Knee Pain

Knee pain is one of the most common musculoskeletal complaints, affecting people of all ages from athletes to older adults. As the body's largest joint, the knee bears significant weight and stress during daily activities. Pain can result from acute injuries like ligament tears or develop gradually from conditions like arthritis. The location, timing, and nature of knee pain provide important clues about its cause. Understanding when knee pain is a minor issue versus a serious problem requiring immediate attention can help prevent long-term damage and maintain mobility.

⚠️ Seek Immediate Medical Care For:

  • Inability to bear weight on the knee
  • Obvious deformity or knee out of alignment
  • Knee gives way or buckles
  • Severe pain and rapid swelling
  • Signs of infection (fever, red, hot knee)
  • Numbness or tingling below the knee
  • Cold or blue foot on affected side
  • Unable to fully straighten or bend knee
  • Heard a "pop" during injury
  • Severe injury mechanism (car accident, fall)

Understanding Knee Pain

The knee joint consists of bones (femur, tibia, patella), cartilage (menisci), ligaments (ACL, PCL, MCL, LCL), tendons, and a joint capsule filled with synovial fluid. This complex structure allows for both stability and flexibility but makes the knee vulnerable to various injuries and conditions. Pain can originate from any of these structures or be referred from the hip or back.

The pattern of pain provides diagnostic information: pain with stairs often indicates patellofemoral problems, pain with twisting suggests meniscus issues, and morning stiffness points to arthritis. Understanding your specific symptoms helps guide appropriate treatment.

Common Causes

Injuries

  • ACL/PCL tears
  • Meniscus tears
  • MCL/LCL sprains
  • Patellar dislocation
  • Fractures
  • Tendon ruptures

Overuse Conditions

  • Runner's knee (PFPS)
  • Jumper's knee
  • IT band syndrome
  • Bursitis
  • Tendinitis
  • Stress fractures

Degenerative Conditions

  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • Pseudogout
  • Degenerative meniscus tears
  • Chondromalacia patella

Other Causes

  • Baker's cyst
  • Osgood-Schlatter disease
  • Infection (septic arthritis)
  • Referred pain from hip
  • Bone tumors (rare)
  • Osteochondritis dissecans

Pain Location Guide

Front of Knee

  • Patellofemoral pain syndrome
  • Patellar tendinitis
  • Quadriceps tendinitis
  • Prepatellar bursitis
  • Arthritis behind kneecap

Inside (Medial) Knee

  • MCL injury
  • Medial meniscus tear
  • Pes anserine bursitis
  • Medial compartment arthritis

Outside (Lateral) Knee

  • IT band syndrome
  • LCL injury
  • Lateral meniscus tear
  • Lateral compartment arthritis

Back of Knee

  • Baker's cyst
  • Hamstring tendinitis
  • PCL injury
  • Deep vein thrombosis (emergency)

Age-Related Knee Pain

Children and Adolescents

  • Osgood-Schlatter disease
  • Growing pains
  • Patellar subluxation
  • Juvenile arthritis
  • Sports injuries

Young Adults

  • Sports-related injuries
  • Ligament tears
  • Meniscus injuries
  • Patellofemoral pain
  • Early overuse syndromes

Middle Age

  • Early osteoarthritis
  • Degenerative meniscus tears
  • Tendinopathies
  • Weight-related stress

Older Adults

  • Advanced osteoarthritis
  • Inflammatory arthritis
  • Spontaneous osteonecrosis
  • Insufficiency fractures

Associated Symptoms

Knee pain often occurs with:

  • Swelling: Immediate or delayed onset
  • Stiffness: Especially morning or after sitting
  • Instability: Feeling knee will give way
  • Locking: Unable to fully bend or straighten
  • Clicking/popping: With or without pain
  • Warmth: Over the joint
  • Weakness: Difficulty with stairs or standing
  • Limping: Altered walking pattern

Medical Evaluation

Physical Examination

  • Inspection for swelling, deformity
  • Palpation for tenderness
  • Range of motion testing
  • Stability tests (ligaments)
  • Special tests (McMurray's, Lachman's)
  • Gait assessment

Diagnostic Tests

  • X-rays: Show bones, joint space, arthritis
  • MRI: Detailed view of soft tissues
  • CT scan: Complex fractures
  • Ultrasound: Tendons, fluid collections
  • Arthroscopy: Direct visualization
  • Joint aspiration: Analyze fluid

Treatment Options

Conservative Care

  • RICE (Rest, Ice, Compression, Elevation)
  • Activity modification
  • Weight loss if needed
  • Physical therapy
  • Knee braces or supports
  • Assistive devices (cane, crutches)

Medications

  • NSAIDs (oral or topical)
  • Acetaminophen
  • Corticosteroid injections
  • Hyaluronic acid injections
  • PRP injections
  • Disease-modifying drugs (for RA)

Physical Therapy

  • Strengthening exercises
  • Range of motion work
  • Balance training
  • Gait retraining
  • Manual therapy
  • Modalities (ultrasound, TENS)

Surgical Options

  • Arthroscopy
  • Ligament reconstruction
  • Meniscus repair/removal
  • Osteotomy
  • Partial knee replacement
  • Total knee replacement

Exercises for Knee Health

Strengthening Exercises

  • Straight leg raises
  • Quad sets
  • Wall squats
  • Step-ups
  • Hamstring curls
  • Calf raises

Flexibility Exercises

  • Hamstring stretches
  • Quadriceps stretches
  • IT band stretches
  • Calf stretches
  • Hip flexor stretches

Low-Impact Activities

  • Swimming
  • Water aerobics
  • Cycling
  • Elliptical machine
  • Walking on level surfaces

Prevention Strategies

  • Maintain healthy weight: Reduces stress on knees
  • Strengthen muscles: Especially quadriceps and hamstrings
  • Warm up properly: Before exercise or sports
  • Use proper technique: In sports and exercise
  • Wear appropriate footwear: Good support and cushioning
  • Gradually increase activity: Avoid sudden changes
  • Cross-train: Vary activities to avoid overuse
  • Listen to your body: Rest when experiencing pain

Living with Chronic Knee Pain

  • Activity modification: Find alternatives to painful activities
  • Pain management: Develop coping strategies
  • Support groups: Connect with others
  • Assistive devices: Use when needed
  • Home modifications: Railings, raised seats
  • Regular monitoring: Track changes
  • Maintain fitness: Focus on what you can do
  • Mental health: Address impact on mood