Knee Pain

Dr Reshma Purella is a Consultant Radiation Oncologist at Medicover Cancer Institute Hitec City.

Reading Time: 9 minutes

Symptoms | Causes | Risk Factors | Treatments

Knee pain is generally because the knee is severely damaged by arthritis or an injury. It will be difficult to perform simple activities like continuous walking, climbing stairs, sitting down or lying down. Knee pain can originate in any of the bony structures compromising the knee joint, the kneecap or the ligaments and cartilage of the knee.

knee pain

The knee joint is where the thigh and shin bones meet. The end of each bone is covered with cartilage, which allows the ends of the bones to move against each other almost without friction. The knee joint has two extra pieces of cartilage called menisci, which spread the load more evenly across the knee.

Knee pain can affect people of all ages, and home remedies can be helpful unless it becomes severe.

Symptoms of knee pain:

Some of the most common signs and symptoms of knee pain include the following:

knee pain symptoms
  • Difficulty in walking
  • Climbing stairs up and down
  • Unable or difficult to bend the knee joint
  • Swelling around the knee joint
  • Lying or sitting down


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Causes of knee pain:

Injuries | Mechanical problems | Arthritis | Other causes

Knee pain is generally caused by injuries, mechanical problems, arthritis, and a few other problems.


An injury to the knee can affect any of the ligaments, tendons or fluid-filled sacs (bursae) that surround the knee joint as well as the bones, cartilage, and ligaments that form the joint itself. Some of the most common knee injuries are listed below:

  • ACL injury: An ACL injury is the tearing of the anterior cruciate ligament (ACL) — one of four ligaments that connect the shinbone to the thighbone. An ACL injury is particularly common in people who are involved in sports like basketball, soccer or other sports that require sudden direction changes.
  • Fractures: The bones of the knee, including the kneecap (patella), can be broken during motor vehicle accidents or falls.
  • Torn meniscus: The meniscus is formed by tough, rubbery cartilage and acts as a shock absorber between the shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it.
  • Knee bursitis: Some knee injuries cause inflammation in the bursae.
  • Patellar tendinitis: Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous tissues that attach muscles to bones. Runners, skiers, cyclists, and those involved in jumping sports and activities are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the shinbone.

Mechanical problems:

Some examples of mechanical problems that can cause knee pain include:

  • Loose body: Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement.
  • Iliotibial band syndrome: This occurs when the tough band of tissue that extends from the outside of your hip to the outside of your knee (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome.
  • Dislocated kneecap: The triangular bone which is called patella that covers the front of your knee slips out of place, usually to the outside of your knee. In a few cases, the kneecap may stay displaced and you will be able to see the dislocation.
  • Hip/foot pain: If a person suffers from hip or foot pain, he or she may change the way they walk to spare these painful joints. But this altered gait can place more stress on the knee joint. In a few cases, problems in the hip or foot can refer pain to the knee.


  • Osteoarthritis: Sometimes called degenerative arthritis, osteoarthritis is the most common type of arthritis. It is a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age.
  • Rheumatoid arthritis: The most debilitating form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect almost any joint in your body, including your knees. Although rheumatoid arthritis is a chronic disease, it tends to vary in severity and may even come and go.
  • Gout: This type of arthritis occurs when uric acid crystals build up in the joint. While gout most commonly affects the big toe, it can also occur in the knee.
  • Pseudogout: Often mistaken for gout, pseudogout is caused by calcium-containing crystals that develop in the joint fluid. Knees are the most common joint affected by pseudogout.
  • Septic arthritis: Sometimes your knee joint can become infected, leading to swelling, pain, and redness. There’s usually no trauma before the onset of pain. Septic arthritis often occurs with a fever.

Other causes:

Patellofemoral pain syndrome is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It’s common in athletes; in young adults, especially those who have a slight mal tracking of the kneecap; and in older adults, who usually develop the condition as a result of arthritis of the kneecap.

There are many different causes of knee pain. A common cause is osteoarthritis, a condition that affects the body’s joints. The surfaces within the joint are damaged so the joint doesn’t move as smoothly as it should.

common causes of knee pain

Some of the most common causes of knee pain include the following:

  • Acute knee injuries
    • Fractures
    • Ligament injuries
    • Meniscus injuries
    • Joint dislocation
  • Rheumatoid arthritis
  • Osteoarthritis
  • Posture: Poor posture especially locking the knees and over-pronation (flattened arches) of the feet can increase the stress around the knee.
  • Incorrect Footwear: Shoes that are too worn or not suitable for your sport, body type, or feet can result in increased knee stresses.
  • Decreased Flexibility: Tight muscles or restricted joint motion can lead to functional weakness or compressive force at the joint.

Risk factors of knee pain:

  • Overweight or obesity is one factor
  • Age is another factor behind the increase in knee pain.

Treatments for knee pain:

treatments for knee pain

Treatments for knee pain are as varied as the conditions that can cause pain.


There are a number of different tablets and creams available. Painkillers such as paracetamol and ibuprofen may help and you should use them if you need to. It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising. Don’t wait until your pain is severe before taking painkillers.

Medication can have side effects so you should read the label carefully and we recommend to check with the pharmacist or doctor if you have any queries related to the medication.


If knee pain is affecting your activity and is persisting, ask your physician about a referral to a physiotherapist. Physiotherapy can help to manage the pain and improve strength and flexibility. A physiotherapist can provide a variety of treatments, help you understand the problem and can make you get back to normal activities.

Physiotherapy will strengthen the muscles around the knee joint. Which will make the knee more stable and for the best mechanical movements. This can help avoid injuries or further worsening of an injury.


