Common Causes of Knee Pain and When to See a Doctor

It’s important to see your doctor if your knee pain doesn’t improve in a few weeks, or if your knee locks, clicks painfully or is unstable (gives way when standing). Knee pain may or may not be caused by an injury.

Injuries that can cause knee pain include:

  • Tendonitis of the kneecap
    • What is it? Pain between your kneecap and shin bone that may develop slowly, over several months.
    • What causes it? usually affects people who participate in sports that involve repetitive jumping or running. (also known as jumpers knee)
  • Torn ligament
    • What is it? An injury to the tough bands of tissue around the knee joint, called ligaments. If you twist your knee or land awkwardly, you may experience sudden pain and swelling around the knee and have difficulty moving, bending, or standing on the injured leg. There may have been a snap or popping sound when the knee was injured.
    • What causes it? This pain may be caused by an injury, that occurs immediately after exercising or vigorous activity where the knee may have twisted suddenly, been over-extended, knocked or from landing awkwardly. It may feel like your knee is unstable or give way when you try to stand up.
  • Osgood-Schlatter’s disease(Osteochondrosis)
    • What is it? It usually affects teenagers and may also develop slowly from repetitive activities. It should clear up on its own when the knees are rested or the repetitive activity is avoided until recovery.
    • What causes it? The pain and swelling below the kneecap is typically caused by repetitive activities such as running and jumping, most commonly in teen boys – and sometimes pre-teen girls – during growth spurts.
  • Dislocated kneecap
    • What is it? This is when the kneecap moves out of place, to the side of the knee joint. The kneecap may be tender to the touch, look out of place and swollen.
    • What causes it? It may happen while participating in a sport or other vigorous activity, from a bump to the knee or sudden change in direction.

Causes of knee pain when there is no obvious injury, include:

  • Osteoarthritis
    • What is it? Osteoarthritis is a common cause of knee pain, particularly in those over the age of 45. Knees may feel stiff, painful and mildly swollen.
    • What causes it? Osteoarthritis is caused by the breaking down of cartilage (the protective layer over the ends of the bones), which feels painful and stiff, and for some people may also cause swelling, tenderness and a crackling or grating sound when bending the knees.6A,B Knee pain from osteoarthritis in someone younger than 50 may be caused by a previous injury.
  • Bursitis
    • What is it? Bursitis causes pain and inflammation in joints like the knee, but if treated should go away in a few weeks, The knee might look swollen and red with a dull achy pain and feel warm to the touch.
    • What causes it? Bursitis is the swelling of fluid-filled sacs (bursa) that cushion your joints. Kneeling and bending might make the pain and swelling worse.
  • Bleeding in the joint
    • What is it? Bleeding in the joint can make the knee feel swollen, warm to the touch and appear bruised. It is more likely to happen if you’re taking blood thinners (anti-coagulants).
    • What causes it? It is usually caused by an injury or a bleeding disorder called haemophilia. It can also happen after knee surgery or from certain illnesses
  • Gout (a type of arthritis)
    • What is it? Gout is a type of arthritis that can cause sudden severe joint pain, look red and feel hot to the touch. Gout pain lasts 1 to 2 weeks if left untreated. Future attacks may last longer if you don’t get treatment. Leaving gout untreated, may cause damage to joints. If you have a fever or feel ill, you may have an infection, which means you’ll need to see a doctor immediately.
    • What causes it? Things that can trigger gout include an illness that causes a high temperature, drinking too much alcohol or eating a large fatty meal, dehydration, joint injury or certain medicines. Gout can run in families and men are more likely to have it, especially as they get older.

You should seek immediate medical advice by calling 111 if:

  • Your knee is very painful, you can’t move it or you’re unable to put weight on it.
  • Your knee is badly swollen, or the shape has changed
  • You have a high temperature, feel hot and shivery or your knee feels hot and red. This may be a sign that you have an infection
  • You have sudden, severe, sharp, or shooting pain in one knee

How to Manage Knee Pain

Some knee injuries or conditions can be treated at home. However, it is important to get medical advice if you are worried, or if you experience any symptoms listed here.

