“The knee joint is one of the most important joints in our body. It is heavily used during everyday activities such as walking, bending, squatting, and sitting. Due to its frequent use, the knee joint is prone to wear and tear and is susceptible to injuries. One of the primary indications of an issue affecting our knee health is knee pain.

So, what could knee pain indicate? What are the causes of knee pain? Before seeking solutions for your knee pain, it’s important to understand the potential causes by reviewing this article.

What Are the Causes of Knee Pain?

Knee pain is a common problem that can affect people of all ages. It can result from various conditions such as injuries, sprains, osteoarthritis, ligament tears, joint inflammation, and even excessive weight. If pain occurs in both knees simultaneously, it is often a sign of osteoarthritis. However, if pain is present in only one knee, different causes may be involved. The location and intensity of the pain vary depending on the underlying causes. Other accompanying symptoms of knee pain may include swelling and stiffness, redness, a burning sensation upon touch, cracking sounds, locking, or inability to fully straighten the knee.

Knee pain should be taken seriously, and its cause should be identified to facilitate appropriate treatment. Knee pain can be temporary (acute) or chronic, and the location of pain can be felt in the knee cap, front of the knee, or back of the knee, depending on the causes of knee pain.

Here are some conditions that can cause knee pain:

• Osteoarthritis: Knee osteoarthritis is one of the most common causes of knee pain, especially in older adults. It occurs when the cartilage tissue and joint area of the knee weaken and become damaged due to various reasons. Over time, the bone ends that make up the knee joint start rubbing against each other, leading to bone surface damage. Delaying treatment can result in the progression of damage and worsening of symptoms. Pain usually starts gradually and continues to worsen as the cartilage damage increases. Sometimes, sudden pain attacks can also occur. Typically, pain and swelling in the knee increase after prolonged periods of inactivity. The pain in the knee is generally described as a weakness and a deep ache from within. Activities such as walking, squatting, and climbing stairs can exacerbate the pain. If conservative treatments such as medication, exercise, physiotherapy, and injections do not provide relief, knee replacement surgery may be necessary. If there is localized osteoarthritis in a specific area of the knee joint, partial knee replacement surgery may be performed, while total knee replacement surgery is carried out when there is widespread osteoarthritis in the joint.

• Rheumatoid Arthritis: Knee pain can be caused by joint inflammation, known as rheumatoid arthritis, which can affect the joint lining or other internal organs. The pain caused by inflammatory rheumatic diseases can hinder daily routine activities. Joint pain, swelling, and prolonged morning stiffness lasting more than 30 minutes are significant symptoms of this disease.

• Bursitis: Bursa is a small sac-shaped tissue located between mobile structures such as bone, muscle, tendon, or skin, serving as a cushion. When the bursa sac becomes inflamed, it can cause pain even at rest. Symptoms of bursitis include pain, redness, swelling, tenderness, and increased heat in the affected area. Although it commonly occurs in the shoulders, elbows, and hips, it can also affect the knees. Inflammation often takes time to develop, but in some cases, sudden inflammation and symptoms can occur.

• Gout: Gout is an inflammatory condition characterized by pain, swelling, tenderness, and increased heat in the joints, caused by the formation of uric acid crystals in the joints. Gout symptoms are associated with the formation of uric acid crystals in the joints. Pain often occurs in the joint of the big toe. Gout attacks can occur suddenly, and the disease can wake a person up with a burning sensation in the big toe at night.

• Tendinitis: Tendinitis, also known as tendonitis, is the inflammation of a tendon. This condition can cause severe pain and tenderness around the knee joint. The pain felt in the front of the knee can intensify during activities such as walking uphill, climbing stairs, and running.

• Osgood-Schlatter Disease: Osgood-Schlatter disease occurs when there is inflammation in the patellar tendon, which connects the shinbone to the kneecap. Symptoms of this disease include swelling and tenderness just below the knee, along with pain that worsens with activity and improves with rest. Osgood-Schlatter disease is one of the most common causes of knee pain in young people, particularly in adolescent boys during periods of rapid growth.

• Dislocated Kneecap: Dislocation of the kneecap, usually occurring as a result of accidents or injuries, is a serious condition that causes knee pain. After sudden twisting of the knee, accompanied by severe pain, the feeling of the kneecap shifting to the outside can be experienced. Swelling and limited mobility occur in the knee due to intra-articular bleeding.

• Ligament Injuries: Ligament injuries, particularly anterior cruciate ligament (ACL) tears, are commonly observed causes of knee pain. ACL injuries usually result from a direct blow or a sudden change in direction or speed while running. Posterior cruciate ligament (PCL) injuries are rare and often caused by high-energy forces applied to the knee. In cases of ligament injuries, severe pain is felt in the knee and throughout the leg.

• Cartilage Damage: Damage to the cartilage tissue in the knee joint, which is softer and more delicate than bone, is a common problem. When joint cartilage is damaged, the joint surface loses its smoothness and becomes rough, leading to knee pain and swelling due to friction. The pain may lessen with rest but may not completely go away over time. Putting weight on the knee increases the pain.

• Excessive Weight: Excessive weight puts additional stress on the knees, increasing the likelihood of damage to the knee joints. People who are overweight are more prone to knee pain as the excess weight adds pressure and strain on the knees.

• Knee Overuse: Overuse is one of the most common causes of knee pain. Overuse strains the knee tissues and can result in temporary pain.

• Meniscus Injuries: The meniscus, a rubbery cartilage in the knee joint, can become damaged and lead to knee pain. Sudden bending of the knee, locking, and swelling of the knee joint are common symptoms of meniscus tears.