Injecting medications directly into your knee might help in certain situations. The two most commonly used injections are corticosteroids and lubricants. Corticosteroid injections can help arthritis. They usually need to be repeated every few months. Lubricants that are similar to the fluid already in your knee joint can help with movement and to reduce the pain.

Replacement Surgery:

If you are severely suffering from knee pain your surgeon may suggest you go for a knee replacement surgery. Generally, knee replacement surgeries can be classified into two categories

Exercises to relief from knee pain:

Low-impact activities such as swimming, cycling and using a cross-trainer are particularly good if you are suffering from knee pain.

Below are few exercises generally prescribed by doctors those are good for knee pain

Thigh muscle (quadriceps) exercises:

Straight-leg raise (sitting) | Straight-leg raise (lying)

thigh muscle exercises for knee pain

Straight-leg raise (sitting):

Sit well back in the chair with good posture. Straighten and raise one leg. Hold for a slow count to 10, and then slowly lower your leg. Repeat this at least 10 times with each leg. If you can do this easily, try it with light weights on your ankles and with your toes pointing towards you. Try doing this every time you sit down.

Straight-leg raise (lying):

Bend one leg at the knee. Hold the other leg straight and lift the foot just off the bed. Hold for a slow count of 5, and then lower. Repeat 5 times with each leg. Try doing it in the morning and at night while lying in bed.

Simple exercises:

Below are some of the simple exercises wherein people who are suffering from knee pain can do in their day to day life.

simple exercises to avoid knee pain

Leg stretch

Sit on the floor with your legs stretched out in front. Keeping your foot to the floor, slowly bend one knee until you feel it is comfortably stretched. Hold for 5 seconds. Straighten your leg as far as you can and hold for 5 seconds. Repeat 10 times with each leg.

Leg cross

Sit on the edge of a table or bed. Cross your ankles over. Push your front leg backward and back leg forwards against each other until the thigh muscles become tense. Hold for 10 seconds, and then relax. Switch legs and repeat. Do 4 sets with each leg.


Sit on a chair. Without using your hands for support, stand up and then sit back down. Make sure each movement is slow and controlled. Repeat for 1 minute. As you improve, try to increase the number of sit/stands you can do in 1 minute and try the exercise from lower chairs or the bottom two steps of a staircase.


Step onto the bottom step of stairs with the right foot. Bring up the left foot, and then step down with the right foot, followed by the left foot. Repeat with each leg until you get short of breath. Hold on to the banister if necessary. As you improve, try to increase the number of steps you can do in 1 minute and the height of the step.

Knee squats

Hold onto a chair or work surface for support. Squat down until your kneecap covers your big toe. Return to standing. Repeat at least 10 times. As you improve, try to squat a little further. Don’t bend your knees beyond a right angle.

Reduce knee pain and swelling:

Rest | Ice & Elevation | Compression

You often lose strength and motion in your knee when it is painful and swollen. This can happen after injury or overuse. The tips listed below will help you decrease pain and swelling, increase range of motion, improve strength and help you return to your normal activities as soon as possible.


Avoid painful activities to give your knee time to heal. Limit your walking and other standing activities when your knee is painful or swollen. Use a cane or crutches to decrease the stress on your knee. It is best to use the cane on the opposite side of your painful knee. Use supportive shoes when you are standing or walking.

Ice & Elevation:

Place a cold pack on your knee with a thin towel between your skin and the cold pack to prevent a rash or burn. Use ice 15-20 minutes, 2-4 times per day as long as your knee is warm, painful or swollen. Elevate your knee above the level of your heart to help with the pain and swelling.


If your knee is swollen, using a knee brace or wrap may help with the pain and swelling and provide support to your knee. Apply the elastic wrap loosely from your calf to right above your knee. You should be able to easily put two fingers under the wrap.

Prevention of Knee Pain:

Avoid over weight | Regular exercises | Protect the knee

Knee pain has a host of causes. Many types of pain are difficult to prevent, but you can do some general things to reduce the likelihood of sustaining a knee injury.

  • Avoid overweight
    • Staying slim reduces the forces placed on the knee during both athletics and everyday walking and, according to some medical research, may reduce osteoarthritis.
    • Keeping the weight down may also reduce the number of ligament and tendon injuries for similar reasons.
  • Regular exercises
    • Many knee problems are due to tight or imbalanced musculature. Stretching and strengthening, therefore, also help to prevent knee pain.
    • Stretching keeps your knee from being too tight and aids in preventing both patellofemoral syndrome and iliotibial band syndrome.
    • Strengthening exercises particularly of the quadriceps (straight leg raises and leg extensions are two excellent exercises, but please see a book on exercise and training for more) can help prevent knee injury.
    • If you have chronic knee pain, consider swimming or water exercises.
    • In water, the force of buoyancy supports some of our weight so our knees do not have to.
    • If you don’t have access to a pool or do not enjoy water activities, at least try to limit hard pounding and twisting activities such as basketball, tennis, or jogging.
    • You may find that your aching knees will act up if you play basketball or tennis every day but will not if you limit your pounding sports to twice a week.
    • Whatever you do, respect and listen to your body. If it hurts, change what you are doing.
    • If you are fatigued, consider stopping; many injuries occur when people are tired.
  • Protect the knee
    • Wearing proper protection for the activity at hand can help avoid knee injuries.
    • When playing volleyball or when laying carpet, protecting your knees may include knee pads.
    • When driving, knee protection may include wearing a seat belt to avoid the knee-versus-dashboard injuries as well as injuries to other parts of your body.

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