When knee pain occurs, how do you know whether to seek emergency care, make an appointment to see your healthcare provider, or try self-care at home?
It may depend on whether your knee pain is acute, due to an injury or overuse, or chronic, possibly due to an underlying condition. If you’re aching but unsure whether to see a doctor, here are some signs and symptoms that your knee pain needs professional help.
An injury or accident can cause a fracture or torn ligament in your knee, which needs to be tended to quickly. Immediate medical attention is needed when you have the following symptoms:
- A popping sound or a “popping” sensation in your knee
- Inability to bear weight or walk
- Intense pain
- Sudden swelling of the knee
- Limited range of motion (you can’t bend or straighten it normally)
- Your knee appears bent or deformed
Symptoms like these could be the result of:
ACL Injury An ACL injury is a tear of the anterior cruciate ligament (ACL), one of four ligaments that connect your shinbone to your thighbone. This type of injury is common in people who play sports that require sudden changes in direction, like basketball and soccer. It is typically a noncontact injury (no direct blow to the knee). A loud pop or "popping" sensation in the knee is a sign of an ACL injury.
Torn Cartilage Torn cartilage is another common cause of knee pain. Trauma to the knee can tear the menisci, which are cushion pads of connective tissue that absorb shock located within the knee joint. Torn cartilage usually won’t get better without professional intervention, and in some cases, surgery may be necessary.
Fractures The knee bones, including the kneecap (patella), can break during incidents like falls or auto accidents, or simply due to stepping the wrong way if your bones are weaker due to osteoporosis.
Dislocated Kneecap This occurs when your kneecap slips out of place. Symptoms include an audible pop, buckling of the knee, intense pain, sudden swelling, bruising, locking of the knee, and an inability to walk.
Infection Occasionally, the bursa — a
fluid-filled sac in the knee that helps cushion your joint — might be infected. Certain factors, like previous joint injuries or a wound on the knee, can increase your risk for this kind of infection.
Infection can also lead to septic arthritis, which includes symptoms of swelling, pain, and redness in the knee. This condition can quickly cause significant damage to the knee cartilage, so see a doctor if you’re having symptoms, especially if you also have a fever.
What if your knee pain seems manageable and not so acute or debilitating that you need emergency care? Should you still check in with your doctor? A good rule of thumb is to consider how many lifestyle changes you’re making to accommodate the pain. If the pain is affecting your daily routine and your sleep, or if the pain is gradually worsening or persisting, it’s a good idea to speak with your healthcare provider about it.
The Pain Won’t Go Away
Sometimes an injury can lead to a sprain that may not seem all that serious initially and that you can treat at home with RICE: rest, ice, compression, and elevation, along with over-the-counter pain medications.
But if the pain doesn’t lessen or disappear, or the knee is giving out when you try to walk, you should see a doctor.
The pain could be due to the following:
Patellar tendonitis affects the tendon connecting your kneecap (patella) to your shinbone. Also called jumper's knee, it often occurs in sports like basketball, where the force of hitting the ground after a jump strains the tendon.
Most cases of tendonitis can be treated with rest, physical therapy, and pain medication. But see a doctor if symptoms persist or worsen, interfere with your daily activities, or there’s redness or swelling around the joint.
Kneecap bursitis happens when your knee’s bursa sac is repeatedly irritated, damaged, or infected. The lining of the bursa thickens, producing extra fluid, which causes the bursa to swell. It can be caused by infection, or the inflammation can occur through overuse or repeated pressure (such as kneeling for long periods of time). Symptoms include swelling, pain, and limited range of motion. Bursitis due to overuse can typically be treated at home with RICE, avoiding activities that irritate the knee, and OTC meds. But bursitis due to infection — often accompanied by fever, achiness, and chills — needs immediate attention from a healthcare provider.
Mechanical problems may be the source of knee pain that eventually requires medical attention. These include iliotibial band syndrome (ITBS), which commonly affects runners and cyclists and occurs when the iliotibial band — the tough band of tissue that extends from the outside of your hip to the outside of your knee — becomes so tight that it rubs against the outside of your thighbone. In addition to knee pain, symptoms may include hip pain, a clicking sensation on the outside of your knee, knee pain, warmth, or redness.
Loose body is another mechanical issue, in which injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space, which can interfere with knee joint movement.
Sciatica — which generally refers to pain that travels from the lower back into the lower legs — can cause pain down the leg through the knee. If you’re unable to increase your pain level or feel a tender spot by pressing or touching your knee, your knee might not be injured at all — and you should consult your doctor to figure out what’s going on.
The Pain Could Be Related to Arthritis
Chronic or recurring pain, stiffness, or swelling in or around one or more of your joints could be due to arthritis.
Osteoarthritis, the most common type of arthritis, occurs when the cartilage in your knee deteriorates with use and age. Inflammatory forms of arthritis, like rheumatoid arthritis (RA), can also cause knee pain, as can gout, when uric acid crystals build up in the joint, and pseudo-gout, caused by calcium-containing crystals in the joint fluid.
If you’re having arthritis symptoms such as pain, stiffness, or swelling in or around one or more of your joints, talk to your doctor.
Maybe you overdid it on a run, moved your leg in a strange way, or put too much pressure on your knees while gardening. If there are no clear signs of trauma and you can still go about your life pretty much as you usually do, at-home self-care may relieve your knee pain. If the pain persists or worsens, however, call your healthcare provider. Home treatment includes:
- Resting Your Knee Stay off your feet as much as possible. Use a cane, walker or other form of mobile support until your knee is healed.
- Icing Your Knee Apply ice to the area for 10 to 15 minutes, every couple of hours, as needed.
- Elevating and Wrapping Your Knee A compression wrap (either a bandage or a brace) can reduce swelling. Just make sure it’s not too tight as to cause pain or swelling in another part of your leg. Keeping your knee elevated, above your heart, can help with pain and swelling. Lie down and place pillows beneath your knee.
- Taking Pain Relievers Over-the-counter pain relievers include topical creams or gels that may contain menthol (Icy Hot, BenGay), or diclofenac (Voltaren). Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) can help reduce pain and inflammation. Acetaminophen (Tylenol) is a good alternative for people with kidney trouble, high blood pressure, or those are prone to stomach upset.
- Keeping Exercise Low-Impact Try to remain active but go easy on your knee joints. This could mean swimming instead of running.
If you’ve been diagnosed with a form of arthritis and have
chronic, aching knees, treating the area with heat may help relieve your pain better than ice, which tends to help with more acute pain due to injury.
Your doctor will perform a physical examination, checking for swelling, tenderness, pain, warmth, or bruising. They’ll also assess the range of motion in your lower leg.
The most common tests for knee pain are X-rays to evaluate bone structure and assess for arthritis, followed by magnetic resonance imaging (MRI) to evaluate soft tissues, including ligaments and tendons.
Additional imaging tests like computerized tomography (CT) scans and ultrasounds can also help detect and reveal the source of knee pain.
Other diagnostic imaging tests can include arthroscopy, a minimally-invasive procedure in which a small tube with a camera is inserted into the knee joint through a small incision in the joint; it projects images of the inside of the joint.
Doctors might also perform a radionuclide bone scan, in which a tiny amount of radioactive material is injected into your bloodstream and can show blood flow to the bone and cell activity within the bone.
Your doctor may request lab tests if they suspect an infection or inflammation. This could mean blood tests along with a procedure called arthrocentesis, in which fluid taken from your knee is analyzed.
These diagnostic tools can help your doctor get to the bottom of what’s causing your knee pain and recommend the best treatment for your specific issue.
