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Knee

This page provides you with information and self-help advice for managing musculoskeletal knee problems.

Knee pain is a common complaint and can be caused by many different things.

When to speak to a health professional

Non-urgent advice: see a GP if knee pain does not improve within a few weeks.

Urgent advice: get advice from 111 now if:

  • your knee is very painful.
  • you cannot move your knee or put any weight on it.
  • your knee is badly swollen or has changed shape.
  • your knee locks, gives way or painfully clicks – painless clicking is normal.
  • you have a very high temperature (or feel hot, cold or shivery) and have redness or heat around your knee – it can be a sign of infection.

111 will tell you what to do. They can tell you the right place to get help if you need to see someone. Either visit them online or call 111.

Please visit this link for information on symptoms of Deep Vein Thrombosis (DVT) a serious condition relating to a blood clot, commonly occurring in the leg.

Self help and recovery

Causes of knee pain

Knee pain can be a symptom of many different conditions. This information might give you an idea of what the cause might be. But do not self-diagnose – see a GP or a healthcare professional (like physiotherapist) if you're worried.

Knee pain after an injury

Symptoms

Possible cause

Pain after overstretching, overusing or twisting, often during exercise or with injury.     

Sprains and strains

Pain between your kneecap and shin, often caused by repetitive running or jumping (but not always).

Tendinopathy

Unstable, gives way when you try to stand, unable to straighten, may hear a    popping sound during injury (common to have swelling)

Torn ligament, tendon or meniscus, cartilage damage

Kneecap changes shape or feels out of place after a collision or sudden change in direction (not always requiring trauma)

Dislocated kneecap

 

Knee pain with no obvious injury

Symptoms

Possible cause

Pain and stiffness in knee(s), mild or severe swelling, more common in older people.

Osteoarthritis

Warm and red, kneeling or bending makes pain and swelling worse

Bursitis

Swelling, warmth, bruising, more likely while taking anticoagulants

Bleeding in the joint

Hot and red, sudden attacks of very bad pain in one or more joints.

Gout or septic arthritis

Teenagers and young adults with pain and swelling below kneecap and sometimes             obvious bony lump.

Osgood Schlatter's disease

 

If you have knee pain, try these things at first:

  • reduce the amount of weight you put on your knee – for example, avoid standing for a long time or put more weight on non-affected leg or use walking aid.
  • use an ice pack or bag of frozen peas wrapped in a tea towel on your knee for up to 20 minutes every 2 to 3 hours
  • you can compress you knee with bandage or brace for short periods of time to help with swelling and with support of the knee.
  • use painkillers such as paracetamol or ibuprofen gel or tablets.
  • for certain problems, like osteoarthritis, heat can also be helpful.

You can make use of the following exercises where appropriate:

There are several different tablets and creams available.

Painkillers such as paracetamol and ibuprofen may help, and you should use them if you need to. It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising. Don’t wait until your pain is severe before taking painkillers.

You shouldn’t take ibuprofen or aspirin if you’re pregnant or have asthma, indigestion or an ulcer until you’ve spoken to your doctor or pharmacist. Medication can have side-effects so you should read the label carefully and check with your pharmacist if you have any queries.

If over-the-counter medication doesn’t work, your doctor may prescribe stronger painkillers or capsaicin cream, which you can rub directly onto the knee.

If you are not sure about use of pain medications, please always consult your pharmacist or GP.

Your physiotherapist will carry out a thorough assessment to find out what component(s) of your knee is the primary cause of your problem. 

PRICE guidelines (Protection, Rest, ICE) may be utilised initially, and this might be in the form of crutches, a knee support or the use of ice therapy.

As your range of movement increases and your pain settles, your physiotherapist will advance your exercises, working on your strength and balance, ensuring that you get back to full fitness.

If your pain is not settling or is worsening over a period of 2-3 weeks, and is stopping you from doing your normal activities, then you should seek further advice from your GP/physiotherapist. Equally, if the pain persists but isn’t interfering with your normal activity, but goes on for more than 6 weeks, you should seek advice.

Physiotherapists are specialists in the care of muscle, bone and joint conditions and will be able to offer sensible advice and treatment. This treatment will be tailored to your needs and based on the best evidence we have.

Please visit here for an example of exercises for your knee: https://www.csp.org.uk/conditions/knee-pain/video-exercises-knee-pain 

A physiotherapist will do a full and thorough assessment of you. This will include taking a detailed history of your pain. 

They will then do a physical assessment to see how you move and how your muscles, nerves and joints are working.

They will discuss with you the options available, and will help you choose the best treatment programme that fits your needs. This may include a range of options such as:

  • a home exercise programme for strength and mobility
  • advice on pain management
  • possibility of manual (hands-on) treatment, but only as part of the overall management programme.

Your physiotherapist will monitor your progress with the treatment plan and help to you get back to your normal daily life.

X-rays and scans can help for a small number of people and in certain situations. However, most of the time it shows us things that are normal for the age of your knee and are not related to your pain. These sorts of findings will not help the knee get better. This is why your GP or clinician may say that it is not needed.

Surgery may be recommended if your pain is very severe or you have mobility problems for a long time and it doesn’t show signs of improvement.

Your doctor or physiotherapist will discuss with you when referral to surgeon is appropriate and what the surgery may involve.

If you are considering knee replacement surgery, please visit this link to help with your decision making.

When should you self refer?

Most knee pain will settle naturally in time with little or no help, but occasionally you may need some extra help to get your knee better. Most people do not need further treatment or investigations, and your physiotherapist is ideally placed to advise if you do. If the above self-help information is not improving your symptoms within 6-8 weeks or if your symptoms are getting worse, then see a healthcare professional. To do this, you will need to fill in our self referral form.

Please find below information on knee conditions and some other useful information: 

The information on this page is adapted from: https://www.csp.org.uk/conditions/knee-pain. Please note: This information is not a replacement for professional help but may aid you and any further information or advice given to you by a medical professional. If you are accessing this site for self-help information in the absence of professional advice, please be aware that the advice and/or exercises may not be suitable for you. If you have any concerns or in the event of any problems, please seek professional advice.

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