Knee pain is one of the most common complaints in the aging population. It is often associated with disability and functional limitations that may interfere with individuals’ conduct of their daily activities. Data shows knee pain to be among the most common reasons a large population of men and women visit healthcare. (1) (2) Amongst the common causes of knee pain in the aging population are conditions like a knee injury and knee osteoarthritis, which is found to have an inevitable consequence of structural damage and disease getting more severe. (3) (4)
What is Knee Pain?
Knee pain is among the most common complaints in individuals with knee problems. This pain may originate from different structures making up the knee joint and those around it. The femur, tibia, fibula, knee cap or patella, ligaments, and tendons. However, pain is a common knee problem that can originate in any of the bony structures.
Conditions that aggravate knee pain include obesity, increased physical activity, or injuries to the knee. The symptoms of knee pain are not only limited to the adult population but may affect individuals of all ages. (5)
What Is The Knee Pain Location Chart?
The knee pain location chart helps all the painful areas of the knee. This chart helps localize the pain to different aspects of the knee, which may include the patellar, medial, superior, inferior medial, medial joint line, inferior lateral, and superior lateral and back of the knee. In addition, the regional classification of the knee joint may include the back of the knee, medial, lateral, and patellar areas.
Common Causes of Knee Pain According to the Knee Pain Location Chart
Knee Pain Above The Knee
An injury of the quadriceps tendons most commonly causes knee pain which is experienced above the knee. This is the site of attachment of the four large muscles of the thigh to the knee cap.
Several reasons: may cause this pain
- Quadriceps Tendonitis: Quadriceps Tendonitis is a condition associated with irritation, injury, or strain to the quadriceps tendon. This leads its inflammation.
- Patellofemoral Arthritis: Arthritis that affects the underside of the patella or knee cap and the femur groove is known as Patellofemoral arthritis. This is caused by the wearing away of articular cartilage.
- Syndrome of Plica: Plica is the fold of synovial membrane lining the knee joint. When this fold gets inflamed, it can lead to significant pain and weakness above the frontal aspect of the knee.
- Synovitis: Synovitis is associated with the inflammation of the synovial lining of the knee joint. It is mostly caused by overuse.
Pain in the Knee
The common reasons for pain in the knee joint itself include:
- ACL Injury: ACL, which stands for the anterior cruciate ligament, provides the knee stability and movement control. Like an ACL tear, Ligament tears are a common cause of pain in the knee. It may also be associated with MCL, LCL, and PCL.
- Patellofemoral Pain Syndrome: Patellofemoral pain syndrome is associated with a dull pain in the knee cap or the front of the knee. This may be caused by the displacement of the knee cap or its overuse.
- Patella Chondromalacia: This presents with a grating feeling on movement and pain in the junction of the thigh bone and knee cap.
- Partial Dislocation of Patella: Partial dislocation of the patella may be caused by trauma or twisting of the knee cap. This is often presented with severe pain in front of the knee.
- Tendonitis of Patella: Inflammation of the patellar tendon may be caused by overstretching or extra stress being imposed on it.
- Osgood Schlatter Disease: This condition is commonly encountered by adolescents. It is commonly caused by inflammation at the shinbone and patellar tendon junction.
- Bursitis: Bursitis is associated with inflammation in the fluid-filled sacs in the front of the knee known as Bursae.
- Osteoarthritis: Osteoarthritis affecting the knee joint is another cause of knee pain. This condition is associated with the breakdown of the articular cartilage, which can no longer cushion the bones.
Lateral Knee Pain
Pain in the lateral aspect of the knee joint is uncommon. However, if it does occur, it may be caused by the following conditions:
- Hamstring Tendinitis: The hamstring tendon connects the hamstring muscle to the back of the knee. This condition is associated with inflammation of this tendon.
- Iliotibial Band Syndrome: Iliotibial band syndrome is caused by inflammation of the iliotibial band that is found between the tibia and pelvis.
- Damage to the Lateral Collateral Ligament: This damage may be caused by a sprain, trauma, or ligament tear.
