Knee pain is common and can affect people of all ages. The knee is a large, complex joint that supports your body and helps your leg bend, straighten, turn and absorb force during daily activities.

Knee pain can happen after an injury. It also can develop over time from arthritis, overuse, extra weight, muscle weakness, sports, physical activity or normal changes in the joint. Having knee pain does not always mean you need surgery. Many knee problems can be managed with nonsurgical treatments, depending on the cause and severity of symptoms.

Talk with your health care team if knee pain limits your activities, causes swelling or makes it hard to walk, stand or climb stairs.

The knee is a joint, which means it is a place where bones meet and movement happens. It is often described as a hinge joint because it allows the leg to bend and straighten. But the knee is more complex than a door hinge. It also allows small amounts of rotation and shifting, which help you stand, walk, run, squat and turn.

The knee includes bones, cartilage, ligaments, tendons, muscles and other tissues. A problem with any of these structures can cause pain, stiffness, swelling or instability.

Knee pain may be caused by arthritis, injury, mechanical problems or inflammation. Common knee problems include:

Osteoarthritis

Osteoarthritis is the most common form of arthritis. It is sometimes called degenerative arthritis. It happens when cartilage, the smooth tissue that cushions joints and helps them move easily, wears down over time.

Osteoarthritis is not curable, but symptoms often can be managed. The chance of developing osteoarthritis may be higher with aging, extra body weight, previous joint injury, stress on the joint, muscle weakness or inherited risk.

Symptoms may include:

• Pain or tenderness.
• Stiffness.
• Swelling.
• Less flexibility.
• A grating or grinding feeling.
• A knobby feeling in the knee.

Mayo Clinic describes osteoarthritis as a wear-and-tear condition in which knee cartilage deteriorates with use and age.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease with autoimmune features. In autoimmune disease, the immune system reacts against the body’s own tissues. Rheumatoid arthritis can affect many joints, including the knees, and symptoms may come and go.

Rheumatoid arthritis is not curable, but medicines can help manage inflammation and help protect joints after diagnosis.

Possible risk factors include heredity, lifestyle and environment. Being overweight or smoking may increase risk.

Knee symptoms may include:

• Pain.
• Swelling.
• Tenderness.
• Morning stiffness lasting at least 30 minutes.

Other symptoms may include:

• Red, puffy hands.
• Firm bumps of tissue under the skin of the arms.
• Fatigue.
• Fever.
• Unintended weight loss.

Loose body in the knee

A loose body is a free-floating piece of bone or cartilage inside the joint. The knee is a common place for loose bodies to occur.

Loose bodies may happen due to osteoarthritis, torn cartilage, chip fractures or decreased blood supply to bone.

Symptoms may include:

• Knee locking.
• Pain.
• Swelling.
• Stiffness.
• A feeling that something is moving inside the knee.

Note that a loose body may not cause problems unless it interferes with knee movement.

Osteonecrosis

Osteonecrosis happens when bone tissue dies because of reduced blood supply. It may worsen over time and often needs ongoing management.

Possible causes include trauma, such as a broken bone or dislocated joint. Other possible causes include corticosteroid use and heavy alcohol use.

Symptoms may include:

• Pain when bearing weight.
• Stiffness.
• Symptoms that may feel similar to arthritis, especially early on.

Patellofemoral pain

Patellofemoral pain is pain between the kneecap and thighbone. It may range from mild discomfort to more severe pain. It often responds to self-care and activity changes.

Possible causes include overuse, alignment problems, sports, physical activity, trauma, falls or a direct blow to the knee.

Symptoms may include:

• Pain around or behind the kneecap.
• Stiffness.
• Mild swelling.
• Catching in the knee.
• Grating or grinding sensations.

Patellofemoral pain syndrome can be described as pain between the kneecap and underlying thighbone and notes it can occur in athletes, young adults and older adults with kneecap arthritis.

Meniscus tear

The meniscus is a C-shaped piece of cartilage that cushions and stabilizes the knee. A meniscus tear can happen when the knee twists or rotates forcefully, such as during a sudden stop or turn. It also can happen gradually as part of wear and tear in the knee.

Symptoms may include:

• Pain along the inner or outer side of the knee.
• Pain with twisting motions.
• Swelling.
• Locking.
• Pain with movement at night.

The meniscus can be described as tough, rubbery cartilage that acts as a shock absorber between the shinbone and thighbone.

Articular cartilage injury

Articular cartilage is the smooth tissue that lines the surface of bones inside the knee. It helps protect and cushion the bones during movement and weight-bearing activity.

Articular cartilage can be injured suddenly, causing pain and swelling. Gradual wear of this cartilage can lead to arthritis or degenerative joint disease.

