Active man hiking pain-free after non-surgical knee pain treatment at M&S Vascular and Orthopedic Group, Forest Hills & Great Neck, NY

Knee Pain · Queens · Long Island

Chronic Knee Pain — Without the Replacement

Same-day, outpatient knee pain treatment from board-certified specialists in Forest Hills, Queens and Great Neck, Long Island.

Medically Reviewed by Dr. Mehran Manouel, MD, FAAOS · April 28, 2026

A Specialist’s View on Knee Pain

Most knee pain falls into one of two patterns: mechanical (a torn meniscus, a sprained ligament, a patella that tracks poorly) or inflammatory and degenerative (osteoarthritis, bursitis, autoimmune arthritis). The pattern matters — mechanical knees often need imaging and sometimes arthroscopic repair; inflammatory knees respond to a different toolkit altogether.

At M&S Vascular and Orthopedic Group, our patients with chronic knee pain don’t walk in to a single answer. Dr. Manouel brings the orthopedic surgery side — arthroscopy, ACL and meniscus repair, sports medicine — and Dr. Salem brings the interventional side, including Genicular Artery Embolization (GAE), the minimally invasive procedure that’s changed the landscape for knee osteoarthritis.

For many patients, that means options before — and often instead of — knee replacement.

Common Causes

What’s Causing Your Knee Pain?

Osteoarthritis (wear-and-tear)

The most common cause of chronic knee pain in adults over 50. Cartilage wears down and the bones rub, causing pain, stiffness, and swelling.

Meniscus tears

A torn meniscus can cause locking, catching, or sharp pain — common in athletes and after sudden twisting injuries.

ACL or ligament injuries

Often from sports or falls. Causes instability, swelling, and pain that may require surgical or non-surgical management.

Patellofemoral syndrome ("runner's knee")

Pain around or behind the kneecap, often worsened by stairs, squatting, or prolonged sitting.

Bursitis or tendinitis

Inflammation of the cushioning sacs (bursa) or tendons around the knee — common after overuse.

Iliotibial band (IT) syndrome

Pain on the outside of the knee, common in runners and cyclists.

Gout or rheumatoid arthritis

Inflammatory conditions that can cause sudden, severe knee pain and require medical management.

When to See a Specialist

Don’t Wait Through These Signs

  • Pain that lasts more than two weeks despite rest, ice, and over-the-counter anti-inflammatories
  • Knee pain that wakes you up at night or doesn't improve when you stop activity
  • Sudden swelling, redness, or warmth around the joint
  • Locking, catching, or buckling sensation when you walk
  • A history of knee surgery or injury where pain has returned
  • Difficulty climbing stairs, getting out of a chair, or walking short distances

Treatment Pathway

From Conservative to Cutting-Edge

We work the ladder from least to most invasive — most patients never reach the top rungs.

1

Conservative first

Physical therapy, anti-inflammatories, weight management, bracing, activity modification. Most patients start here.

2

Image-guided injections

Cortisone, hyaluronic acid (viscosupplementation), or PRP — performed at our office under ultrasound guidance for accuracy.

3

Minimally invasive embolization

GAE (Genicular Artery Embolization) addresses chronic pain at the vascular root — no incision, no general anesthesia, same-day discharge.

4

Arthroscopic surgery

For mechanical issues like meniscus tears or loose bodies, Dr. Manouel performs arthroscopic repair through small incisions.

5

Joint replacement (last resort)

When non-surgical options have been exhausted. Many of our patients use GAE, PRP, and viscosupplementation to delay replacement by years.

Our Specialty Procedure

Genicular Artery Embolization (GAE)

GAE is the minimally invasive treatment that addresses chronic knee osteoarthritis at its vascular root. Through a pinhole in the wrist or thigh, Dr. Salem guides a thin catheter to the genicular arteries that feed the inflamed knee lining and blocks the abnormal vessels driving pain. No incision. No general anesthesia. Same-day discharge. Clinical studies show 70-90% pain reduction lasting two years or more.

Learn About GAE Book Now

Other Knee Treatments

A Full Toolkit for the Knee

Knee Replacement Alternatives

Non-surgical pathway to delay or avoid knee replacement

Learn more

Joint Embolization

Embolization across knee, hip, shoulder, and other joints

Learn more

PRP Injections

Regenerative platelet-rich plasma therapy

Learn more

Joint Pain Treatment

Comprehensive non-surgical joint pain care

Learn more

Sports Medicine

For active patients and athletes of every level

Learn more

Pain Management

Coordinated, evidence-based pain care

Learn more

FAQ

Knee Pain — Patients Ask

When should I see a doctor for knee pain?
See a specialist if your knee pain lasts more than two weeks, limits daily activities, wakes you at night, or is accompanied by swelling, redness, or instability. Early evaluation often means simpler treatment.
Can I avoid knee replacement?
Many patients can delay or avoid knee replacement using non-surgical treatments. GAE clinical studies show 70-90% pain reduction lasting 2+ years. PRP and hyaluronic acid injections also provide meaningful relief. The right approach depends on your arthritis severity, age, and goals.
What is GAE and how does it help knee pain?
Genicular Artery Embolization (GAE) is a minimally invasive procedure that reduces inflammation in the knee by blocking the small abnormal arteries that feed the inflamed joint lining. Performed through a pinhole incision in the wrist or thigh, with same-day discharge.
How is knee pain different at night vs. during activity?
Pain at rest or at night often suggests advanced osteoarthritis or inflammation, while activity-related pain may indicate mechanical issues like meniscus tears or patellofemoral syndrome. The pattern helps guide the right test and treatment.
Do you treat knee pain at both Forest Hills and Great Neck?
Yes. Dr. Manouel and Dr. Salem see patients at both our Forest Hills, Queens office and our Great Neck, Long Island office. GAE and other minimally invasive procedures are available at both locations.

Ready to Take the Next Step?

Most consultations are available within the same week. See Dr. Manouel or Dr. Salem at our Forest Hills or Great Neck office.

Book Now (718) 897-2228
Forest Hills, Queens Great Neck, Long Island