- Lateral Meniscus Tear: The lateral meniscus is usually crescent-shaped and acts as a shock absorber for the knee joint. The symptoms of its tear include walking difficulty and swelling.
- Posterolateral Corner Injury: The poster lateral corner injury may be caused by trauma due to sporting injuries. This may also be associated with Posterior Cruciate Ligament injury.
- Tibial Plateau Fracture: This is a complex injury that is associated with a fracture of the shinbone or the proximal end of the tibia.
Medial Knee Pain
The causes of medial knee pain are similar to lateral knee pain. These include:
- Medial Meniscus Tear: A tear of the medial meniscus, which is found on the inner side of the knee, can cause swelling, mobility issues, and significant pain. These symptoms are similar to a lateral meniscus tear.
- Damage to the Medial Collateral Ligament: MCL damage is among the most common knee ligament injuries. This injury may present itself in the form of a stretch, tear, or outwards force. Symptoms often include bruising and stiffness.
Back of the Knee Pain
Pain that is felt at the back of the knee is believed to originate from the ligaments, muscles, or tendons found there. These include:
- Hamstring Tendonitis: The hamstring is amongst the three muscles found at the back of the leg. This is located more specifically between the knee and the hip. The tendon of the hamstring connects the knee to the hamstring muscle. This tendon may become inflamed due to overuse.
- Tear of Hamstring: Over overuse of the hamstring muscle is also associated with hamstring tear or pull, which is a common cause of the back of the knee pain.
- Posterior Cruciate Ligament Injury: Injury to the posterior cruciate ligament is another cause of back of the knee pain. The posterior cruciate ligament is among the four major ligaments of the knee joint.
- Bakers Cyst: Bakers cyst is a unique condition associated with the accumulation of synovial fluid in the bursa of the popliteal fossa.
- Meniscus Tear: tear in the posterior horn of the medial or lateral meniscus can lead to significant pain in the back of the knee. The medial and lateral meniscus tear is most commonly caused by excessive wear and tear or athletic activity.
How is Knee Pain Diagnosed?
Healthcare experts usually diagnose knee pain via detailed medical history and general examination. This may be done by asking a question relating to the patients’ health and their specific symptoms relating to their knee. This may include:
- How long is the knee pain lasting?
- How severe is the pain on a scale of 1 to 10?
- What are the things that make the pain better or worse?
A physical examination may follow these questions. During the physical examination, the doctor may evaluate the range of motion, stability of the ligaments, and presence of any swelling or tenderness. In order to find out the exact cause of the knee pain, the doctor may also conduct radiographic examinations like X-rays. (6)
What Are The Treatment Options for Knee Pain?
Many of the structures in the knee have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
Other treatment options include:
- NSAIDs: Non-steroidal anti-inflammatory drugs are effective for knee conditions like osteoarthritis and rheumatoid arthritis. This is particularly recommended in addition to other treatment forms, as the NSAIDs may help improve the overall functioning of the joint. It is important to note that NSAIDs do not fix the problem and are not advised to take long-term due to irritation of the stomach lining. (7)
- Weight Loss: Weight loss is another management method for knee pain that experts recommend worldwide. Losing weight may improve the discomfort of the knee and may also reduce stiffness and improve functions. However, this may prove to be challenging for obese patients, who may not get relief from their pain immediately.
- Knee injections: Intraarticular Knee injections containing hyaluronic acids, steroids, pain killers. Unfortunately these injections only provide temporary relief. (8)
- Physical Therapy: Physical therapy under the supervision of an experienced physiotherapist can lead to significant improvement in the pain and function of the knee joint. However, not all individuals may be able to comply with their regular physiotherapy appointments due to a lack of time, lack of transport, or experiencing pain during exercises. (9)
- Knee Braces: Knee braces and associated modalities can help improve the pain and functions of the knee joint. (10)
An orthopaedic doctor may also recommend knee replacement surgery when none of the more conservative approaches are working for knee pain. Knee surgery should only be conducted in cases where other treatment modalities have failed due to the high risk associated with these procedures.
