Why Does My Knee Hurt?
Knee pain is one of the most common complaints seen in orthopedic clinics. The knee is the largest joint in the body and bears the full weight of standing, walking, climbing, and running — making it highly susceptible to injury and degeneration.
Understanding the cause of knee pain is essential for effective treatment. The cause determines whether rest and physiotherapy are sufficient, or whether more advanced interventions are needed.
Most Common Causes of Knee Pain
1. Osteoarthritis (Knee Roughness — خشونة الركبة)
The most common cause in adults over 45. Cartilage breakdown causes bone-on-bone friction, leading to pain, stiffness, and swelling. Worsens with activity and improves with rest initially, then becomes constant in advanced stages.
2. Ligament Injuries
Anterior cruciate ligament (ACL) tears are common in athletes and active individuals. They cause sudden sharp pain, swelling, and instability of the knee. Posterior cruciate ligament (PCL) and medial collateral ligament (MCL) injuries also occur from direct trauma.
3. Meniscus Tears
The meniscus is a C-shaped piece of cartilage that cushions the knee. Tears can occur from sudden twisting movements or degenerative changes with age. Symptoms include pain on the inner or outer side of the knee, clicking, locking, and swelling.
4. Patellar Problems
Patellofemoral pain syndrome (runner's knee) causes pain around the kneecap, especially when climbing stairs, squatting, or sitting for long periods. Patellar tendinitis (jumper's knee) affects the tendon below the kneecap.
5. Bursitis
Inflammation of the small fluid sacs (bursae) that cushion the knee. Causes localized pain and swelling, often from repetitive kneeling or direct impact.
6. Referred Pain from Hip or Spine
Pain from a hip or spinal condition can radiate to the knee. This is why a thorough examination of the entire lower extremity is important when diagnosing knee pain.
How Is Knee Pain Diagnosed?
Accurate diagnosis begins with a detailed history of when the pain started, its location (inner side, outer side, front, or behind the knee), what makes it worse or better, and whether there was a specific injury.
Physical examination assesses range of motion, ligament stability, meniscal signs, and joint-line tenderness. Imaging studies include X-rays (to evaluate bone and joint space), MRI (for soft tissue — ligaments, meniscus, cartilage), and ultrasound (for tendons and bursae).
Effective Treatment for Knee Pain
Rest, Ice, and Anti-Inflammatories
For acute injuries, the RICE protocol (Rest, Ice, Compression, Elevation) is the first line of treatment. Non-steroidal anti-inflammatory drugs (NSAIDs) help control pain and swelling in the short term.
Physical Therapy
Targeted strengthening of the quadriceps and hamstrings is the cornerstone of knee pain management. Strong muscles unload the joint, reduce pain, and slow the progression of osteoarthritis. A specialist-guided physiotherapy program is essential.
Injections
Corticosteroid injections reduce inflammation and provide fast pain relief. Hyaluronic acid injections improve joint lubrication. PRP (platelet-rich plasma) therapy stimulates natural healing — particularly useful in early-to-moderate osteoarthritis and tendon injuries.
Arthroscopic Surgery
For meniscus tears, cartilage damage, and loose bodies in the joint, knee arthroscopy provides direct access via tiny incisions. Recovery is fast compared to open surgery.
Knee Replacement Surgery
For severe osteoarthritis, total or partial knee replacement is the definitive solution. At Bone Art Clinic, our internationally trained surgeons use the latest implant systems to deliver pain-free, natural-feeling results.
When Is Knee Pain an Emergency?
Seek immediate medical care if: you cannot bear weight on the knee, the joint appears deformed, severe swelling develops within minutes (suggests internal bleeding or rupture), or the knee is hot and red with fever (possible infection).
Frequently Asked Questions
What is the most common cause of knee pain?
In adults over 45, knee osteoarthritis (cartilage degeneration) is the most common cause. In younger patients, ligament injuries, meniscus tears, and patellar problems are more frequent causes.
Does knee pain always require surgery?
No. The majority of knee pain cases are successfully managed without surgery through physical therapy, medications, weight management, and injections. Surgery is reserved for severe osteoarthritis, complete ligament ruptures, and cases where conservative treatment fails after an adequate trial.
What exercises help with knee pain?
Low-impact exercises that strengthen knee-supporting muscles are ideal: straight leg raises, wall squats (mild), swimming, cycling, and water aerobics. Avoid high-impact activities like running on hard surfaces or jumping when experiencing pain.
How long should I wait before seeing a doctor about knee pain?
See a doctor if knee pain persists beyond 2 weeks, does not improve with rest and over-the-counter pain relief, worsens progressively, or is accompanied by significant swelling, locking, or instability. Do not delay — early treatment produces better outcomes.