Overview

Knee pain is a common problem for children and adults.

There are many different causes for knee pain at different stages of life although most will improve with simple management and will not require surgery.

Knee pain can be related to the joint or soft tissue structures including the ligaments or tendons. The hip and foot position can also contribute to knee problems.

Find out more about your knee pain in the other sections for further help.

Type of Knee Pain

Pain With No Obvious Injury

Osteoarthritis is a normal, age related process affecting the knee joint. It is most common in adults over 55. The joint space will narrow and the knee becomes stiff. This can affect movement and mobility.
Commonly pain and stiffness is worse after prolonged rest or prolonged activity. Often this stiffness can be worse in the morning and may last up to half an hour.
Although many people associate osteoarthritis with a joint replacement, this is only needed in the most severe cases.
Most often knee osteoarthritis can be self-managed well with physical activity, weight loss and specific exercises.
These leaflets provide information, answers and self-help strategies regarding the condition:
Watch this short video of a real patient’s experience of how gaining knowledge and understanding of knee osteoarthritis has helped her to manage the condition herself.
For useful exercises to carry out at home to manage your knee osteoarthritis, Click here.
For help with weight loss, visit Provide Essex Lifestyle Services and self-refer.

The patellofemoral joint is where the kneecap (patella) meets the upper leg bone (femur). Patellofemoral pain is commonly felt around or below the kneecap.

It is often aggravated when going up and down stairs and also when sitting or driving for prolonged periods. Pain can often be triggered by starting or increasing an activity such as running or jumping.

With these symptoms it is important to reduce the duration and/or the intensity of activities but complete rest is not advised.

Alongside activity modification, a strengthening programme targeting the lower limb can help.

This leaflet provides information on patellofemoral pain syndrome and how to manage it :

Knee Pain After Injury

A muscle strain is an injury where a muscle is overstretched or torn.
The most common muscles injured that can cause knee pain are muscles in the thigh or calf region.
Muscle strains often happen during sports involving fast movements, muscles can also be pulled with as little as stepping down off a curb or lifting something fairly light.
Mild strains will have no visible symptoms but larger strains will have swelling, discolouration and you may feel a loss of strength. A ‘popping’ sensation and complete loss of strength may indicate a torn muscle.
These strains often get better by themselves as muscles are excellent healers although you are likely to need to reduce your usual levels of activity or sport initially, gradually restore the normal flexibility and strength of the muscle(s) involved before returning to your normal activities.
Click here for advice on what to do in the early stages to help your pain, swelling and overall recovery and when to seek further support.
Ligaments help to keep the knee joint stable. Ligament injuries often involve direct force to the knee, sudden changes in direction or landing from a jump.
Swelling is a common symptom of a ligament injury if there has been a specific trauma.
A feeling of giving way can occur due to either pain or less commonly, reduced stability of the knee. This is normally due to pain affecting the function of the muscles around the knee. An exercise programme can help to restore this stability.
Management of this type of knee injury will depend on what ligament(s) has been injured and the severity of the injury so seek further help from a healthcare professional if your symptoms are not improving after a few weeks.
The menisci are C-shaped discs which cushion the knee. There are two menisci in each knee.
Meniscus injuries can be degenerative or traumatic. A traumatic tear generally occurs after a quick twisting leg movement with a fixed foot. This is common in sports such as football. Degenerative tears are very common as we get older alongside osteoarthritis.
Swelling is also a common symptom of a meniscus injury. A feeling of catching or a locking sensation is common and does not normally require surgery to correct this.
An exercise programme will help to restore the strength of the knee.
Management of degenerative meniscal injuries is very similar to how you would manage knee osteoarthritis so see this section for further help and support, including useful exercises to carry out at home.
Osgood Schlatter’s is a common problem in teenagers during a growth spurt.
Often there is localised swelling or a lump as well as pain below the kneecap where the thigh muscle attaches to the shin bone.
This is normally worse after repetitive activities such as running or gymnastics.
You will not usually need to stop sport completely but you may need to reduce the frequency or duration.
Stretching and strengthening the lower limb, particularly the quadriceps, can help.
This condition usually completely resolves once full growth has stopped and even before in some cases with no lasting problems of the knee in adulthood.

Is my knee pain likely to persist?

Take our one minute test

This quick questionnaire can help you identify how likely your pain is to persist over the next 6 months and whether you may need some extra support. It has been developed by a team of experts from Keele University – Click here for more information about the tool.

The tool has been shown to be very useful for people with common Musculoskeletal pain to profile individual risk of having a poor recovery and to use as a guide in conjunction with support from a healthcare professional if necessary.

