Knee Pain: Causes, Diagnosis & Treatments

Everyone gets knee pain at some point in their lives. Maybe it’s from an injury, like a torn ligament or cartilage. It could also be something medical like arthritis or an infection.

If you have minor knee pain, you can usually take care of it yourself. You can also wear a knee brace or do physical therapy to make it feel better. But if you’re hurt or the pain lasts, see a doctor immediately.

In this article, we’ll explain the various causes of knee pain, how doctors diagnose the problem, and the available treatments. 

What is Knee Pain?

Knee pain is when your knee joint hurts, where two bones in your leg meet – your thigh bone (femur) and shin bone (tibia). Your knee is a big joint that handles a lot of your body weight when you move, so it can get injured often.

Knee pain comes in different forms, from short-term discomfort to long-lasting issues that need medical help. Where the pain is can tell you what’s wrong:

• Pain on the surface, above or behind the knee, usually means a problem with muscles, tendons, or ligaments.
• Deeper knee pain might come from issues with your bones or cartilage.

Knee pain doesn’t always stay in one spot; it can spread to other parts of your knee or leg. You might feel pain on one side, like it’s from the back of your knee, and it can even go down to your lower leg or thigh.

Knee pain can come and go during the day. You might hurt when you move or bend your knee, but feel better when you rest. Some people have more pain in the morning or at night, especially if they were active during the day.

Usually, you can treat knee pain at home by taking a break from activities and using over-the-counter pain relievers. But if your knee pain really messes up your daily life or lasts more than a few days without getting better, you should see a doctor.

Common Knee Pain Symptoms

Knee pain can show up in various ways, depending on what’s causing it. Watch for these common signs and symptoms linked to knee pain:

• The knee exhibits visible puffiness or fluid accumulation.
• A reduction in the knee’s range of motion.
• The skin around the knee appears red and feel warm to the touch.
• A sensation that the knee is unable to support the body’s weight.
• Audible sounds from the knee during movement.
• Inability to fully straighten the knee.
• Changes in skin color around the knee area.

Causes of Knee Pain

Knee pain can stem from a variety of sources, including

• Injuries: These can range from sprains and strains to more severe conditions such as torn ligaments (e.g., ACL injuries), cartilage tears, and fractures. Injuries can occur due to falls, incorrect landings, twisting movements, or direct impacts.
• Arthritis: Several forms of arthritis can affect the knee, including osteoarthritis (a wear-and-tear condition), rheumatoid arthritis (an autoimmune disease), gout (caused by uric acid crystal buildup), and pseudogout (caused by calcium-containing crystals).
• Overuse Injuries: Repetitive activities can lead to conditions such as tendinitis and bursitis, where tendons or bursae (fluid-filled sacs) around the knee become inflamed.
• Mechanical Problems: Issues such as loose bodies (fragments of bone or cartilage floating in the joint space), iliotibial band syndrome (tightness of the tissue band from the hip to the outside of the knee), and dislocated kneecap can cause knee pain.
• Other Conditions: These include Osgood-Schlatter disease (affecting the knee’s growth plate), patellar dislocation, and patellofemoral pain syndrome (related to muscle imbalance and alignment issues).

Diagnosing Knee Problems

To diagnose knee issues, doctors use various tests along with a patient’s medical history and physical examination:

• X-ray: This test uses invisible energy beams to create images of the inside of the knee, including bones and tissues.

• Magnetic Resonance Imaging (MRI): An MRI uses powerful magnets, radiofrequencies, and a computer to produce detailed images of the knee’s structures. It’s helpful for detecting damage to ligaments or muscles.

• Computed Tomography Scan (CT or CAT Scan): This combines X-rays with computer technology to create cross-sectional images of the knee, providing a comprehensive view of bones, muscles, fat, and organs.

• Arthroscopy: This minimally invasive procedure involves inserting a small camera (arthroscope) into the knee through a tiny incision. It allows doctors to examine the joint’s interior for degeneration, arthritis, bone diseases, tumors, and the cause of pain or inflammation.

• Radionuclide Bone Scan: This test involves injecting a small amount of radioactive material into the bloodstream, which is then detected by a scanner. It shows blood flow and cell activity within the bone, aiding in diagnosis.

Factors That Can Raise Your Risk of Knee Problems

There are several factors that can make you more likely to have knee problems. These include:

• Excess Weight: Carrying extra weight, whether you are overweight or obese, can put extra stress on your knee joints. Even everyday activities like walking or climbing stairs can make this stress worse. It can also speed up the wearing down of the cartilage in your joints, which increases the risk of osteoarthritis.

• Lack of Muscle Strength and Flexibility: Not having strong muscles and flexibility can increase your chances of getting knee injuries. Strong muscles are important for keeping your knee joints stable and protected, while flexibility helps you move your knees through their full range of motion.

