Online physiotherapy for knee pain
For long-lasting knee pain that fits osteoarthritis, a video appointment lets your physiotherapist watch you squat and step, then set up a strengthening and activity plan. A 2024 trial found video care was non-inferior to in-person care for this group. A locked, giving-way or hot swollen knee needs to be seen in person.
If you’re in the Glasgow area, you can book a home visit instead of a video call.
How online physiotherapy works for knee pain
One randomised trial, PEAK, looked at video physiotherapy for knee osteoarthritis. It was published in The Lancet in 2024 and enrolled 394 adults with chronic knee pain consistent with osteoarthritis at 27 clinics in Australia. Both groups had five consultations over three months covering strengthening, physical activity and education. Video care was non-inferior to in-person care for pain and for function at three months.
That finding is specific. It covers adults with chronic knee pain consistent with osteoarthritis in that trial, not every knee problem, and it does not describe our service. We mention it because it is relevant to knee pain from osteoarthritis, and our plans for knee osteoarthritis follow the same ground: exercise, activity and education.
NICE guidance on osteoarthritis lists therapeutic exercise, and weight management where appropriate, as core treatments, with information and support. Our plans start there. On camera we watch how you rise from a chair, climb a step and lower into a squat, and we use what we see to choose exercises for the muscles around your knee.
Knee pain has other causes, and we ask about them. If your pain is mainly at the front of the knee, we assess that too, using the single leg decline squat check where it is safe for you to try.
We cannot feel your knee or test its ligaments by hand. If the knee locks, gives way or painfully clicks, the NHS advises getting help from 111, and we will ask you to be seen in person instead of by video.
What the video assessment checks
- Where the pain is felt, whether at the front, the sides or all around the joint, and what brings it on, such as stairs, walking or sitting for long.
- How you stand up from a chair, step up and down from a step, and lower into a squat, with attention to how the knee tracks over your foot.
- The single leg decline squat check, if you can do it safely, which shows how the knee copes with load.
- Swelling and stiffness in the knee, how much it limits walking, and how it affects sleep, work and leisure.
- Your current activity levels, any weight-management goals you want help with, and how your hip and ankle move.
- The red flag questions below, including locking, giving way after an injury and a hot swollen joint, which we ask at the start of every appointment.
What treatment usually involves
A knee plan centres on strengthening the thigh, hip and calf muscles in steps, with advice on pacing activity and what to do on sore days. We show you each exercise on camera and give you a small number to start with, so that the plan is not so big that you stop doing it.
It depends on your condition; your physiotherapist will give you an estimate after your assessment. The first is a 60-minute video assessment at £40, and follow-ups are 30 minutes at £30. In PEAK, both groups had five consultations over three months, but that was a research design and we do not treat it as a promise for you.
The NHS advises that more severe osteoarthritis may need a structured exercise plan with a physiotherapist, and suggests aiming for 150 minutes of moderate activity a week plus strength exercises. We talk about how to build toward that in a way that your knee tolerates.
NICE guidance recommends telling people with osteoarthritis that joint pain may go up for a while when they start exercising, and that regular exercise kept up over time brings more benefit. It says not to offer acupuncture or dry needling for osteoarthritis, and not to offer glucosamine or strong opioids. If you have questions about medicines, speak to your GP or pharmacist.
How long recovery usually takes
Knee osteoarthritis is a long-term condition, according to the NHS, so we cannot give you a reliable recovery range. Our aim is a plan that gets you moving and that you can keep going. We review how your pain, walking and daily tasks are changing at each follow-up, and adjust the exercises or suggest further help from your GP if progress stalls. In PEAK, results were measured at three months, and knee pain from other causes can behave differently.
When you need to be seen in person instead
A video appointment is not the right route for the situations below, and a home visit is not a substitute for urgent care.
- Call 111 if you have a very high temperature, or feel hot, cold or shivery, and have redness or heat around your knee.
- Call 111 if your knee is badly swollen or has changed shape, or you cannot move it or put any weight on it.
- Call 111 if your knee locks, gives way or painfully clicks.
- Call 111 if your knee pain is very bad.
- If you are not sure how urgent your symptoms are, call 111 or speak to a GP before booking a video appointment.
Exercises and self-checks
Common questions
Does online physio work for knee osteoarthritis?
The PEAK trial in The Lancet (2024) found video physiotherapy was non-inferior to in-person care for pain and function at three months in adults with chronic knee pain consistent with osteoarthritis. That applies to that group and trial, not to every knee problem, and we cannot promise the same result for you.
What does NICE recommend for knee osteoarthritis?
NICE guidance on osteoarthritis says the core treatments are therapeutic exercise and weight management where appropriate, with information and support. It says not to offer acupuncture or dry needling, glucosamine or strong opioids.
Can you help with pain at the front of my knee?
We assess it on video, including how the knee moves on stairs and squats. We cannot examine the joint by hand, so if a diagnosis is uncertain or you have had an injury, we will tell you plainly and suggest in-person care.
Should I stop exercising if my knee hurts?
Not necessarily. The NHS suggests regular activity and strength exercises for osteoarthritis, and our plans pace them to your knee. If your knee locks, gives way, is badly swollen, or you have a high temperature with redness or heat around it, call 111.
Further reading
This information is general and not a substitute for an assessment. Don't start a new exercise programme without advice from a physiotherapist or doctor who knows your condition. If an exercise causes pain that doesn't settle, stop and seek advice.
Sources
Book an online assessment
A 60-minute video assessment with an HCPC-registered physiotherapist is £40.
Book my assessment