Try out the questionnaire for yourself to see how you score and to get further help and advice. It will also be useful to retake the questionnaire after you have learned more key facts about your pain, either from this website or from a healthcare professional, to re-assess in time whether your knee pain problem is improving.

For question 1 – 9, think about just the last two weeks:
Pain intensity
1. On average, how intense was your pain? [where 0 is “no pain”, 10 is “pain as bad as it could be”]











Select one of the options for each question below Yes No
2. Do you often feel unsure about how to manage your pain condition?
3. Over the last 2 weeks, have you been bothered a lot by your pain?
4. Have you only been able to walk short distances because of your pain?
5. Have you had troublesome joint or muscle pain in more than one part of your body?
6. Do you think your condition will last a long time?
7. Do you have other important health problems?
8. Has a pain made you feel down or depressed in the last two weeks?
9. Do you feel it is unsafe for a person with a condition like yours to be physically active?
10. Have you had your current pain problem for 6 months or more?

 

Low Risk

Congratulations! You most likely have the right ideas about your knee pain, and feel in control of how you manage your recovery.

We all know an episode of knee pain is very annoying, and at times extremely painful. Carrying on as normal and continuing to move your knee allows the quickest recovery, and stops your knee stiffening up and losing strength.

Keep going as you are, although check out this link for more information and advice to get better even quicker.

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to your knee pain.

Medium Risk

This test suggests you may have some doubts about how well your knee pain will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your knee.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the Self Help section.

Most knee problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your knee to return to normal.

Painkillers can help you to move normally, while your knee recovers.

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to your knee pain.

High Risk

This test suggests you have some serious concerns about how well your knee pain will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your knee.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the Self Help section.

Also, visit the section on Persistent Pain for more information and support.

Most knee problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your knee to return to normal.

Painkillers often help you to move normally, while your knee recovers.

If you are feeling low or anxious, whether this I related to your knee pain or not, and you would like further help and support, visit NHS website – Health in Mind.

Please select all options.

Self help

Evidence has shown that people who understand their Musculoskeletal health problem and take an active involvement to help themselves have a much better outcome.

Here are some really helpful leaflets, videos and useful links to other websites that have been approved by our physiotherapists so that you can start getting better with your knee pain today!

Leaflets

Knee Osteoarthritis
Source: Versus Arthritis
Source: Versus Arthritis

Videos

Play

We have specially-trained clinicians that administer corticosteroid injections as part of your treatment for joint and soft tissue problems where appropriate
Source: Dead Ready Productions

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Useful Links

Further support

If your knee pain is still not improving despite following the advice and guidance provided on the website for up to 6 weeks and you score a ‘Medium’ or ‘High Risk’ when completing the Is My Knee Pain Likely To Persist?, you may require further help and support from the Physiotherapy Outpatients Service. Please see your GP if you wish to be referred or discuss the management of your knee problem further.

With all knee pain it is best to try to keep the knee moving as able and to continue your normal activities but in smaller amounts until you can resume them normally again. If you are finding it difficult to walk then using crutches or a walking aid may help.

Remember that most causes of knee pain are not due to anything serious, although there are rare cases where you would need to seek urgent medical help. Contact NHS 111 for immediate medical advice if you have any of the symptoms below:

  • Your unable to take any weight through your knee after trauma
  • our knee is badly swollen or has changed shape
  • you have a very high temperature, feel hot and shivery, and have redness or heat around the knee

Click here for further support and guidance.

FAQs

Listen to your body. It is beneficial to find a type of exercise that you can continue to do. It is safe to work through a low level of pain. If a particular type of exercise is too painful then reduce or avoid this activity initially.

There is a poor link between changes visible on x-ray and symptoms of osteoarthritis. You can be in lots of pain but have minimal changes on x-ray and vice versa. Changes seen on X-ray does not mean you have to stop being active – Keeping active can help hip pain.

An x-ray is not necessary to diagnose arthritis. It is only needed if you are going to have joint replacement surgery. An x-ray can be useful if it is not obvious if the knee joint is contributing to your symptoms and your symptoms are lasting longer than 3 months.

Most people will never need a joint replacement and can manage their symptoms conservatively.

Physiotherapists are able to perform steroid injections for certain knee conditions including osteoarthritis. Whilst injections can be very effective in the short term, research shows medium to long term relief is not often achieved, and physiotherapy is the best long-term option for pain relief. Your physiotherapist will be able to discuss if an injection is appropriate if you are being seen within the Physiotherapy Outpatient Service.

Giving way is a common feeling most often associated with pain. It is not a sign of your injury being worse because of this.