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Knee pain symptoms

We look at the different types of knee pain and their possible causes. We also shed light on how knee pain at night can affect your mental health

Knee pain is an extremely common issue. From the time we get out of bed in the morning to the time we go to sleep at night, we will usually have spent quite a bit of time moving. Whether that's from exercising, walking to the shops or just pottering around the house, nearly every time we move our body from one position to another, our knee joints are actively involved in the process.

In a healthy knee joint, we can usually move around without any awareness of just how much work the joint is doing. On the other hand, if we have pain anywhere in the knee, we are often extremely aware of it. Knee pain can make a real difference in our ability to do many of the things we normally take for granted. For example, we may:

  • Find it increasingly difficult to stand up from a chair (or to sit down onto a chair);
  • Struggle to kneel down to play on the floor with our grandchildren;
  • Not be able to walk around shops as easily;
  • Take longer going up and down stairs;
  • Have to reduce the amount of walking we do in the hope that will stop the pain getting any worse, and
  • Realise that we need to stop exercising for a while, because the knee pain gets worse during or after exercise.

Knee pain is a fairly generic complaint, and your doctor will want to learn as much as possible about the:

  • Type of pain: For example, is it a dull ache or a sharp stabbing pain?
  • Position of the pain: Is it only in a particular part of the knee, or is it a more general pain?

When you first meet with your knee doctor, they will talk with you about your symptoms and how they are affecting the quality of your life.

Knowing the type of knee pain you have, how long you've had it and its severity can all help the doctor to narrow down the potential causes. Their experience in helping many other people with similar knee problems will often mean they'll be able to pinpoint the cause of your pain before they've even examined your knee.

Some of the most common complaints about knee pain a doctor hears include:

  • Right knee pain/left knee pain;
  • Back of knee pain;
  • Inside knee pain/pain on inner side of knee;
  • Knee pain after running;
  • Swollen knee and pain;
  • Hip and knee pain;
  • Sharp pain in knee;
  • Burning pain in knee;
  • Knee clicking and pain;
  • Pain under knee cap/sharp pain in kneecap;
  • Throbbing knee pain, and
  • Knee and thigh pain.

As you can see, there are a number of places and ways that knee pain can show up. Maybe slightly surprisingly, the exact location of your knee pain is not always a good indicator of the cause. This is because the knee is a bad localiser of pain.

Certain parts of the body (for example, the lips or the tips of the fingers) are extremely sensitive as they contain a lot of nerves. Other parts of the body have far fewer nerves, making them far less reliable when trying to pinpoint specific pain points. The knee is one of these areas.

Knee pain could affect different sections of your knee, for example at the back of your knee, or the inside of your knee. Sudden or sharp knee pain can have a devastating impact on your ability to perform everyday activities. If you enjoy doing sports, you may be forced to stop running or cycling to avoid further injury. Pain and swelling in your knee can also be debilitating and impact your daily life.

We look at the different types of knee pain and their possible causes. We also shed light on how knee pain at night can affect your mental health.

Pain in the front of the knee may be caused by a problem with the patella. This could be damage as a result of trauma, disease or age-related "wear and tear". A significant trauma to the knee can cause the kneecap to move out of its normal position (dislocate). 

This usually happens following a hard blow to the knee, or from a sudden change of direction while the leg is on the ground. There may be immediate swelling of the knee, and often it will be impossible to fully straighten the leg.

A dislocated kneecap can pop back into place again by itself, but if it doesn’t, or if you are in severe pain, you should get medical help as a matter of urgency.

Pain at the back of the knee is usually caused by some type of swelling within the joint. There are a number of reasons you may get a knee swelling (for example, a Baker's cyst) but the underlying problem is that something is causing this swelling, and then it is this swelling that is causing the pain in the back of your knee.

Your doctor will be able to diagnose what is causing the swelling and then discuss treatment options with you. Treating the cause of the swelling will usually mean that the pain goes away.

If you have pain in the outer (lateral) or inner (medial) side of your knee, it is sensible to have a doctor assess things. There may be nothing to worry about, and the pain may end up resolving naturally, but if you are concerned about your knee pain, talking with an expert in knee health can help put your mind at ease.

Outer knee pain is fairly common in long distance runners, people who suddenly increase the distance they run and cyclists. Inner knee pain can be caused by arthritis, damage to the meniscus or inflammation in a fluid-filled sac (bursa) in the knee.  

Whenever you have any type of pain anywhere in the body that is bad enough to wake you up at night, it is strongly recommended that you see a doctor for help. If you notice that you are more aware of the pain in your knee at night, it can make sleep difficult.

Short-term, most of us are able to cope with a bit of sleep deprivation, but long-term it starts to have more of a debilitating effect. Everything can become more challenging, and it can be difficult to focus on things.

The most common reason people wake up in the night with knee pain is because they are struggling with bad arthritis in their knee. Arthritis is a degenerative condition, which means the joint becomes more damaged as the disease progresses.

As the damage increases, so too does the pain. At its more advanced stages, arthritis can cause excruciating pain. The two most common types of arthritis seen in the knee are "wear and tear" (known as osteoarthritis) or inflammatory (rheumatoid arthritis). 

If you find yourself being woken up by knee pain, or suspect you may have some sort of arthritis, a consultation with a knee doctor can be incredibly helpful. Once they have assessed the condition of the joint and determined the cause, they'll be able to talk you through specific treatments

Specialists offering Knee pain symptoms

Mr Jeya Palan

Orthopaedic Consultant Surgeon

BSc (Hons), MB BS, PhD, FRCS (Tr & Orth)

The Huddersfield Hospital

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Mr David Wood

Consultant Orthopaedic Surgeon

MB ChB, MRCS, FRCS (Tr and Orth)

Thornbury Hospital

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