Frequently Asked Questions
How do I know if my knee pain is serious?
An individual may require medical help for their knee when they cannot bear any weight on their knees or feel like their knees will give out every time they try to walk. They may also require consultation in the case of severe swelling in the knees or the presence of an obvious deformity. In addition, the presence of fever is an indication of an active infection, and the individual may be required to start antibiotics.
How can you tell what kind of knee pain you have?
The types of knee pain can be differentiated from one another on the basis of the cause. These differences may be detected accurately using diagnostic modalities like X-ray, MRI, CT Scan, Arthroscopy, and Radionuclide bone scan. What makes arthroscopy different from the other diagnostic techniques is that it is not only a diagnostic modality but may also prove as a treatment modality.
How do you diagnose knee pain at home?
While a trained health professional can make the most accurate diagnosis of knee pain in a healthcare setup, after a medical history, physical examination, and imaging techniques – this may not be accessible to all individuals. These individuals can diagnose their knee pain at home by inspecting their knee joint for the presence of any pain, swelling or tenderness, or pressing on the skin. They should also be asked to look for bruising. This may be followed by checking the range of motion of the leg. They may do this by moving their lower leg in a different direction and keeping in mind the angles that triggered pain. Furthermore, in order to check the integrity of the joint structures like ligaments, muscles, and tendons, the joint may be lightly pushed or pulled.
How long should knee pain last before seeing a doctor?
A knee pain that lasts more than two days may require a consultation from a doctor. This is not only because of the symptoms of pain and discomfort experienced by the patients but also its interference with their daily activities. This time duration is generally recommended for individuals with work requiring them to be very active, like an athlete or a soldier. However, a retired individual who is not required to indulge in high-intensity activity every day may even wait three weeks before getting treated. This is also the usual waiting time for appointments.
Is walking good for knee pain?
Light walking is considered a healthy activity for knee pain, particularly the one elicited by knee arthritis. Light walking does not impose too much pressure on the joint while keeping the joint moving and structures around it healthy. It can also improve the stiffness associated with arthritis.
How do you know if knee pain is arthritis or something else?
Knee pain caused by arthritis usually presents with pain, swelling, and stiffness in the knees. This may also present with locking of the knee joint. It is recommended to consult a doctor who can confirm the diagnosis by conducting a detailed history examination and imaging tests like x-rays.
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- Fransen, M., Su, S., Harmer, A., Blyth, F. M., Naganathan, V., Sambrook, P., Le Couteur, D., & Cumming, R. G. (2014). A longitudinal study of knee pain in older men: Concord Health and Ageing in Men Project. Age and ageing, 43(2), 206–212. https://doi.org/10.1093/ageing/aft188
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- Thomas, E., Peat, G., Mallen, C., Wood, L., Lacey, R., Duncan, R., & Croft, P. (2008). Predicting the course of functional limitation among older adults with knee pain: do local signs, symptoms and radiographs add anything to general indicators?. Annals of the rheumatic diseases, 67(10), 1390–1398. https://doi.org/10.1136/ard.2007.080945
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- DeRogatis, M., Anis, H. K., Sodhi, N., Ehiorobo, J. O., Chughtai, M., Bhave, A., & Mont, M. A. (2019). Non-operative treatment options for knee osteoarthritis. Annals of translational medicine, 7(Suppl 7), S245. https://doi.org/10.21037/atm.2019.06.68
- Ayhan, E., Kesmezacar, H., & Akgun, I. (2014). Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis. World journal of orthopedics, 5(3), 351–361. https://doi.org/10.5312/wjo.v5.i3.351
- Shori, G., Kapoor, G., & Talukdar, P. (2018). Effectiveness of home-based physiotherapy on pain and disability in participants with osteoarthritis of knee: an observational study. Journal of physical therapy science, 30(10), 1232–1236. https://doi.org/10.1589/jpts.30.1232
- Paluska, S. A., & McKeag, D. B. (2000). Knee braces: current evidence and clinical recommendations for their use. American family physician, 61(2), 411–424.