American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first-line treatment for Patellofemoral Pain Syndrome?

1. Injection therapy

2. Physical therapy

3. Bracing

4. Surgical intervention

The correct answer is: Physical therapy

Physical therapy is recognized as the first-line treatment for Patellofemoral Pain Syndrome (PFPS). This condition is often related to an imbalance or weakness in the muscles around the knee and hip, which can lead to pain and decreased function. Physical therapy emphasizes strengthening and stretching exercises tailored to the individual’s specific needs. Focused rehabilitation can help improve the alignment and function of the patella (kneecap), enhance muscle strength, and promote better biomechanics during movement. Therapists may implement therapeutic modalities, gait training, and modifications to activity levels to aid recovery. While injection therapy, bracing, and surgical intervention may have roles in treating PFPS, these options are typically reserved for cases that do not respond adequately to conservative measures like physical therapy. Injection therapy can be useful for alleviating pain but does not address the underlying muscle imbalances. Bracing may provide some support but should be used in conjunction with strengthening exercises. Surgical intervention is considered only in persistent cases where other treatments have failed. Thus, physical therapy is the most appropriate initial approach.