The site of your knee pain and the knee’s stability will help your consultant decide the most likely underlying condition and what treatment options are suitable for you.
Some medical issues, like osteoarthritis, can trigger pain in several areas, such as the outer and inner parts of the knee and under the kneecap. An injury or blow can affect specific ligaments, cartilages, or tendons.
Mr Punwar said: “We often ask patients to point to the pain with one finger. Then we’ll look closely at that area on X-rays and scans, guiding certain treatments.”
Back of knee pain (posterior)
Pain behind the knee, also known as posterior knee pain, may result from wear and tear (osteoarthritis or rheumatoid arthritis), a blow causing a posterior cruciate ligament tear or a Baker’s cyst. It may also be muscle strain.
Inside knee pain (medial)
Medial means ‘close to the midline of the body’. One of the most common reasons for pain on the inside part of the knee is damage to the shock absorber (menisci) or medial collateral ligament (MCL) from a blow to the outside of the knee.
Pain on the outside of the knee (lateral)
Lateral means ‘away from the midline of the body’. Pain on the knee’s outer side is called lateral knee pain (LKP). Typical causes of LKP are sports injuries, such as running or skiing, and overuse.
Pain in the front of the knee (anterior)
Anterior means ‘nearer the front’. Rapid swelling following an injury, such as a sudden stop or twist, can cause a rupture of the anterior cruciate ligament (ACL). The ACL is damaged more often than other knee ligaments.
Pain under the kneecap (patellofemoral joint)
Mr Punwar said: “If it hurts around the kneecap at the front, then it may be a small amount of cartilage-wear underneath the kneecap. It will hurt when you sit or kneel for long periods, and then when you get up, the knee clicks.”
Patella tendonitis could also be the culprit if the pain is between your kneecap and the shin.
Referred knee pain from the hip
Sometimes, knee pain may be a result of a problem in the hip.
Mr Punwar explains: “With knee pain, it’s important to examine the hip because there’s a fairly large percentage of referred pain. You can have a stiff arthritic hip and feel the pain exclusively in your knee. A thorough examination and history are key to treating your knee pain.”
Several knee surgeons at The Blackheath, including Mr Punwar, are skilled at first-time (primary) hip replacements, so you won’t need to be referred to another specialist if the hip is the cause of your knee pain.