or bowels, if a leg is becoming weak rather than just painful, if the pain followed a serious fall or a car crash, if you have a fever with back pain, if you have unexplained weight loss alongside it, if you have a history of cancer, or if a headache came on suddenly and is the worst you have ever had. We would rather you rang your doctor and never rang us at all.
Hips and knees generate a particular kind of despair, because the words attached to them sound so final. Wear and tear. Bone on bone. Degenerative changes. Those phrases appear on radiology reports of enormous numbers of people who walk around perfectly comfortably, and they correlate poorly with how much anybody hurts. What they mostly describe is a joint that has aged, which every joint does, and which is not the same as a joint that must hurt.
The overwhelming majority of hip and knee pain we see is a loading problem. The tissue is being asked for more than it is currently prepared to give — because the mileage went up, because a new job involves stairs, because six months of sitting was followed by a return to five-a-side, because a hip has been quietly weak for years and the knee below it has been absorbing the difference. This is genuinely good news, because capacity can be built and it responds reasonably quickly.
That is also true of osteoarthritis, which is where the despair is thickest and where it is least warranted. Exercise is one of the better-supported treatments for hip and knee osteoarthritis, better than most of the passive things sold for it, and strength work in an arthritic knee reliably improves pain and function even though it changes nothing on the x-ray. Being told your knee is worn out and you should rest it is close to the worst available advice.
What we see most
Four patterns with four different plans.
Pain at the front of the knee
Aching around or under the kneecap, worse on stairs, after long sitting, or a mile or two into a run. Common in runners, cyclists and people who suddenly increased something. It is almost always a loading problem rather than damage, and it responds well to a temporary reduction plus targeted hip and quadriceps work over six to twelve weeks.
Pain on the outside of the hip
Tenderness over the bony point of the hip, worse lying on that side at night and worse on stairs. It is usually a tendon problem rather than bursitis, and — importantly — it is frequently made worse by the stretching people are told to do for it. Loading it progressively works considerably better than stretching it.
Pain deep in the groin
Groin or deep front-of-hip pain, worse on rotation, sometimes with catching, is the pattern that most often indicates something inside the joint. It needs proper examination, and it is the hip presentation most likely to warrant imaging and occasionally an orthopaedic opinion, particularly in younger athletic patients.
Osteoarthritis
Stiffness first thing that eases with movement, pain later in the day and after activity, gradually reducing range. It is common after fifty and it is far more treatable than the language around it suggests. Strength and general exercise improve pain and function reliably, and they do so independently of anything visible on imaging.
What actually works
In descending order of how much difference it makes, which puts the hands-on part lower than people expect.
Progressive strength
The single most effective thing available for the large majority of hip and knee pain, including osteoarthritis. Loading builds the capacity that was missing, and it does so within weeks. It has to be genuinely progressive rather than the same three exercises with a yellow band for two months, which is why we write the progression down and review it.
Adjusting the load, temporarily
Not stopping — adjusting. Fewer miles, flatter routes, a lower box, a shorter shift on the stairs, for a defined period with a plan for coming back up. Total rest deconditions the joint and the muscle around it and makes the return worse, while carrying on unchanged keeps provoking it. The middle path is where the recovery happens.
Hands-on work, in support
Soft-tissue work and joint mobilisation reduce pain and improve range, which makes the loading possible and more comfortable. It is a genuine part of the treatment and it is not the part that fixes it. A clinic treating a knee with hands alone for two months is not treating the knee.
Looking above and below
A knee frequently hurts because of what the hip is not doing, and a hip frequently hurts because of what the foot and ankle are doing. Assessing the whole chain rather than only the painful part is routine here, and it is often where the actual answer is. Occasionally the answer involves orthotics, which have their own page.
When to see somebody else
A short list. Two of these want assessing quickly.
A knee that locks or gives way
A knee that genuinely locks and will not straighten, or that buckles unexpectedly, suggests something mechanical inside the joint. So does a knee that swelled substantially within an hour of an injury. These need assessment and often imaging rather than a rehabilitation programme, and we refer rather than persevere.
A hot, swollen, very painful joint
A single joint that is hot, red, markedly swollen and severely painful, particularly with a fever, needs urgent medical assessment the same day. Joint infection is uncommon and it is an emergency. This is not a case for hands-on treatment and not a case for waiting until morning.