Symptoms may include:

• Pain.
• Swelling.
• Stiffness.
• Grinding in the knee.

Tendonitis

Tendons attach muscles to bones. Tendonitis means a tendon is inflamed or irritated.

Tendonitis may be caused by injury, overuse, wear and tear, or inflammatory disease.

Symptoms may include:

• Pain.
• Tenderness.
• Swelling.

Patellar tendinitis can occur when the tendon from the kneecap to the shinbone becomes irritated or inflamed, especially in activities involving running, kicking or jumping.

Heat

Heat may help relax tissues and improve blood flow. It may be helpful for arthritis-related discomfort. Ask your health care team how to use heating pads or other heating products safely.

Healthy Weight

Maintaining a healthy weight is one of the best ways to protect your knees. Extra weight increases stress on the knee joints and may increase the risk of osteoarthritis or worsen symptoms. Losing weight, if recommended, may help reduce knee pain.

Maintaining a healthy weight as one of the best things people can do for their knees.

Activity changes

Taking a break from activities that cause pain can reduce strain and irritation and may allow an injury time to heal. You may need to change how you exercise.

Lower-impact activities may include:

• Swimming.
• Biking.
• Water aerobics.
• Other low-impact exercises.

Medicines

Your health care professional may recommend over-the-counter medicines or prescribe medicines to help manage pain or inflammation. Ask which medicines are safe for you, especially if you have other medical conditions or take other medications or supplements.

Movement and Exercise

Gentle movement can help keep the knee from becoming stiff. Strengthening the muscles around the knee can improve support, strength and flexibility.

A physical therapist or another health care professional can teach you exercises to do safely at home.

Arch Supports, Shoe Inserts or Braces

Arch supports and shoe inserts may help shift pressure away from the knee. A brace may help support and protect the knee joint.

Injections

Your health care professional may recommend injecting medicine into the knee joint. Injections may reduce inflammation and provide pain relief for several weeks in some people.

Acupuncture

Acupuncture may help some people with osteoarthritis-related knee pain. This treatment involves placing very thin needles into the skin near the knee.

Healthy daily habits may help reduce knee symptoms and support overall health.

Helpful habits include:

• Eat a balanced diet.
• Stay active with appropriate exercise.
• Maintain a healthy weight.
• Avoid smoking and tobacco use.
• Practice stress management and self-awareness.
• Get enough sleep.
• Stay connected with family, friends and your support network.

Ask your health care professional whether a referral to a physical therapist, dietitian, wellness coach or another specialist may help.

During a knee exam, your health care professional may:

• Look for swelling, tenderness, warmth, bruising or deformity.
• Move your lower leg in different directions to check range of motion.
• Push or pull on the knee joint to assess strength, flexibility and stability.

Your care team may recommend imaging tests, lab tests or other evaluations depending on your symptoms and exam findings.

Not everyone with knee pain needs surgery. Many types of knee pain improve with nonsurgical treatments. But some people may need surgery, especially after certain injuries or when symptoms do not improve with other treatments.

The amount of pain alone does not determine whether surgery is needed. Treatment decisions depend on the cause of pain, the type of injury or condition, how the knee functions, overall health and personal goals.

Before deciding on treatment, talk with your health care team about the benefits and risks of nonsurgical treatment and surgery.

Contact your healthcare professional if you:

• Have new or increased knee swelling.
• Have new or increased knee pain.
• Cannot fully straighten or bend your knee.
• Notice an obvious deformity in your leg or knee.
• Have a fever over 100.4 F along with redness, pain and swelling in the knee.
• Feel as if your knee cannot support your weight.
• Injure your knee.

What are the most common causes of knee pain?

Common causes of knee pain include arthritis, meniscus tears, tendonitis, patellofemoral pain, articular cartilage injury, loose bodies in the joint and injuries from sports or falls.

Does knee pain always mean I need surgery?

No. Many knee problems can be managed without surgery using treatments such as ice, elevation, heat, activity changes, medicine, exercise, physical therapy, braces, shoe inserts or injections.

What is the best nonsurgical treatment for knee pain?

The best treatment depends on the cause of the pain. For some people, rest, ice and activity changes help. Others may benefit from physical therapy, weight management, medicines, braces or injections. A health care professional can help identify the right plan.

Is walking good for knee pain?

Walking may help some types of knee pain, but it may worsen others. If walking increases pain, swelling or instability, reduce the activity and talk with your health care professional. Lower-impact options such as swimming, biking or water exercise may be recommended.

When should I be concerned about knee pain?

Seek medical advice if you cannot bear weight, have significant swelling, cannot fully bend or straighten the knee, notice a deformity, have fever with redness and swelling, or have severe pain after an injury.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

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