What Causes Bad Knee Pain

Pain Behind Knee: Common Causes Symptoms And Treatment

Written byDr. Victor MarchionePublished onNovember 23, 2016

Pain behind knee is not unusual, but it can hurt and limit movement. Developing a clear understanding of pain behind knee causes can be important.

When we refer to pain behind knee, we are really talking about discomfort or soreness behind the knee joint. This uncomfortable feeling can happen to a person who still has movement in their knee or it can severely limit movement. Sometimes, pain behind knee is accompanied by inflammation or a burning sensation. In many cases, the soreness is nothing to worry about. There are situations where the pain does not disappear, and there is swelling or even bruising. If this happens to you, it is important to seek medical attention.

When To See A Doctor

If you are experiencing chronic pain or pain more associated with serious injury, see your doctor promptly. Not addressing your pain properly can lead to increased pain, joint damage, and disability. Depending on the cause of your knee pain, your doctor may suggest the following treatments:

• Medications: Your doctor may prescribe medications to help relieve pain in the back of the knee and swelling and treat underlying conditions like arthritis.
• Physical therapy: Your doctor may prescribe stretching exercises or a physical therapy/rehabilitation program to help you restore range of motion, strength and stability to your knee.
• Injections: In some situations, your doctor may suggest injecting medications and other substances directly into the knee joint in order to reduce inflammation, lubricate the knee and promote healing.
• Surgery: If conservative measures do not provide relief, your doctor may recommend surgical options.

Torn Acl Symptoms And Signs

With an acute injury, the patient often describes that they heard a loud pop and then developed intense pain in the knee. The pain makes walking or weight-bearing very difficult. The knee joint will begin to swell within a few hours because of bleeding within the joint, making it difficult to straighten the knee.

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Can Dehydration Cause Pain In The Back Of The Knee

In general, dehydration does not cause pain in the back of the knee. However, if you are dehydrated, you may experience cramping of your muscles. This is due to electrolyte imbalances leading to muscle irritation. This can lead to pain in the back of your leg if those muscles cramp. Most commonly, dehydration leads to exhaustion, thirst, muscle cramps, and dizziness.

Complementary And Alternative Therapies

A number of mind-body therapies may be used to treat knee pain. These include:

• Acupuncture
• Tai chi

These are especially common for knee osteoarthritis.

The once-popular supplements glucosamine and chondroitin have fallen out of favor for knee osteoarthritis. That’s due to a lack of scientific proof. Always talk to your healthcare provider before taking any supplements or medications.

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What Are The Symptoms Of Knee Pain

This type of knee pain is marked by a dull, aching pain in the front of the knee in the area under and around the kneecap. This pain may start quickly or slowly. Your pain might be worse when you squat, run, or sit for a long time. You might also sometimes feel like your knee is giving out. You might have symptoms in one or both of your knees.

Home Care For Knee Pain

Inflammation is the body’s physiologic response to an injury. In treating many types of knee pain, a common goal is to break the inflammatory cycle. The inflammatory cycle starts with an injury. After an injury, substances that cause inflammation invade the knee to assist in healing. However, if the injury and subsequent inflammation is not resolved, inflammation can become a chronic issue, leading to further inflammation and additional injury. This cycle of inflammation leads to continued or progressive knee pain. The cycle can be broken by controlling the substances that cause inflammation, and by limiting further injury to tissue.

Some common home care techniques for knee pain that control inflammation and help to break the inflammatory cycle are protection, rest, ice, compression, and elevation. This regimen is summarized by the memory device PRICE.

PROTECT the knee from further trauma.

• This can be done with knee padding or splinting.
• A pad over the kneecap, for example, helps to control the symptoms of some knee injuries by preventing further repetitive injury to the prepatellar bursae.

REST the knee.

• Rest reduces the repetitive strain placed on the knee by activity.
• Rest both gives the knee time to heal and helps to prevent further injury.

ICE the knee.

COMPRESS the knee with a knee brace or wrap.

• Compression reduces swelling.
• In some knee injuries, compression can be used to keep the patella aligned and to keep joint mechanics intact.

ELEVATE the knee.

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What Causes Chronic Knee Pain

Temporary knee pain is different from chronic knee pain. Many people experience temporary knee pain as a result of an injury or accident. Chronic knee pain rarely goes away without treatment, and it isnt always attributable to one incident. Its most often the result of several causes or conditions.

