Pain behind the Knees – Causes, Risk Factors and Treatment

Pain behind KneeWhat causes pain behind the knee

An injury or blow to the back of the leg due to a fall or some other accident may lead to considerable pain in the posterior knee region. A sprain may lead to considerable pain, that may be accompanied by redness and swelling. Applying some ice or a hot water bag may help, while you may also consider over the counter pain relief sprays and gels for reducing the pain. Consult your doctor in case of persistent pain.

Being overweight may also lead to pain in the thighs, knees and calf muscles due to the extra pressure. Reducing body weight usually resolves this kind of pain.

Many women experience pain in lower back, hips, behind knees and lower legs before the start of their menstrual period. Pain at the back and sides of the knees as well as around knee caps is also common during pregnancy due to the extra weight and pressure from the baby.

Other possible causes of pain in the back of the knees

Apart from small injuries and sprains, knee pain may have a more serious underlying cause and may require medical assistance.

Dull to gradually worsening, throbbing pain with swelling and stiffness

Knee Bursitis
Dull, throbbing pain that may become more pronounced with pressure or when walking, kneeling or bending the knee. The area may feel warm and tender to the touch along with tightness, swelling and redness (in some cases).

Causes: Repetitive injury, overuse of the knee joint, due to chronic conditions like rheumatoid arthritis or gout.

Treatment: RICE therapy, exercise, antibiotic treatment and surgical intervention (in case of an infection)

Posterior meniscus tear
A tear in the meniscus (cartilaginous structure providing a cushion between the femur and tibia) that causes pain and swelling with limited range of movement and decreased activity of the knee. Those with a meniscus tear often feel their knee giving way while other characteristic symptoms include catching, locking or clicking of the knee joint.

Common causes: Gradual wearing off of the cartilage with age or sudden blow or injury of the knee.

Treatment: Rest, Ice, compression, elevation (RICE), physiotherapy, knee braces and arthroscopic surgery (less common)

Baker’s Cyst
Extreme cases may lead to a constant dull pain along with stiffness, swelling, and tenderness of the joint. The symptoms usually occur only in one knee, so if you notice an abnormal lump at the back of the left or right knee, contact your doctor.

Causes: Injury, existing age related chronic degenerative conditions such as osteoarthritis and rheumatoid arthritis

Treatment: Ice pack, OTC pain killers, treatment of the chronic condition (if any)

Blood clotting disorders
Deep vein thrombosis (DVT) is a common blood clotting disorder that causes a noticeable swelling in one leg below the knee, along with dull to severe pain and tenderness in the calf that radiates toward the back of the knee, thigh and groin.

Causes: Blood clots may form in the lower legs due to extended periods of inactivity, such as driving or travelling for a long time, or when in rest after a surgery. Pregnancy and c-section delivery are other risk factors.

Treatment: Blood thinning medications, movement exercise, compression stockings

Pain that aggravates with movement (walking, running and bending of knees) or lack of movement (sitting for a long time)

In the beginning the pain is felt with movement, like when climbing up the stairs, squatting or suddenly standing up from a sitting position. It is also normal to feel it after a long period of inactivity, like when you get out of bed in the morning or after sitting for a long time. Symptoms may include stiffness of the joint, swelling, and tenderness while the area may feel warm when touched. There are three types of arthritis, depending on the causes and the age of onset.

Causes: Wearing of cartilage due to age (osteoarthritis), inflammation due to over-activity of the immune system (rheumatoid arthritis), past injury or trauma (post-traumatic arthritis)

Treatment: Application of ice packs, exercise, anti-inflammatory medications (Tylenol)

Runner’s knee (chondromalacia patella)
Often causes a clicking or grinding sensation in the knee, especially when you are lifting or stretching the leg. Pain may become worse after sitting for prolonged periods or putting pressure on the knee, like standing or exercising for an extended period.

Causes: Repeated stress or injury, or overuse of the knee joint (more common in athletes and sportspeople)

Treatment: RICE therapy, anti-inflammatory medications

Patellar tendinitis
The pain is usually felt behind the kneecap, along with pain and weakness in the calf. Initially, it hurts with activities like walking, cycling or jogging, gradually worsening to considerably reduce the range of movement.

Causes: Tears and inflammation of the patellar tendon due to overuse

Treatment: Stretching and strengthening knee exercises, patellar tendon strap, pain killers (ibuprofen, naproxen sodium)

One sided pain that starts gradually (sneezing or laughing may trigger it), and is accompanied by a numbness or tingling sensation in the legs. The pain usually begins around the lower back and buttocks, radiating towards the knee and lower leg. Occurs more commonly at night and may be severe enough to wake you up from a sleep.

Causes: Occurs as a symptom of other conditions like a slipped disk, spinal stenosis or a pelvic injury. Pregnancy is a common risk factor.

Treatment: Ice packs, OTC pain killers (ibuprofen), treating the causative condition

Sudden sharp or shooting, burning pain behind the knee

Hamstring Injury
Mild hamstring injury (grade 1) is characterized by a sudden, severe pain at the back of the knee, and thigh, making it difficult to straighten and bend the leg. A more severe injury (grades 2 and 3) causes relatively frequent and acute, stabbing pain accompanied by swelling and tenderness. You may also feel a popping sensation when flexing the leg with a pulled hamstring muscle.

Causes: Injury to one of the three hamstring muscles

Treatment: RICE therapy, knee brace, physiotherapy, OTC pain killers (ibuprofen, acetaminophen)

Ligament injuries
It includes injuries to the ACL (anterior cruciate ligament), PCL (posterior cruciate ligament) and MCL (medial collateral ligament), leading to a sudden, stabbing pain around the groin and back of the knee that may radiate toward to lower leg as well. ACL and PCL pains are often accompanied by swelling, inability to put any pressure on the knee joint and feeling like the joint is becoming loose. An MCL injury may cause knee pain with no noticeable swelling.

Causes: Injury, overuse of the knee joint

Treatment: RICE therapy, knee braces, stretching and strengthening exercise, anti-inflammatory pain killers (ibuprofen, aspirin)

Varicose veins are another condition that may lead to pain in your thighs and knees, as well as swelling of the legs and ankles, making your legs feel heavy. You may notice bluish veins running down the back of the legs.

It is also common to develop pain around the sides and back of the knees after an invasive procedure like a knee replacement or a surgery to repair a tear or fracture in a muscle, cartilage or bone in the area.

Causes of pain behind the knees in children

Children often experience pain in their legs due to a blow or fall during play. However, a throbbing pain in their thighs, calves and behind the knees around late evening or at night may indicate a condition called the growing pains. It may occur in toddlers and older children up to 10 to 12 years of age.


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