2. Assessing Knee Pain

So your knee hurts, but why? Initial knee pain assessments typically look at where pain is coming from and which activities are causing it. Here, we review common knee conditions based on these questions. To get a diagnosis, be sure to consult your healthcare provider.

2. Assessing Knee Pain

So your knee hurts, but why? Initial knee pain assessments typically look at where pain is coming from and which activities are causing it. Here, we review common knee conditions based on these questions. To get a diagnosis, be sure to consult your healthcare provider.

2.1 Locating Knee Pain

A good first step in assessing your knee pain is to identify the location of your pain. You can start by determining if the pain is on the inner or outer side of your joint. In medical terms, inside knee pain is referred to as medial knee pain. Outside knee pain is lateral knee pain.

2.1 Locating Knee Pain

A good first step in assessing your knee pain is to identify the location of your pain. You can start by determining if the pain is on the inside of your joint or the outside. In medical terms, inside knee pain is referred to as medial knee pain. Outside knee pain is lateral knee pain.

Inside Knee Pain

Inside Knee Pain

Knee pain and swelling on the inside (medial side) of your joint can be caused by an acute injury like a meniscus tear or medial collateral ligament sprain. Inside knee pain can also indicate an overuse injury like bursitis, or a chronic condition like medial knee osteoarthritis.

Figure 1.  Inside knee pain may indicate an issue with the medial meniscus (in red). This image shows the left knee from the front.

Outside Knee Pain

Outside Knee Pain

Acute injuries like a meniscus tear or lateral collateral ligament sprain are common causes of pain on the outside (lateral side) of your knee. Other possible causes include chronic issues like IT band syndrome or lateral knee osteoarthritis.

Figure 2.  Outside knee pain may indicate an injury in one of the lateral structures of the knee, such as the Lateral Collateral Ligament (LCL) or the lateral meniscus. Another possibility is osteoarthritis of the lateral tibiofemoral compartment. This image shows the right knee from the side.

2.2 Knee Pain During Activity

2.2 Knee Pain During Activity

Another method of assessing knee pain is to make note of the activities that trigger it. Specific activities that cause pain may provide clues about the type of condition you have. Be sure to consult with a healthcare practitioner for a full assessment of your knee pain.

Knee Pain When Walking

Knee Pain When Walking

An acute injury like a meniscus tear or ligament injury can cause pain during walking. If you are not injured and start to notice your knee hurts when walking, it could be a sign that you are developing osteoarthritis.

Pain When Weight Bearing

Knee Pain When Weight Bearing

The knee absorbs several times your body weight during weight bearing activities, like squatting or using the stairs. The more the knee bends, the more force it must absorb. This increased force can make your pain symptoms more noticeable.
knee pain when bending caused by patellofemoral knee pain overuse injury
knee pain when bending caused by patellofemoral knee pain overuse injury

Figure 3.  As the knee bends, the patella glides along the end of the femur. Activities that involve repeated bending of the knee place particular stress on the patella. Too much bending can make the knee susceptible to overuse injuries, like patellofemoral knee pain.

Knee Pain Going Down Stairs

Knee Pain Going Down Stairs

Walking down stairs often causes more knee pain than walking up stairs because it puts more weight on your knee cap. Common causes of knee pain when going down stairs include patellofemoral pain syndrome or patellofemoral osteoarthritis.

Knee Pain When Squatting

Knee Pain When Squatting

Knee pain when bending, kneeling, squatting, or lunging could be caused by acute injury, overuse, or improper tracking of the kneecap. It’s also a common symptom of osteoarthritis.

2.3 Assessing Your Osteoarthritis Stage

2.3 Assessing Your OA Stage

If you suspect you have osteoarthritis, you can assess its potential severity using the Kellgren-Lawrence classification system. The system includes four stages ranging from mild to severe. Your symptoms can help you identify which stage you may be at.

inside knee pain may indicate stage of osteoarthritis on the kellgren lawrence classification system
inside knee pain may indicate stage of osteoarthritis on the kellgren lawrence classification system

Figure 4.  The Kellgren-Lawrence classification system assesses the severity of osteoarthritis based on the amount of joint space, osteophytes, and cartilage degeneration in the knee.

Early Stage OA (Doubtful)

Early Stage OA (Doubtful)

In early stage osteoarthritis, there are likely little to no symptoms. Although it’s unlikely your knee will be painful, physiological changes are starting to occur in your knee joint.

Mid Stage OA (Mild)

Mid Stage OA (Mild)

Mid-stage osteoarthritis is typically when you start to experience knee pain and stiffness. For example, you may feel discomfort after sitting for a long time, after getting up in the morning, or after exercising.

Late Stage OA

Late Stage OA (Moderate)

During late stage osteoarthritis, joint inflammation and pain frequently occur during and after activities like walking, running, bending, or kneeling. You may also hear popping or cracking sounds when moving your knee.

Surgical Stage (Severe)

Surgical Stage (Severe)

At the surgical stage, you’ll likely experience severe bone on bone knee pain. At this point, the cartilage in your knee will be almost completely worn away, which will cause a chronic inflammatory response. Your range of motion will be limited and your knee may feel unstable while weight bearing. These symptoms can make daily activities like walking or going down stairs very challenging.

An In-Depth Guide to Osteoarthritis

In-Depth Guide to Osteoarthritis

(Free Download)

Osteoarthritis Explained:

Your Complete Guide to Understanding Severe Knee Arthritis

Osteoarthritis Explained: A Guide

knee pain causes ebook

If you have osteoarthritis, or suspect you do, this eBook is a useful starting point for improving your understanding of the disease. Inside, you’ll find answers to many common questions about knee osteoarthritis. Topics include knee anatomy, the different patterns and stages of osteoarthritis, and what to expect as the disease progresses.

knee pain causes ebook

What’s Next?

Treating Knee Pain

knee pain causes diagnosed through xray assessment

What’s Next?

Treating Knee Pain

treating knee pain

After you’ve assessed the cause of your knee pain (ideally with the help of a healthcare professional), you may be ready to begin trying different treatments. In the next section, we discuss treatment options, including early self-care, bracing, injections, and surgery.