Physical conditions or diseases can cause knee pain. These include:

• osteoarthritis: pain, inflammation, and joint destruction caused by degeneration and deterioration of the joint
• tendinitis: pain in the front of the knee that is made worse when climbing, taking stairs, or walking up an incline
• bursitis: inflammation caused by repeated overuse or injury of the knee
• gout: arthritis caused by the buildup of uric acid
• Bakers cyst: a buildup of synovial fluid behind the knee
• rheumatoid arthritis : a chronic autoimmune inflammatory disorder that causes painful swelling and can eventually cause joint deformity and bone erosion
• dislocation: dislocation of the kneecap most often the result of trauma
• meniscus tear: a rupture in one or more of the cartilage in the knee
• torn ligament: tear in one of the four ligaments in the knee the most commonly injured ligament is the anterior cruciate ligament
• bone tumors: osteosarcoma , most commonly occurs in the knee

Factors that may make chronic knee pain worse:

• injuries to the structure of the knee can cause bleeding and swelling and can create a chronic problem over time if not treated properly

• injections

What Else Could It Be

If you are still not sure what is causing your severe knee pain, visit the knee pain diagnosis section where we help you work out what is going on by thinking about the location of the pain e.g. front, back or side of the knee.

Alternatively, in the knee symptoms guide we look at other symptoms typically linked with knee pain such as pain when running or bending, knee locking, sharp pain or pain on the stairs. And remember, if you are suffering from severe knee pain, get checked out by your doctor as soon as possible.

Page Last Updated: 10/06/21

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Professional Help For Knee Injuries

• Aspiration if the knee joint is grossly swollen, the doctor may release the pressure by drawing off some of the fluid with a fine needle.
• Physiotherapy including techniques to reduce pain, kneecap taping, exercises for increased mobility and strength, and associated rehabilitation techniques.
• Arthroscopic surgery or keyhole surgery, where the knee operation is performed by inserting slender instruments through small incisions . Cartilage tears are often treated with arthroscopic surgery.
• Open surgery required when the injuries are more severe and the entire joint needs to be laid open for repair.

Wearing The Proper Shoes Is Important For Healthy Knees

Supportive and comfortable shoes help take pressure off the knee joint by promoting proper leg alignment and balance. So it’s no surprise that wearing high heels is a common cause of knee pain.

“When high heels lift your heel up, your weight bearing line tips forward so your quadriceps have to work harder to hold your knee straight, which then leads to knee pain,” says Bush-Joseph. “Whereas, if your heel is closer to the floor in low pumps or flats, your thigh muscles don’t have to work as hard to maintain stability, which is easier on the knees.”

While strength training and stretching can help build up the muscles around the knees to minimize knee damage from heels, it’s best to save the stilettos for special occasions.

Proper shoes are particularly important during exercise. “If you are taking up running as a newbie or starting a new form of aerobic exercise, getting professionally fitted from someone at a running or sporting goods store can help with knee problems and will certainly lower your incidence of having overuse problems due to footwear,” says Bush-Joseph.

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When Should I Call The Doctor About Knee Pain

See your doctor right away if you have severe knee pain after a fall or accident, or if your knee is too painful or unstable to support your weight. You should also see your doctor if your knee is swollen or you cant extend it all the way. Call your doctor if you have pain that keeps bothering you longer than a few days.

Last reviewed by a Cleveland Clinic medical professional on 11/03/2020.

References

How To Identify The Culprit And Which Drugs Injections And Habits Will Bring You The Most Relief

by Alison Gwinn, AARP, September 20, 2019

En español | Oh, my aching knees! If that’s your daily refrain, whether you’re walking the dog, climbing stairs or just sleeping, you’re not alone.

For many, the culprit behind that nagging soreness is osteoarthritis, which affects an estimated 31 million Americans quite often, in this particular joint according to the Arthritis Association.

But there are other common causes of knee pain, stemming from the fact that knees are our largest, most complex joints. Knee joints allow you to stand up straight, walk stairs and get up and down from sitting, says Daniel Saris, an orthopedic surgeon at the Mayo Clinic and professor of orthopedic surgery at the Mayo Medical School. But they are also the most difficult joint because they’re not stable. Hip joints and ankles are both pretty stable by themselves, but the knee is just three bones trying to be good friends, and they need muscles and ligaments for stability.”

Knee pain is not to be taken lightly. A Japanese study, published last year in the Journal of the American Geriatrics Society, found a link between the onset of knee pain in people 65 or older and depression. And a recent study from the University of North Carolina School of Medicine Thurston Arthritis Research Center and Harvard’s Brigham and Women’s Hospital found that knee pain in men and women over age 45 correlated with higher rates of death.

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The Pros And Cons Of Cortisone Shots

If you’re experiencing pain that makes it difficult for you to start physical therapy to address your knee problem, your doctor might recommend that you get an injection of cortisone to lessen the pain.

