Common causes of knee pain
Knee pain can arise from the joint surfaces (arthritis), the cartilage (meniscal tears), the ligaments (ACL, MCL, PCL injuries), the kneecap (patellofemoral syndrome), the tendons (patellar or quadriceps tendinopathy), or from referred pain from the hip or spine. The pattern of pain — location, timing, what makes it worse or better — often points to the likely cause before any investigation.
Age, activity level, injury history and alignment (e.g., bow-legs or knock-knees) all influence which structures are involved. A thorough evaluation distinguishes mechanical from inflammatory causes, which is important because the treatment approach differs significantly.
- Osteoarthritis — stiffness, swelling, pain with weight-bearing that improves with rest
- ACL/meniscal tears — swelling after injury, giving way, locking
- Patellofemoral pain — anterior knee pain with stairs, sitting, squatting
- Patellar tendinopathy — pain below the kneecap with jumping or running
- Pes anserine bursitis — inner knee pain below the joint line
- IT band friction — outer knee pain with repetitive activity
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Treatment approach
Most knee pain responds to non-surgical treatment. The foundation includes activity modification, physiotherapy to strengthen the muscles around the knee, weight management (for arthritis), and appropriate pain relief. Injections (corticosteroid, hyaluronic acid) may be considered for specific indications.
Surgery is discussed when conservative measures are inadequate, when there is a correctable structural problem (e.g., meniscal tear, ligament rupture), or when arthritis is advanced and joint replacement would improve quality of life. Dr. Gautam ensures patients understand the expected outcomes and recovery for each option.
| Cause | First-line treatment | When to consider specialist review |
|---|---|---|
| Osteoarthritis (mild–moderate) | Weight loss, quadriceps strengthening, analgesics | Persistent pain despite 3 months of conservative care |
| ACL tear (unstable knee) | Physiotherapy, bracing | Recurrent giving way affecting function |
| Meniscal tear (mechanical symptoms) | Activity modification, physiotherapy | Locking, persistent catching, or inability to fully straighten |
| Patellofemoral pain | Quad and hip strengthening, activity modification | Pain persists beyond 6–8 weeks despite exercises |