Knee Pain Location Chart

Knee pain is an issue that affects many people across various age groups, often hindering daily activities and impacting the quality of life. The location of the pain can play a critical role in diagnosing its cause, which in turn aids in deciding the most effective treatment plan. 

This article aims to provide a guide to understanding the meaning behind the location of knee pain, its causes, and answers to commonly asked questions about knee pain.

Pain Above the Knee

Pain above the knee, often referred to as ‘thigh pain,’ is frequently a result of issues with muscles, ligaments, tendons, and other soft tissues connected to the knee joint. This pain can be sharp, dull, intermittent, or constant, sometimes radiating down the knee and into the lower leg.

Key causes of pain above the knee include:

1. Quadricep or hamstring tendinitis occurs when the tendons that attach your quadriceps or hamstrings (the muscles at the front and back of your thigh) to your bones become inflamed. Overuse from activities like running or jumping, direct injuries, or age-related wear and tear can lead to tendinitis. You may experience a dull ache, especially when moving the knee or thigh.
2. Arthritis: Arthritis of the knee or hip can lead to pain above the knee. Osteoarthritis, the most common form of arthritis, happens when the protective cartilage cushions the ends of your bones and wears down over time. It can cause pain, swelling, and stiffness in the area above the knee.
3. Bursitis: Bursae are small, fluid-filled sacs cushion the muscles, tendons, and bones near your joints. Knee bursitis occurs when one or more of these bursae become inflamed, causing pain above the knee.

Additional causes of pain above the knee can include:

1. Muscle Strains: Strains to the quadriceps or hamstring muscles are common, particularly in athletes and active individuals. These strains can result from overstretching or tearing the muscle fibers and can cause pain and tenderness above the knee, as well as potential swelling or bruising.
2. Stress Fractures: Stress fractures are tiny cracks in the bone that can occur over time due to overuse or repeated impact. In the upper part of the shinbone or lower part of the thighbone, stress fractures can result in pain above the knee.
3. Hip Conditions: Issues in the hip, like hip arthritis, hip impingement, or hip labral tears, can sometimes result in referred pain that’s felt above the knee.
4. Nerve Impingement: Conditions like meralgia paresthetica, where the lateral femoral cutaneous nerve is compressed, can cause tingling, numbness, and pain in the outer thigh, potentially extending towards the knee.

Pain at the Kneecap

Kneecap pain, also known as patellar pain, can feel like a general ache, a sharp pain, or a severe burning sensation. The kneecap, or patella, is a bone that covers your knee joint. It plays an essential role in protecting the joint and enhancing leg muscle leverage. Because it’s in the center of the knee joint, the kneecap can be prone to injuries and conditions that cause pain.

Key causes of pain at the kneecap include:

1. Patellofemoral syndrome: Commonly known as “runner’s knee,” this condition results from stress on the knee joint, often due to an abrupt increase in physical activity. This strain can irritate the nerves of the kneecap, leading to a dull, aching pain around the patella.
2. Chondromalacia patellae: This condition involves the deterioration of the cartilage beneath the kneecap. Without sufficient cartilage to cushion the kneecap, it can grind against the thigh bone, causing pain and inflammation.
3. Patellar tracking disorder: This condition occurs when your kneecap is not aligned correctly and moves out of position when the leg bends or straightens. This misalignment can put extra stress on certain parts of the knee joint, leading to pain.

Further causes of kneecap pain encompass:

1. Patellar instability: Also known as patellar subluxation, this is a partial dislocation of your kneecap. It can cause sudden, severe pain and a feeling that your knee may “give out.”
2. Hoffa’s fat pad impingement: This condition affects a layer of fatty soft tissue under your kneecap. Overuse or trauma can cause it to become pinched (“impinged”) between the kneecap and femur, leading to inflammation and pain.
3. Patella stress fracture: This occurs when a hairline break in the patella bone, usually due to overuse or high-impact activities, causes persistent pain and discomfort.
4. Patellofemoral osteoarthritis: This type of arthritis affects the underside of the patella and the groove in the femur in which the patella sits, resulting in pain, stiffness, and loss of function.
5. Patellar Tendinitis: This is an inflammation or injury to the tendon connecting your kneecap to your shinbone. Known as “jumper’s knee,” it’s commonly seen in sports that involve jumping and landing.

Pain on the Inner Side of the Knee (Medial Pain)

Pain on the inner side of the knee, also known as medial knee pain, is often caused by the deterioration of cartilage due to injuries, overuse, or underlying health conditions. This pain can manifest as a dull ache, sharp pain, or even a burning sensation, affecting mobility and overall quality of life.

Some of the key causes of medial knee pain include:

1. Medial collateral ligament (MCL) injury: The MCL runs along the outside of your inner knee to stabilize the joint. If overstretched due to injury or sudden movement, it can lead to an MCL sprain or tear, causing pain, swelling, and instability.
2. Meniscus injury: The meniscus is a C-shaped piece of cartilage providing a cushion between your thighbone and shinbone. When your knee is twisted or put under excessive pressure, it can lead to a meniscus tear. This condition is often associated with pain, stiffness, and difficulty moving your knee normally.
3. Pes anserine bursitis: This condition involves inflammation of the bursa located between the shinbone and three tendons of the hamstring at the inside of the knee. It can cause pain, swelling, and tenderness on the inner part of your knee, just below the joint.

