What can I do for knee pain?

Robert J. Otto, MD
Orthopedic Surgery
First, it is recommended that you be evaluated by a doctor to determine the cause for your knee pain. There are many causes of knee pain, which may include:
  • arthritis
  • tendinitis
  • ligament injuries
  • meniscus tears
  • knee fractures
The doctor can direct the appropriate treatment, whether it be physical therapy, over-the-counter medications, activity modification, or surgery.
Knee pain is unfortunately a common complaint and can vary from mild intermittent discomfort to a much more debilitating disorder. The cause of the knee pain will determine how it is treated (for example inflammatory knee pain from Lyme disease is treated with antibiotics). One of the most common causes of knee pain is osteoarthritis, a type of “wear and tear” arthritis. If your doctor determines the cause of your knee pain to be osteoarthritis, the treatment options will depend on the severity of the arthritis and other aspects of your health. Most otherwise healthy adults will find some relief from anti-inflammatory medications, such as NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen. Physical therapy can be an important part of knee pain therapy. By strengthening the muscles around the knee, we can increase joint stability and often improve discomfort. Other treatments exist as well and should be discussed with your physician.
Treatment of knee pain depends on the cause of the knee pain. If you have been working on your knees all day then potentially rest and anti-inflammatories such as ibuprofen can help. If the cause is trauma and there is possible joint damage then you should seek medical attention. Additionally if there is swelling, there are other causes that must be considered such as autoimmune, septic, psoriasis, and gout which should propt you to seek medical attention. Generally for most aches and pains you can use Over the counter meds to help reduce the occasional joint ache. With that being said if you find you are using over the counter anti-inflamatories on a daily basis you should seek medical attention.
Knee pain is often caused by bad habits in the way we walk, stand, sit, or run. According the the National Academy of Sports Medicine, the body is a kinetic chain. When one part of the chain is weak, or moves incorrectly, the rest of the chain compensates and creates further imbalances, pain and even injuries. One such result is knee pain.
Start with the feet. Observe your feet when you walk, stand, or run. Do they point outward or inward? Is your foot rotated toward your little toe, or do you walk on your arch?
To make corrections in the feet make it a habit to stand or move with the middle toe pointed strait ahead. Try to put equal pressure on the bottom three-points of your feet; the heel, the inner and outer ball of your foot. It might feel exaggerated at first but it is important to align your feet in order to get your knees to follow.

Next observe your knees. Look strait on in a full body mirror so you can see your bare knees. Draw an imaginary vertical line from the center of your knee toward the floor. Where does this line hit the floor? If it lands toward the inside of your foot, this may mean that your knees are ad-ducted, or inward. This may be the cause of some of your knee pain. Try to open your knees until the vertical line lands on the center of your feet, where your shoe laces would be.
Next perform a squat looking strait on at the mirror. Do your knees move inward (ad-duct) or outward (abduct)? Again, try to keep them over the center of your feet.
Now perform a squat looking side-on. Do your knees move forward over your toes? Make sure to anchor your heels into the ground, be sure your aren't gripping with your toes but you can wiggle them freely. During the squat your hips should move to the rear, like you're going to sit in a chair, the upper body will tilt forward slightly. The knees should not move forward, and you should be able to see your toes as you squat.

Stretch your IT band - the outer upper-leg - and your calves. Practice single-leg balance exercises to strengthen the small stabilizing muscles in the knee.

Making correct movement is not a guarantee to cure your knee pain, but it may help, and it may even prevent an injury. It might feel strange or exaggerated at first, but over time you create good habits of moving correctly and possibly save yourself from a worse injury.
Brian Yee
Physical Medicine & Rehabilitation
Treating knee pain depends on the location and severity of the symptoms. If it is swollen, you should apply cold packs, compress, and elevate it to reduce swelling. You should consider contacting a qualified physician or physical therapist to assess your injury.

If things are clear for any significant injury - and as swelling calms - determining where the location of knee pain helps guide things you can do to treat it.

Commonly pain is in either behind the knee cap or along the inside border. You may get a diagnosis of chondromalcia patella or patelofemoral pain which indicates that your knee cap is not tracking correctly along its groove. And with this pain, and most other types of knee pain - the pain usually originates from poor lower extremity mechanics, not just at the knee itself but at the hip and foot as well.

You have to look at the knee as a junction between two different stilts, one from above from the hip and femur, and one from below from the ankle/foot and shin. If the hip and/or ankle/foot are do not have the proper strength or flexibility many times the knee suffers increased stress and torque to it.

Exercises are then based on not only getting the knee stronger - but also improving the flexibility/strength of the entire leg.

If you have knee pain, you should perform a combination of flexibility and strengthening techniques to help your body heal and prevent further injury. Begin by foam rolling your IT-band and calves. Foam rolling is a form of self-massage that can help relax tight muscles before you stretch them. Hold the tender spots for 30 seconds to allow your muscle time to relax and release the knots that are causing tension in the muscle. After you have completed the foam rolling, statically stretch the hip flexor complex. Hold each stretch for 30 seconds to allow your muscles time to elongate. Next, perform strengthening exercises for the hips and core. This can be done by performing stability ball bridges and planks to help strengthen the muscles that stabilize the core and hips. Lastly, perform a single-leg balance exercise to strengthen the muscles of the entire leg. When performing any single-leg exercise, ensure that you keep the arch of your foot lifted while performing the exercise. Perform 1-3 sets of 10-15 repetitions of each of these exercises.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.