• Patellofemoral Pain Syndrome: Patellofemoral pain syndrome, also known as anterior knee pain, refers to pain that occurs around the kneecap. It is often felt during activities such as climbing stairs, prolonged sitting, and squatting. The pain may be accompanied by a feeling of knee buckling or instability.

• Sports Injuries: Knee pain is highly prevalent in athletes, especially during contact sports such as football, basketball, and wrestling. Excessive stress on the knees during sports activities can lead to muscle pain, which can evolve into knee pain.

Injuries caused by sprains, falls, postural abnormalities, lack of warm-up exercises, or improper muscle stretching can also contribute to knee pain.

It’s important to note that these are just some of the possible causes of knee pain. Proper evaluation and diagnosis by a healthcare professional are essential to determine the specific cause of knee pain and develop an appropriate treatment plan.

In sprains, falls, impacts, poor posture, lack of warm-up exercises before exercise, or incorrect muscle straining, traumas can occur that cause knee pain. If these conditions are not treated, they worsen and can lead to larger permanent problems. Therefore, knee pain should be taken seriously and appropriate treatment should be applied.

What are the Causes of Knee Pain According to Age?

Knee pain can occur in people of all ages. However, the causes of knee pain in children, young people, and the elderly are different. The knee joint, which is the most commonly used joint in daily life, can affect the entire life as it provides mobility. Therefore, knee health should be well protected at every stage of life, from childhood to old age.

In Children: Bones that are small at birth complete their growth and development until the age of 17-18. The rapid growth of bones can be the cause of knee pain in children. These pains can be temporary and a mild pain that does not pose a problem, or they may not be a simple growing pain. Therefore, follow-up and control are important.

In Young People: In young people, especially athletes, one of the most common problems is meniscus injuries. Meniscus tears that can occur during sudden knee movements and twisting can cause pain, locking, and difficulty in stairs especially during movement and bending of the knees. Another common cause of knee pain in young people is patellar (kneecap) pain. It is often seen in young people between the ages of 16 and 40 who work sitting for long periods, go up and down stairs frequently, and engage in intense sports activities.

In the Elderly: In older age, cartilage tissue damage and osteoarthritis complaints are commonly seen. Knee pain in the elderly gradually limits their movements over time. In advanced stages, night pain can also be felt. The likelihood of knee pain is much higher in elderly individuals who have struggled with meniscus tear problems or avoided surgery.

What Increases the Risk of Knee Pain?

• A previous knee injury increases the likelihood of re-injury to the knee.
• Being overweight increases the pressure on the knee joints, even during daily activities, and causes knee pain. These pains and excessive load on the knee joint accelerate the deterioration of joint cartilage and increase the risk of osteoarthritis.
• Muscle flexibility provides full range of motion and strong muscles protect the joints and maintain balance. Lack of flexibility or muscle weakness can increase the risk of knee pain.
• Certain sports and occupations apply more stress to the knees compared to others and increase the risk of knee damage and pain.

Excess Weight Increases Knee Pain!

In the treatment of knee pain, the severity of the underlying problem is important. In overweight patients, treatments for knee pain generally do not yield positive results unless they lose weight. Every extra kilogram puts more strain on the knees and the intensity of pain increases over time. It is a known fact that excess weight damages the knees and leads to osteoarthritis. Losing excess weight, maintaining a healthy diet, and not neglecting exercise are crucial for a healthy and pain-free life.

When Should I See a Doctor for Knee Pain?

Knee pain can have non-serious temporary causes. However, every pain is a signal that your body sends to you, and you should not neglect taking these pains seriously. If your answer is yes to the following questions, seek medical attention immediately:
• Do you experience locking of your knee when you wake up from sleep or make a wrong movement?
• Do you observe swelling and increased heat in your knee?
• Do you have difficulty squatting and getting up?
• Do you have knee pain during your daily walks?
• Do you experience stiffness and pain in your knee when you sit by bending your knee?
• Do you hear a cracking sound or feel a gap in your knee when swinging your leg?

Knee Pain Can Worsen Over Time!

In advanced cases of knee damage, severe and constant pain can occur. In fact, these pains may not decrease with rest or sleeping at night. The joint cannot move comfortably and normally as before. Knee pain can increase and intensify day by day. Knee pain should not be underestimated with the thought of “it will pass.” When you experience pain, swelling, or any other abnormal symptoms in your knees, do not hesitate to consult your doctor immediately. Preventing knee pain and receiving necessary treatment as early as possible are crucial for your knee and joint health.

How to Prevent Knee Pain?

Although it is not always possible to prevent knee pain, the following recommendations can help prevent injuries that cause knee pain:
• One of the best things you can do to prevent knee pain is to maintain a healthy weight. Every extra kilogram puts additional strain on your joints and increases the risk of pain.
• Strengthen your body and keep moving to prevent knee pain. Weak muscles are one of the leading causes of knee damage. Consult your doctor about exercises that support your knees. The exercises performed should not exert excessive strain on the knees. Jumping and leaping sports may not be suitable for individuals with knee problems.
• Always perform stretching and warm-up exercises before and after sports activities. Exercises without warming up and stretching can cause painful injuries.
• If there is noticeable osteoarthritis and it causes knee pain while walking, using assistive devices such as a cane can reduce the pressure on the knee.
• Do not neglect to walk during pain-free periods.

The sensation of pain is a message that our body sends when something is not right. Understanding the message that knee pain gives us is an important part of treatment. A knee injury can heal over time or progress gradually. If damage to the knees and joints is prevented, knee pain can also be prevented.