Further causes of medial knee pain include:

1. Plica syndrome: The plica is a fold in the membrane surrounding your knee joint. An injury or inflammation to the plica can cause plica syndrome, marked by pain, clicking, or a sense of catching on the inside of the knee.
2. Knee contusion: A direct blow to the knee can cause a bruise or contusion, leading to immediate pain, swelling, and discoloration.
3. Osteoarthritis: This degenerative joint disease damages the cartilage, causing the bones in your joints to rub together. Symptoms include pain, swelling, and stiffness, especially first thing in the morning or after a period of inactivity.
4. Rheumatoid arthritis (RA): RA is an autoimmune condition that affects the lining of your joints, leading to inflammation, pain, and swelling. Over time, it can lead to joint deformity and erosion of the surrounding bones.
5. Gout: This type of arthritis occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Gout most commonly affects the big toe, but it can also occur in the knee.

Pain on the Outer Side of the Knee (Lateral Pain)

Pain experienced on the outer side of the knee, or lateral knee pain, can stem from various sources, including injuries, overuse, or underlying health conditions. It can be accompanied by symptoms such as swelling, stiffness, instability, and difficulty in moving the knee.

Below are some common causes of lateral knee pain:

1. Iliotibial band syndrome (ITBS): The iliotibial band is a strip of connective tissue that runs down the outside of the thigh, from the hip to the shinbone. ITBS occurs when this band becomes tight or inflamed, usually due to overuse from activities such as running or cycling. The pain usually worsens with continued movement and improves with rest.
2. Lateral collateral ligament (LCL) injury: The LCL is a ligament located on the outer side of the knee, providing stability to the joint. It can become strained, sprained, or torn due to direct impact or a sudden twist, causing pain and swelling.
3. Lateral meniscus tear: The meniscus is a piece of cartilage providing a cushion between your thighbone and shinbone. A tear in the outer part of this cartilage can cause pain, swelling, and a sense of instability in the knee.

Additional causes of lateral knee pain include:

1. Lateral tibial plateau fracture: This condition occurs when the top of the shinbone (tibial plateau) suffers a break or crack. It often results from high-energy trauma, like a fall or car accident. Symptoms include severe pain, swelling, and inability to bear weight on the affected leg.
2. Arthritis: Osteoarthritis and rheumatoid arthritis can both affect the outer side of the knee, causing pain, swelling, and reduced mobility.
3. Bursitis: Bursae are small, fluid-filled sacs that cushion the joints. Inflammation of the bursa on the outer side of your knee can lead to pain, particularly when moving the joint or applying pressure.
4. Popliteal Cyst or Baker’s Cyst: This is a fluid-filled cyst that forms at the back of the knee, causing pain and stiffness. It is often associated with other knee conditions like arthritis or cartilage tears.
5. Nerve entrapment: The peroneal nerve, located near the outer part of the knee, can become compressed or trapped, leading to pain, numbness, or weakness in the knee.

Pain Below the Knee

Pain below the knee often stems from conditions affecting the tendons and bones in the lower knee and upper shin region. Such discomfort can be sharp or dull, chronic or acute, and may be worsened by specific activities, particularly those involving substantial leg use.

Here are some prevalent causes of pain below the knee:

1. Patellar tendinitis: Also known as “jumper’s knee,” this condition arises from an injury to the tendon connecting your kneecap to your shinbone. It is common among athletes who frequently jump, such as basketball and volleyball players. Symptoms include pain directly below the kneecap, especially when running, jumping, or climbing stairs.
2. Osgood-Schlatter disease: This condition typically occurs during growth spurts in adolescence. It causes inflammation where the tendon from the kneecap attaches to the shinbone, leading to a painful lump below the knee that worsens with activity and improves with rest.

Further causes of pain below the knee can include:

1. Osteochondritis dissecans (OCD): This condition occurs when a lack of blood flow leads to the death of bone tissue, resulting in bone collapse and cartilage damage. Symptoms include pain, swelling, and joint popping.
2. Sinding-Larsen-Johansson syndrome: Common in physically active children and adolescents, this condition is caused by stress on the area at the bottom of the kneecap, leading to swelling and pain below the knee.
3. Shin splints: This common exercise-related problem occurs when the muscles, tendons, and bone tissue around the shinbone become inflamed. Pain is usually along the inner part of the shinbone, below the knee.
4. Stress fractures: Repetitive strain or overuse can cause small cracks in the bones of the lower leg or feet. This results in aching pain that usually increases over time.
5. Peripheral artery disease (PAD): This circulatory condition, where narrowed arteries reduce blood flow to the limbs, can cause pain below the knee, often accompanied by leg fatigue and cramping.
6. Baker’s cyst: Although typically causing pain behind the knee, a Baker’s cyst can sometimes cause pain in the area below the knee. The cyst is a fluid-filled sac that forms due to excess joint fluid.