The shot injects a corticosteroid drug and a local anesthetic into the joint to temporarily relieve pain and swelling. But it isn’t a long-term fix. “Often people think that injections, especially cortisone injections, will fix a knee problem. What they do is provide a window of pain relief so you can make progress with rehabilitation,” says Dr. Rebecca Breslow, an instructor in orthopedic surgery at Harvard Medical School. “But when cortisone injections are overused, there is some evidence that they can actually accelerate osteoarthritis.”

In short, while cortisone shots put you on the path to healing, they should be used judiciously and aren’t a permanent solution to the underlying problem that’s causing your knee pain.

Symptoms Of Pain Behind The Knee

Since several conditions can cause pain behind the knee, the symptoms can vary. The most common symptoms include:

Varying types of pain

The pain can be sharp, dull, or burning. It may come on suddenly or gradually. It may be constant, or it may occur when you put weight on the leg or when you bend the knee. This information can help a doctor diagnose your knee problem.

Swelling or stiffness

The knee may look swollen or misshapen. You may be unable to bend the knee, or your knee may pop, lock up, or collapse when you put weight on it. These symptoms usually indicate that you have sustained an injury, but there are other possibilities as well.

Redness or warmth

Under certain circumstances, the back of your knee could feel hot to the touch, or redness could be visible. You might also have a fever. These symptoms would point to a different cause than if you only have pain.

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How Are Knee Problems Diagnosed

In addition to a complete medical history and physical exam, other tests for knee problems may include:

• X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.

• Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body can often determine damage or disease in a surrounding ligament or muscle.

• Computed tomography scan . This test uses X-rays and computer technology to make horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube , which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen used to evaluate any degenerative or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation.

• Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

Causes Of Pain Behind The Knee

Pain behind the knee can be simple or difficult to diagnose, depending upon the cause. Here are some of the most common causes of posterior knee pain:

Baker’s cyst

A lump-like swelling behind the knee is characteristic of Baker’s cyst, making it fairly easy to diagnose. This type of cyst is also called a popliteal cyst because it is located in the popliteal fossa, a small hollow at the back of the knee.

It forms when synovial fluid gathers at the back of the knee. Injury or stress from arthritis can trigger the accumulation of fluid.

Different forms of arthritis

Arthritis is the generic name given to diseases that affect the joint. Arthritis can cause pain anywhere in the knee joint, including the back.

Knee pain is most often associated with osteoarthritis, the type that is related to aging or overuse. Knee pain can also occur with rheumatoid arthritis, but it will occur in both knees at once.

Gout is a type of arthritis that first attacks the big toe, but later attacks may strike the knees. Septic or infectious arthritis is caused by an infection that lodges in a joint, usually a knee.

Infection

Besides infection in the knee joint , posterior knee pain could result from several other infections, including:

• Infection in the bone
• Infection of one of the fluid-filled sacs called bursae

These infections have different causes and symptoms, although pain, redness, heat, and swelling are typical of most infections.

Injury

Tumor

Deep vein thrombosis

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Posterior Knee Pain Exercises

Pain behind the knee can be quite debilitating, as we use our legs to walk every day. If you are unfortunate enough to suffer from knee pain, certain exercises may help.

Prone wall stretches While standing, lay your back flat on the surface of a wall. Place the heel of your injured knee on to the wall without bending the knee. Increase the stretch by moving your body closer to the wall and hold for 30 seconds. Then slowly move your body away from the wall, decreasing the stretch. Repeat this exercise about eight times.

Leg to chest maneuver While sitting upright in a firm chair, place both feet firmly on the floor. Now, slowly lift the leg with the contracted muscles off the floor and bend your knee as you lift your leg toward your chest. You can also place your hand behind your knee to increase the stretch. Hold this position for five seconds. This exercise will help to loosen your contracted hamstrings.

Upright wall stretch Stand about three feet from the wall as you open your palm and place them on to the wall at shoulder level. Now slowly lean forward, bending at your elbows and keeping the rest of your body straight. It is also important to keep your feet flat on the ground while doing this to stretch the calf muscles.

How Is Arthritis Of The Knee Treated

Healthcare providers can’t cure knee arthritis. But they have some tips that might reduce the severity of your symptoms and possibly stop the arthritis from getting worse, including:

• Maintain a healthy weight.
• Exercise using low-impact activities instead of high-impact activities . Aim for about 150 minutes of exercise per week.
• Wear shock-absorbing inserts in your shoes.
• Apply heat or ice to the area.
• Wear a knee sleeve or brace.
• Physical therapy exercises that help with flexibility, strength and motion.
• Use a cane.

Most people have stage 4 arthritis when they get surgery.

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