Is your knee painful and swollen, and you are having difficulty bending, moving and straightening it.
Having knee pain is a common symptom in people of all ages. Knee pain could start suddenly without any injury or after an injury or exercise.
Your knee pain might start suddenly, or it could build up from mild discomfort to more painful over time. It can also swell on top or all around.
In this article, I draw on my experience as a diagnostic radiographer and research from scientific studies to answer the most frequently asked questions about knee pain.
Happy reading😀
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: August 2024. Written by Juliet Semakula, a diagnostic radiographer.
Disclaimer: no affiliate links.
▶️What are some of the causes of knee pain with or without any injury?
The knee is composed of different bones, muscles, tendons and ligaments. All these can be affected with injury or unknown causes that can lead to knee pain.
Image source: Bunt CW,2018: Anterior view of the osseous, ligamentous, and fibrocartilaginous structures of the knee.
Here are some possible conditions and explanations that may be causing your knee pain.
| Condition of knee pain | Possible symptoms you may be feeling |
| Torn ligament is where an anterior cruciate ligament (ACL) or medial collateral ligament (MCL) is injured. | May cause bleeding into your knee, swelling, or an unstable knee.Pain in the medial or lateral knee |
| Strain or sprain minor injuries to the cruciate ligaments caused by sudden or unnatural twisting | Can cause knee pain and swelling. Audible pop, instability. Swelling around the joint in 1 to 2 hours |
| Meniscus tear or torn cartilage | Can cause pain on the inside or outside of the knee joint.Cutting or twisting injury while bearing weight. Locking or giving away knees.Swelling or effusion in 24 to 48 hours. |
| Patellar dislocation this means that your kneecap slides out of positionFracture of knee surrounding bones. | causing knee pain and swelling.Not able to weight bear or limited range of movement. |
| Sinding-Larsen-Johansson (SLJ) syndrome is pain at the bottom of the kneecap (patella). It is caused by swelling and irritation of the growth plate which is a layer of cartilage near the end of a bone where the bone growth happens. | Occurs mainly in 10 to 13 years old, caused by repetitive running, jumping or squatting. 🟣Tenderness on the top of the patella.🟣Soft tissues swelling. 🟣Reduced range of movement on the quadriceps. |
| Iliotibial band syndrome is often called IT band syndrome. It most commonly happens in athletes, especially distance runners, or those new to exercise. | Causes pain on the outside of the knee. The pain is an aching, burning feeling that sometimes spreads up the thigh to the hip. You might notice this pain only when you exercise, especially while running |
| Meniscal tear these are certain disorders of the joint including torn meniscus, loose bodies in the knee, and damaged collateral or cruciate ligaments | Medical or lateral pain on your knee.Advanced osteoarthritis in the knee |
| Osteoarthritis of the knee | You will feel diffusion pain, stiffness when initiating movement, and difficulty to weight bear. Swelling, absence of trauma Chronic bony deformity. |
| Patellofemoral syndrome is sometimes called runner’s knee. It’s more common in people who run and who play sports that involve running and jumping. | Pain in the front of your knee and around the kneecap. |
| Bursitis these are caused by Inflammation when excess fluid collects in or around your knee joint from repeated pressure on the knee, such as kneeling for a long time, | Tender to touch and swelling. 🟣Redness around the joint 🟣In some cases, fever |
| Tibial apophysitis or Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. | It is an inflammation or swelling of the area just below the knee where the tendon from the kneecap attaches to the tibia. |
| Inflammation (non-infectious) gout or pseudogout), lupus, rheumatoid is arthritis because it causes similar symptoms that come and go just like gout. | More in older adults(post-menopausal), 🟣limited range of movement.it can causes sudden flares of pain. 🟣Swelling and erythema, 🟣Fever is possible |
| Inflammation (infectious)septic joint is inflammation of the joints secondary to an infectious disease such as bacterial, fungal, mycobacterial, viral, or other pathogens. | painful infection in a joint that can come from germs that travel through your bloodstream. 🟣Cause joint swelling, erythema warmth and joint immobility. |
| Baker cyst is a fluid-filled sac that forms in the popliteal fossa, which is located on the posterior aspect of the knee. Sometimes it goes away on its own or fluid may be drained from the cyst. | knee swelling occurs behind the knee (inflammation) from other causes, such as arthritis. 🟣Knee tightness, discomfort, and pain behind the knee |
| Medical plica syndrome is a fold in the membrane that protects your knee joint. Most people have four folds in each knee. Sometimes the plica located in the middle of your knee becomes irritated | It’s characterised by pain, swelling and instability. |
| Cancers that either spread to your bones or begin in the bones | Can cause you know to fill pain in your knees |
| Obesity -When you are overweight, this puts pressure on your legs | Sometimes causing your knee to swell and pain. 🟣Limited range of movement and stiffness. |
Are you not sure what type of knee pain you have? Lost among all these terms?
No worries at all! The treatment you will get will be based on the pain location of the knee after examinations.
▶️How to know if it’s indeed one of these conditions mentioned in the table above.
The location of knee pain will help you identify the cause
However, you can only be sure only when you see a doctor and an examination is done to determine what exactly is causing your knee pain.
During the physical exam, your doctor is likely to:
🟠Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
🟠Check to see how far you can move your lower leg in different directions
🟠Push on or pull the joint to evaluate the integrity of the structures in your knee
In some cases, your doctor might suggest tests such as:
X-ray- which can help detect bone fractures and degenerative joint disease.