Treatment by a healthcare professional

If you see your GP, they will assess your knee pain, and based on the cause, may:

  • Prescribe medicine
  • Recommend physiotherapy
  • Refer you to a hospital for a scan or specialist treatment

Managing knee pain at home

You can treat mild knee pain at home first, by following these tips:

  • Minimise the amount of weight you put on your knee, such as avoiding standing for long periods of time.
  • Try using an ice pack (or bag of frozen peas wrapped in a tea towel) on your knee for up to 20 minutes every 2 to 3 hours
  • You may want to use painkillers such as paracetamol or ibuprofen to help with the pain, or apply a gel or medicated plaster containing ibuprofen.

It’s important to seek medical advice if your knee pain does not improve in a few weeks.

Physiotherapy

A physiotherapist will make a thorough assessment of your injury or the cause of your pain. They may start by recommending knee protection and rest, as well as ice therapy (applying a cold pack to your knee). Once you have better movement and the pain has settled, a physiotherapist may then recommend exercises to improve your strength and balance. They may also suggest wearing a knee brace or taping the kneecap to change the way it sits or moves.

Self-management at home

Here are some tips that can help you to recover from an injury :

  • Once the pain has settled try gentle exercises to keep your joint moving and help build your strength back up. You could speak to a physiotherapist, who can tailor an exercise programme best suited to your needs.
  • Try to strike a balance between rest and exercise. Resting for too long could mean your recovery takes longer.
  • Visit a physiotherapist who can recommend appropriate exercises to support your knees.

These tips may help you manage a long-term condition such as osteoarthritis:

  • Regular exercise may be helpful to treat mild knee pain
  • Wearing suitable footwear or using special devices to reduce the strain on your knees during everyday activities.

How to Avoid Knee Pain

Although we can’t stop the aches and pains that might come with ageing, there are things that we can all do to help prevent knee pain and injury.

Exercise

It’s important to warm up properly before exercise. If you have gout or osteoarthritis, try to exercise regularly but you may want to choose exercises that don’t put too much pressure on your joints. Fast walking, strength exercises done at home, cycling and swimming are all good options that don’t put excessive strain on your joints, unlike running or weight training. Teens or adolescents with Osgood Schlatter disease don’t need to completely stop sport or exercise, but reducing their exercise or minimising sports or activities involving repetitive action may help.

Weight management

If you are overweight, it’s a good idea to try to lose weight to reduce the pressure on your knees and other joints. Osteoarthritis is not completely avoidable once we get older, however being overweight may increase your chances of developing it. You might consider speaking to your GP or a dietitian to help you with a weight loss plan.

Healthy eating

Following a healthy diet can help prevent conditions like gout. It’s a good idea to cut down on alcohol and smoking, and try to stay hydrated.

Posture and Protection

When you’re kneeling, remember to put padding down to protect your knees and take regular breaks between activities that put pressure on your knees. If you work at a desk for long periods, try to get up and stretch your legs regularly. Try to avoid keeping your legs in one position for too long, for instance sitting with your legs crossed. If your work involves heavy lifting or physically demanding tasks, you may want to discuss lighter duties or fewer hours with your employer. Try not to knock or bang your knees, but if you injure your knees, clean any cuts or grazes properly to prevent infection.

FAQs

What does it mean when your knee hurts without injury?

You may feel confused if you have knee pain without an obvious injury. There are many possible causes for this, but some of the more common reasons include gout, osteoarthritis, bursitis, or bleeding inside the joint. Read more about these here, If you are worried about your knee pain, read about when to speak to a doctor here.

Can children get knee pain?

It’s not uncommon for children to have knee pain. It may be caused by growing pains and growth spurts, joint hypermobility syndrome (a condition where the joints have more movement than most people) and jumper’s knee from repetitive jumping. Read more about knee pain caused by growth spurts here.

Can your knees hurt from not using them?

Your knees can feel stiff after not moving for a while, such as when you wake up in the morning. However this is usually a symptom of osteoarthritis and should only last about 30 minutes or less. Keeping active with non-load bearing, low intensity exercises, will help with osteoarthritis knee pain. If you have knee pain that gets worse when you’re resting or in the morning, or if it lasts more than 15 to 30 minutes after no activity, with swelling, tenderness or warmth around the knee, then you should speak to your GP or call 111. This may be a sign of a type of arthritis.

Can tight hamstrings cause knee pain?

It is possible that muscle tightness is causing your knee pain. In fact hamstring muscles, which are at the back of your thigh along with the quadricep muscles on the front of your thigh, are the most common muscles to become tight and cause knee pain. The muscle tightness puts pressure on you kneecap, which in turn causes it to rub on the knee joint.

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