• Specific Sports or Jobs: Some sports and occupations can be tough on your knees. Sports like alpine skiing, with its rigid ski boots and potential for falls, basketball with its frequent jumps and quick turns, and activities like running or jogging that involve repeated impact on your knees can all raise the risk of knee injuries. Similarly, jobs that require you to put a lot of stress on your knees, like construction or farming, can also make you more vulnerable.

• Previous Injury: If you’ve had a knee injury before, you are more likely to have another one in the future.

How to Treat Knee Pain

If you suffer from knee pain, it’s important to consult with a healthcare professional to determine the most appropriate treatment plan for your specific situation. They can help diagnose the cause of your knee pain and recommend the best course of action, whether it involves home remedies, medical treatments, or a combination of both.

In general, a doctor might recommend the following treatments for knee pain:

Home Remedies

• RICE Method: For acute injuries or arthritis flare-ups, the RICE method is highly recommended. This involves Rest (taking a break from activities that cause pain), Ice (applying cold packs to reduce swelling), Compression (using a bandage to apply gentle pressure on the knee), and Elevation (keeping the knee raised above heart level).
• Heat and Cold Therapy: Applying heat can relieve stiffness, while cold therapy can reduce swelling and numb the pain. For the first 48 to 72 hours after an injury, use cold packs. After this period, heat packs can be used to ease stiffness.
• Supportive Devices: Using walking aids like crutches or canes, knee splints, and braces can help stabilize the knee and reduce pain.
• Massage and Acupuncture: These therapies can offer pain relief for some individuals. Massage can improve circulation and reduce stiffness, while acupuncture may help relieve knee pain by targeting specific points on the body.

Medical Treatments

• Medications: Over-the-counter pain relievers such as ibuprofen, naproxen, and acetaminophen can help manage pain and inflammation. For more severe cases, your doctor may prescribe stronger medications or recommend injections of corticosteroids or hyaluronic acid to reduce inflammation and lubricate the knee.
• Physical Therapy: A physical therapist can design a personalized exercise program to strengthen the muscles around the knee, improving its function and reducing pain.
• Surgery: In cases where knee pain is severe and other treatments have not been effective, surgery may be considered. Options include arthroscopic surgery to repair damage, partial or total knee replacement, or osteotomy to realign the bones.

How to Prevent Knee Pain

Here are some health tips to prevent knee pain:

1. Exercise and Stretch Regularly

Regular physical activity can strengthen the muscles that support your knees, reducing the risk of injury and pain. Low-impact exercises such as walking, swimming, cycling, and using an elliptical machine are particularly beneficial. These activities help control weight and build muscle without putting excessive stress on the knees.

It’s also important to incorporate stretching in your workout routine. Stretching exercises improve flexibility and can prevent injuries that lead to knee pain. You may focus on stretches that target the quadriceps, hamstrings, and calf muscles to support the knee joint effectively. 

2. Weight Management

Excess weight puts additional stress on your knees, which can lead to pain and increase the risk of osteoarthritis.

For every pound of body weight, the knee experiences a force of three to six times that amount with each step. This means even a small amount of excess weight can significantly increase the pressure on the knees.

According to the American College of Rheumatology/Arthritis Foundation, losing 5 percent of your body weight can improve knee function and treatment.

3. Dietary Changes

A healthy diet can play a significant role in managing knee pain, particularly for those suffering from conditions like osteoarthritis.

Here’re the foods you might include in your anti-inflammatory diet:

• Fatty Fish: Rich in omega-3 fatty acids, fatty fish like salmon, mackerel, and sardines can help reduce inflammation.
• Fruits and Vegetables: These are high in antioxidants and phytochemicals that combat inflammation. Berries, cherries, and leafy greens are particularly beneficial.
• Whole Grains: Foods like brown rice, oatmeal, and whole-wheat bread are high in fiber, which can lower levels of C-reactive protein (CRP), a marker of inflammation.
• Nuts and Seeds: Almonds, walnuts, chia seeds, and flaxseeds provide healthy fats and antioxidants that support anti-inflammatory efforts.
• Olive Oil: A staple of the Mediterranean diet, extra virgin olive oil is rich in polyphenols that have anti-inflammatory properties.
• Turmeric and Ginger: These spices contain compounds that offer significant anti-inflammatory effects

4. Wear Proper Footwear

Choosing the right shoes is essential for knee health. Shoes with good arch support and cushioning can help absorb shock and distribute weight evenly, reducing the strain on your knees.

On the other hand, you should avoid wearing high heels for extended periods, as they can increase pressure on the knee joint.

When Should You See a Doctor for Knee Pain?

If you have ongoing knee pain that interferes with your daily routine or stops you from doing regular activities, you may see a doctor or physical therapist.

If you’ve experienced a major accident like a car crash or a bad fall and can’t move your knee or think it might be broken, go to the emergency room or call 911 immediately.

Sophia Anderson, PT, DPT

Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.

She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.

If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.