Hip pain after a fall in an older adult
Groin or hip pain and difficulty weight-bearing after a fall, particularly over sixty-five or with thinning bone, needs a fracture excluded before anybody treats it. Some hip fractures still allow walking, which is exactly why they get missed. Imaging first, treatment afterwards.
A joint that has stopped responding
Osteoarthritis that has progressed to the point where pain is constant, sleep is broken most nights and walking distance has collapsed despite genuine effort at strength work is a reasonable point to discuss joint replacement with an orthopaedic surgeon. That is a good outcome for the right person, and we will say so rather than keep treating.
Hip & Knee Pain in western Queens
Hips and knees that ache on stairs, after sitting, or a mile into a run. Usually a loading problem, usually improvable, and occasionally arthritis that is far more treatable than people expect.
Every course of care here starts the same way: a full hour, a proper history, an examination, and then a plain statement of what we think is going on and how confident we are about it. You are told what we propose, roughly how many visits it ought to take and what should have changed by when — and we agree a date to stop and look at whether it worked. If the honest answer at any point is that this needs somebody else, you get that instead, and we write to them the same week.
Chiropractic care is not a substitute for medical diagnosis. Chiropractic care is not a substitute for medical diagnosis, and nothing on this website is medical advice for your particular problem. We are not physicians: we do not prescribe medication, we do not perform surgery, and we do not treat disease. What we do is examine how your spine and joints move, work on them by hand, and give you something to do between visits. If your problem turns out to be outside that, we say so and refer you — which happens often enough that you should expect it as a normal outcome rather than a failure.
What chiropractic does not treat. We treat musculoskeletal problems: the spine, the joints, the muscles and the nerves that are irritated by them. We do not claim that adjusting a spine treats asthma, allergies, ear infections, colic, digestive disease, high blood pressure, infertility, immune function or any other internal illness. Chiropractors who make those claims are making them without good evidence, and you should be wary of anybody who does. If somebody has told you that spinal care will fix a condition on that list, we will tell you honestly that it will not.
Questions
Hip & Knee Pain — the questions we are asked most
My x-ray says bone on bone. Is exercise safe?
Yes, and it is one of the better-supported treatments available for hip and knee osteoarthritis. Strength work reliably improves pain and function in arthritic joints, and it does so without changing anything visible on the x-ray — which tells you how loosely the image and the symptoms are connected. Being told to rest a worn joint is close to the worst available advice, because the muscle around it is doing a great deal of the work.
Should I stretch my painful hip?
For pain on the outside of the hip, usually not — and this is a common mistake. That pattern is typically a tendon problem, and the stretches people are given for it compress the very structure that hurts, which is why so many people report the stretching making it worse. Progressive loading works better. Bring in whatever you have been told to do and we will go through it.
Can I keep running with knee pain?
Often yes, with modifications. Complete cessation deconditions the tissue and makes the return harder, while carrying on unchanged keeps provoking it — so the answer is usually reduced volume, flatter routes and a rule about acceptable symptoms during and after. Pain that stays below a low threshold and settles within a day is generally acceptable. Swelling, locking or giving way is not.
Do I need orthotics?
Most people do not. They have a real place — for some foot and lower limb problems, for particular foot types, and for people whose symptoms clearly change with footwear — and they are considerably oversold. We assess whether the foot is genuinely part of your problem before suggesting them, and quite often the answer is better shoes and stronger hips instead. The custom orthotics page is honest about it.
How long does runner's knee take to settle?
Typically six to twelve weeks of consistent work, which is longer than most runners want to hear. The pain often improves within two or three weeks of reducing the load, and the mistake is treating that as recovery and going straight back to full volume. The capacity has to be built for it to hold, and that is the part that takes the full span.
Is a clicking or popping knee something to worry about?
Almost never on its own. Joints make noise, they make more of it as they age, and painless clicking or grinding is not evidence of damage or of anything progressing. What matters is whether it hurts, whether the joint swells, and whether it locks or gives way. Noise plus any of those three is worth examining; noise on its own is worth ignoring.
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Book an appointment
Pick a chiropractor and an hour from the calendar — it shows only the times each of them genuinely has free. A first visit is a full hour and costs $95 for the examination on its own, or $145 if we treat you at the same appointment. You decide which after the examination, not before.