Understanding Meniscus Tears and Degeneration: MRI Findings, Symptoms, and Non-Surgical Treatments

Introduction

The meniscus is a C-shaped cartilage cushion in the knee that absorbs shock and stabilizes the joint. It plays a crucial role in maintaining smooth movement and protecting the joint from wear and tear. When a patient experiences knee pain, swelling, or mechanical symptoms like locking or clicking, a knee MRI often reveals findings such as a meniscus tear, meniscal degeneration, or meniscus extrusion.

Understanding what these terms mean, how they affect daily life, and the non-surgical treatment options available in Singapore can help patients make informed decisions before considering surgery.

What is a Meniscus Tear?

A meniscus tear occurs when the cartilage is damaged, often due to trauma, sports activity, or degeneration over time. The tear may involve the inner edge, outer edge, or body of the meniscus and can vary in type:

  • Horizontal tear: Parallel to the tibial plateau, often degenerative.
  • Vertical tear: Perpendicular to the tibial plateau, sometimes called a longitudinal tear.
  • Radial tear: Begins in the inner edge and extends outward.
  • Flap tear: A fragment of the meniscus is displaced, potentially causing locking.
  • Complex tear: Combination of multiple tear types.

Symptoms:

  • Pain along the joint line
  • Swelling or stiffness
  • Catching or locking of the knee
  • Difficulty fully bending or straightening the leg

MRI Findings:

  • High signal within the meniscus on T2-weighted images
  • Disruption of the normal C-shaped meniscus contour
  • Meniscus extrusion (displacement of the meniscus beyond the joint line)

Meniscal Degeneration

Meniscal degeneration is the gradual wear and tear of meniscus tissue over time, typically associated with aging or chronic stress. Unlike acute tears, degenerative meniscal changes are usually slow and may cause intermittent pain rather than a sudden injury.

MRI Findings:

  • Increased signal within the meniscus without a clear tear line
  • Thinning or fraying of the meniscus edges
  • Early extrusion in advanced degeneration

Implications:
Degeneration can reduce the shock-absorbing capacity of the knee, contributing to early osteoarthritis. Patients may notice pain when walking, climbing stairs, or after prolonged sitting.

Meniscus Extrusion

Meniscus extrusion refers to the displacement of the meniscus beyond the tibial plateau. It is commonly associated with degeneration or large tears and can indicate reduced meniscus function.

Symptoms:

  • Pain along the medial or lateral joint line
  • Swelling, especially after activity
  • Feeling of instability

MRI Findings:

  • Meniscus edge protruding more than 3mm beyond the tibial plateau
  • Associated cartilage wear or joint space narrowing

Why MRI is Important

While X-rays can show bone changes, MRI is the gold standard for evaluating soft tissue structures like the meniscus. MRI helps to:

  • Confirm the presence and type of meniscus tear
  • Detect early degenerative changes
  • Identify associated cartilage or ligament injuries
  • Guide non-surgical treatment or surgical planning

At The Pain Relief Clinic in Singapore, same-day or next-day MRI scans are available, with rapid reporting to support timely treatment decisions.

Non-Surgical Treatment Options

Not all meniscus tears require surgery. Many degenerative tears respond well to conservative, non-invasive management, especially when combined with modern therapies.

1. Physiotherapy (The Pain Relief Practice)

  • Strengthens muscles around the knee
  • Improves joint stability and alignment
  • Reduces pain and swelling
  • Focuses on quadriceps, hamstrings, and hip stabilizers

Typical Regimen:

  • Low-impact exercises (cycling, swimming)
  • Targeted strengthening for the medial/lateral muscles
  • Balance and proprioception training

2. HotHeal Therapy

  • Combines manual therapy with non-invasive radiofrequency
  • Reduces inflammation
  • Stimulates tissue repair
  • Improves mobility and decreases pain

3. Shockwave Therapy

  • Promotes healing of degenerative tissue
  • Reduces chronic inflammation
  • Often used for stubborn meniscus or tendon-related symptoms

4. Lifestyle and Activity Modification

  • Avoiding high-impact activities that worsen symptoms
  • Maintaining healthy weight to reduce knee load
  • Using supportive footwear

Case Scenarios

Case Scenario 1: Middle-Aged Runner

A 45-year-old recreational runner develops knee pain after a minor twist. MRI shows a degenerative medial meniscus tear and early cartilage thinning.

Treatment: Physiotherapy at The Pain Relief Practice, HotHeal Therapy sessions. After 8 weeks, the patient reports reduced pain and improved mobility, avoiding surgery.

Case Scenario 2: Office Worker with Meniscal Degeneration

A 52-year-old office worker has knee stiffness and swelling. MRI reveals meniscal degeneration with mild extrusion.

Treatment: Non-invasive approach including physiotherapy, targeted strengthening, and shockwave therapy for symptom relief. Follow-up MRI confirms no progression after 6 months.

Case Scenario 3: Senior Patient with Advanced Meniscus Tear

A 62-year-old retiree presents with knee locking. MRI shows a flap meniscus tear with extrusion and early osteoarthritis.

Treatment: Combination of physiotherapy, HotHeal Therapy, and activity modification. Surgery is reserved only if symptoms worsen significantly.

FAQs

Q1: Do all meniscus tears require surgery?
No. Many degenerative or small tears can improve with non-surgical care.

Q2: Can meniscus extrusion be reversed?
Complete reversal is unlikely, but non-invasive therapies can reduce symptoms and slow further degeneration.

Q3: How long does physiotherapy take to show results?
Most patients notice improvement within 6–12 weeks, depending on tear severity and adherence.

Q4: When should I get an MRI?
Consider MRI if: persistent pain, swelling, locking, instability, or failed conservative management.

Key Takeaways

  • Meniscus tears, degeneration, and extrusion are common MRI findings in knee pain patients.
  • Early detection and management can prevent further degeneration and delay surgery.
  • Non-surgical therapies — physiotherapy, HotHeal Therapy, shockwave — are effective for many patients.
  • MRI at The Pain Relief Clinic provides precise diagnosis to guide personalized treatment plans.

Taking proactive steps based on MRI findings can improve mobility, reduce pain, and preserve knee health for years to come.

Ask Dr Tan A Question About Your Problem