knee pain overview for patients

Overview

Knee pain is any discomfort, soreness, or stiffness in or around the knee joint. The knee is one of the largest and most complex joints in the body, and it supports your weight and allows your legs to bend and straighten. Pain can come from the bones, cartilage, ligaments, tendons, or the fluid-filled sacs around the joint. It can range from a mild ache to severe, sharp pain that makes it hard to move.

Yes. Knee pain is one of the most common bone and joint problems seen by doctors and physiotherapists. Millions of people around the world experience knee pain at some point in their lives.

Anyone can develop knee pain, but it becomes more common as people get older. It also affects people who are very active in sports, people with physically demanding jobs, those carrying extra weight, and those with a family history of joint problems.

Symptoms

Common symptoms

• Aching or stiffness in the knee, especially after sitting for a long time or after activity
• Swelling around the knee joint
• Redness or warmth over the knee
• Weakness or giving way of the knee
• A feeling that the knee is catching, clicking, or locking
• Difficulty bending or straightening the knee fully

Symptoms in children

• Limping or preferring not to use one leg
• Pain in the knee that may actually come from the hip (children often feel referred pain)
• Swelling or stiffness that appears without a clear injury, or after sports

Symptoms in older adults

• Gradual worsening of pain when walking, climbing stairs, or getting up from a chair
• Morning stiffness that eases after moving around
• A grinding sensation in the knee, often from wear and tear

Causes

Main causes

• Injuries such as ligament sprains or tears, meniscus tears, or fractures
• Osteoarthritis, the common 'wear and tear' type of joint damage that comes with age
• Inflammation of the sacs around the knee (bursitis) or of the tendons (tendinitis)
• Rheumatoid arthritis or other forms of inflammatory joint disease
• Infection in the joint (septic arthritis), which is rare but serious
• Gout or other crystal-related joint conditions

Risk factors

• Being overweight or obese, which puts extra pressure on the knee
• Participating in sports that involve running, jumping, or sudden stops
• Having weak thigh or hip muscles that do not support the knee well
• Previous knee injury or surgery
• Getting older
• Occupations that require kneeling, squatting, or heavy lifting

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number right away.
• See a doctor the same day if you have a fever with knee swelling, or if the knee is suddenly very swollen and painful without an injury.

Book a routine appointment if:

• If your knee pain lasts more than two weeks or is getting worse
• If you cannot do your usual activities because of the pain
• If you have stiffness every morning that lasts more than 30 minutes
• If the knee keeps feeling unstable or 'gives way'

Diagnosis

A healthcare professional, such as a doctor or physiotherapist, will ask about your symptoms, when the pain started, and what makes it better or worse. They will examine your knee, checking for swelling, tenderness, range of motion, and stability. They will compare both knees and may ask you to walk or perform simple movements.

Tests that may be done

• X-rays to look for bone damage, fractures, or signs of arthritis
• Ultrasound to check for fluid, cysts, or problems with tendons
• MRI (magnetic resonance imaging) to see the soft tissues, like ligaments, cartilage, and meniscus
• Blood tests if your doctor suspects an inflammatory type of arthritis or infection

What to expect at your appointment

Often the diagnosis is clear from the physical exam alone. If you need a scan or blood test, your doctor will explain why and what to expect. Sometimes you may be referred to a bone and joint specialist or a physiotherapist for a more detailed assessment. Do not be afraid to ask questions and write down any instructions.

Treatment

Treatment for knee pain depends on the cause and how much it affects your daily life. Most plans start with simple self-care and gentle exercises to keep the knee moving and strengthen the muscles around it. If needed, your healthcare provider may offer additional treatments, from therapy to injections or surgery.

Self-care at home

• Rest the knee for a day or two after an injury, but avoid long periods of immobility.
• Apply a cold pack wrapped in a cloth for 15 to 20 minutes a few times a day to reduce swelling.
• Elevate your leg on a stool or cushion when sitting to help fluid drain away.
• Gentle range-of-motion exercises, like straightening and bending the knee, once the sharp pain settles.
• Over-the-counter pain-relief medicines can help, but always ask your pharmacist or doctor which type is safe for you and follow the instructions on the label.

Medical treatments

Your doctor or physiotherapist may recommend a structured exercise programme, physical therapy, or use of a knee brace or support. For conditions like osteoarthritis, anti-inflammatory medicines (taken by mouth or applied to the skin) can help manage pain and swelling. These medicines should only be used under professional advice. In some cases, your doctor may discuss joint injections, such as corticosteroids or lubricating gels, to reduce inflammation and improve movement.

When is surgery considered?

Surgery is usually considered only when other treatments have not helped enough, or when there is a clear structural problem like a torn ligament, a torn meniscus, or severe arthritis. Common procedures range from keyhole surgery to repair damage, to a partial or total knee replacement. Your surgeon will explain the benefits, risks, and recovery time so you can make an informed decision.

Living with this condition

Living with knee pain means finding a balance between activity and rest. Listen to your knee: if an activity makes the pain worse within a few hours, scale it back. Plan your day to avoid long periods of standing or sitting, and take short breaks to move around. Use handrails on stairs, and choose chairs that are easy to get out of.

Lifestyle tips

• Keep moving: gentle walking, swimming, or cycling on a flat surface can help keep your knee flexible.
• Strengthen your thigh and hip muscles with simple exercises, like straight leg raises or sitting-to-standing repetitions.
• Use supportive footwear with good cushioning.
• Lose extra weight if you are overweight, as every kilo of body weight adds extra load to the knee.
• Avoid high-impact activities that involve jumping or sudden twisting, especially when your knee is already sore.

Diet and exercise

Eating a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein can help maintain a healthy weight and support your joints. Some people find that fatty fish, nuts, and olive oil are helpful, but there is no proven 'joint diet.' For exercise, aim for at least 150 minutes of moderate activity per week, but choose low-impact options. Start slowly and gradually increase.

Mental health and emotional wellbeing

Living with chronic knee pain can be frustrating and can affect your mood, sleep, and enjoyment of life. It is normal to feel low or anxious at times. Talking to your doctor, a counsellor, or a trusted friend can help. Remember that treatment often improves with a good support plan, and you are not alone.

Prevention

You cannot prevent every type of knee problem, but you can reduce your risk by staying active, strengthening the muscles around your knee, keeping a healthy weight, warming up before exercise, and using proper technique for sports and lifting. Also, wear appropriate footwear and avoid sudden increases in training intensity.

Vaccines

Vaccines do not prevent knee pain directly, but keeping up to date with immunisations can reduce the risk of infections that might sometimes spread to the knee.

Screening programmes

There is no routine screening test for knee pain in otherwise healthy people. If you have a family history of arthritis or a previous knee injury, talk to your doctor about whether any preventive check-ups are useful.

Complications

If left untreated

• Prolonged pain and reduced mobility that can make daily tasks harder
• Muscle weakness and stiffness in the leg due to not using the knee normally
• Worsening of underlying damage, such as an untreated ligament tear or arthritis
• In rare cases, an untreated infection can spread and cause serious joint damage

Long-term outlook

The outlook for knee pain is usually very good, especially when you act early. Many people recover fully with simple measures, and even chronic conditions like arthritis can be managed so you can stay active and independent. With the right support from your healthcare team, most people can find relief and improve their quality of life.

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