Computerised tomography (CT) scan to help diagnose bone problems such as gout, joint inflammation and subtle fractures.
Ultrasound-uses sound waves to produce real-time images of the soft tissue.
Magnetic resonance imaging (MRI)- This test is particularly useful in revealing injuries to soft tissues such as ligaments, tendons, cartilage and muscles.
For an infection or inflammation, you’re likely to have blood tests and sometimes a procedure called arthrocentesis, in which a small amount of fluid is removed from within your knee joint with a needle and sent to a laboratory for analysis.
▶️What are the different types of knee pain and what could they mean?
Knee pain is categorised differently based on the symptoms and type and location of injury you have.
That’s why, if you have undergone examinations such as knee x-rays, a CT scan ultrasound or MRI, your doctor will be able to tell you what kind of pain or condition you have.
Pain location will help your doctor determine your problem.
⏭️Pain on top or anterior of the knee suggests involvement of the patella, patellar tendon, or its attachments.
You will feel a dull or aching and exacerbated pain in your knee after a prolonged sitting or climbing stairs this is common in patellofemoral pain syndrome
This can also be caused by:
🟠Bursitis.
🟠Arthritis.
🟠Softening of the patella cartilage as in chondromalacia patella.
⏭️Pain under or posteriorly of the knee. This Posterior knee pain after acute trauma raises suspicion for injury of the:
🟠Posterior cruciate ligament and posterior portions of the meniscus.
🟠Quadriceps tendons, or neurovascular structures
🟠Chronic posterior knee pain can suggest hamstring tendinopathy
🟠Arthritis.
⏭️Medial or lateral knee pain with corresponding joint-line tenderness can result from acute injury or chronic overuse and may indicate:
🟠Meniscal derangement or a sprain or rupture of a collateral ligament.
⏭️Other soft tissue and bone injuries
Your knee is surrounded by soft tissue and bone that you can damage or fracture.
▶️Is it OK to ignore knee pain?
🟠When do you seek medical treatment for knee pain?
🟠You have severe knee pain.
🟠You cannot move your knee or put any weight on it.
🟠Your knee is badly swollen or has changed shape.
🟠If achiness is isolated to one knee and you’re not able to bear weight, fully extend your leg or there’s significant swelling
🟠Your knee buckles, clicks, or locks.
🟠You cannot flex your knee or have trouble straightening it all the way out.
🟠You have a fever, redness or warmth around the knee.
🟠Numbness, tingling, or bluish discoloration in the calf below the sore knee.
Knee pain can often be treated at home if you have not injured or fractured your knee, it’s safe to try treating the knee pain at home first before you see a doctor.
You can use the RICE (Rest, Ice, Compression, and Elevation) guidelines.
🟦Rest and avoid activities that cause pain and put weight on your knee.
🟦Apply ice– You can apply ice where the pain is every hour for up to 15 minutes on the first day than 4 times per day use a towel to cover your knee before applying ice. Do not put ice directly to the knee.
🟦 Compress– Wrap the injured or sore area with an elastic bandage (such as an Ace wrap) to help decrease swelling.
Don’t wrap it too tightly, because this can cause more swelling below the affected area.
Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage.
🟦Elevation-Keep your knee raised as much as possible to bring down any swelling. You can put a cushion under your knee for support.
🟦Take painkillers such as ibuprofen, paracetamol and naproxen (Aleve) for pain and swelling.
Always consult your doctor before taking any medication because you could be allergic.
🟦 Sleep with a pillow underneath or between your knees this will support the knee.
▶️What is the fastest way to recover from knee pain?
I can not give you any reassurance how fast your knee pain will disappear because it will be individualised treatment based on the type and cause of pain or injury you have.
Depending on the cause of your knee pain, treatment could fall in these categories below.
1️⃣Medication- Your doctor may prescribe medications to help relieve pain and to treat the conditions causing your knee pain, such as rheumatoid arthritis or gout.
2️⃣Therapy Your doctor may recommend physical therapy or different types of strengthening exercises based on the specific condition that is causing your pain.
3️⃣Injections- your doctor may suggest injecting medications or other substances directly into your joint
4️⃣Surgery such as arthroscopic, knee replacement and patella fracture surgery.
You should remain optimistic to recover quickly and effectively even without undergoing specific treatment.
We have come to the end of this article, wishing a quick recovery.🙋
📚Sources:
Rabelo NDDA, Lucareli PRG. Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision-making process in patients with patellofemoral pain? Braz J Phys Ther. 2018 Mar-Apr;22(2):105-109. doi: 10.1016/j.bjpt.2017.10.002. Epub 2017 Nov 8. PMID: 29157738; PMCID: PMC5883958.
Smith RDJ, Smith KN, Shanmugam V, Beltran LS. Knee pain and swelling. Skeletal Radiol. 2023 Sep;52(9):1799-1800. doi: 10.1007/s00256-023-04345-0. Epub 2023 Apr 26. PMID: 37099069.
Bunt CW, Jonas CE, Chang JG. Knee Pain in Adults and Adolescents: The Initial Evaluation. Am Fam Physician. 2018 Nov 1;98(9):576-585. PMID: 30325638.
Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: part II. Differential diagnosis. Am Fam Physician. 2003;68(5):917-922.
Hong E, Kraft MC. Evaluating anterior knee pain. Med Clin North Am. 2014;98(4):697-717.