Pain Behind the Knee

Experiencing pain behind the knee can be a result of various conditions. Some are connected with overuse or strain, while others may be due to more serious underlying health problems. This pain might present as a persistent ache, a sharp stab, or a dull throbbing sensation, varying according to the root cause.

Here are some common reasons why you might feel pain behind the knee:

1. Baker’s cyst: A Baker’s cyst is a fluid-filled sac that arises due to an excess of synovial fluid, which naturally lubricates the knee joint. This cyst forms in the popliteal space, the small indentation located behind the knee, often causing pain and stiffness.
2. Hamstring tendinitis: This condition occurs when there is inflammation or degeneration in the tendons of the hamstring muscles located at the back of the thigh. Symptoms can include pain in the back of the knee and upper leg, especially when walking or bending the leg.
3. Popliteal artery entrapment syndrome (PAES): PAES is a rare vascular disease that affects the legs, particularly in young athletes. This condition can cause pain behind the knee and calf discomfort, particularly during exercise.

Additional causes of pain behind the knee include:

1. Arthritis: Osteoarthritis and rheumatoid arthritis can cause pain behind the knee. The chronic inflammation of these conditions can lead to pain and swelling in all areas of the knee, including the back.
2. Deep Vein Thrombosis (DVT): DVT is a blood clot that forms in a vein deep inside your body, usually in the lower leg or thigh. It can cause pain, swelling, and warmth in the back of the leg.
3. Gastrocnemius tendinitis: This condition causes inflammation or degeneration in the tendon of the calf muscle, causing pain behind the knee, especially when stretching the calf or bending the foot upwards.
4. Posterior cruciate ligament (PCL) injury: The PCL is one of the four main ligaments in the knee and is most often injured due to a blow to the knee while it’s bent, causing pain and instability in the knee.
5. Calf cramps: Although calf cramps usually cause pain in the lower leg, they can sometimes be felt up to the back of the knee.
6. Meniscal tear: Tears in the meniscus, a piece of cartilage providing a cushion between the thighbone and shinbone, can cause pain, stiffness, and swelling, potentially affecting the back of the knee.

Other Conditions that Lead to Knee Pain

Beyond the localized knee pain, there are other conditions that can contribute to knee discomfort in a more generalized way. Here are some of them:

1. Lupus: This autoimmune disease can cause inflammation in various parts of the body, including the joints. It can lead to pain, stiffness, and swelling when it affects the knees.
2. Gout: Gout is a type of inflammatory arthritis caused by high levels of uric acid in the blood, which can form crystals in the joints. While the big toe is often the primary target, gout can also affect the knees, leading to severe pain and swelling episodes.
3. Infectious arthritis: Also known as septic arthritis, this is a painful infection in a joint, including the knee. The condition is usually caused by bacteria, but it can also result from a fungal or viral infection, leading to inflammation, swelling, and pain in the knee.
4. Knee bursitis: Bursae are small fluid-filled sacs that reduce friction between moving parts in the body’s joints. If the bursae in the knee become inflamed, this can lead to knee bursitis, causing pain, swelling, and difficulties in movement.
5. Bone tumors: While rare, both benign and malignant bone tumors can occur in the knee, causing pain, swelling, and a range of other symptoms.

Remember, a healthcare provider should always evaluate persistent knee pain to ensure proper diagnosis and treatment. Don’t hesitate to seek medical attention if you’re experiencing ongoing discomfort in your knee.

When is Knee Pain Normal, and When is it Serious?

While occasional knee pain after intense physical activity can be normal, persistent or severe knee pain is not. Suppose you experience chronic knee pain, significant swelling, redness, or warmth around the joint, inability to straighten or bend the knee fully, or a noticeable deformity. In that case, it’s essential to seek medical attention. These could be signs of a serious condition requiring immediate treatment.

Recovery from Knee Pain

The time it takes to heal from knee pain largely depends on the cause and severity of the condition. Minor injuries may heal within a few weeks with rest, ice, compression, and elevation (RICE). In contrast, more severe or chronic conditions, like arthritis, may require long-term management strategies, including medication, physical therapy, and in some cases, surgery.

The Role of Stress in Knee Pain

While stress itself does not cause knee pain, it can exacerbate the symptoms of knee pain. Chronic stress can lead to tension in the muscles, which can contribute to pain. Moreover, stress can affect the immune system, potentially worsening symptoms of autoimmune disorders like rheumatoid arthritis.

Conclusion

Understanding the location of knee pain can help identify potential causes and appropriate treatments. Whether it’s an injury, a chronic condition, or a symptom of overuse, addressing knee pain early can help prevent long-term damage and disability. Always consult a healthcare professional if you have persistent or severe knee pain. Remember, no amount of self-diagnosis can substitute for a professional medical opinion.