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HealthInfo Waitaha Canterbury

Knee pain in adults

Mamae ā-turi ki ngā pakeke

Knee pain can happen for many reasons. It can be caused by an injury, disease, infection or overuse. This page covers two less sudden and persistent causes of knee pain – patellofemoral syndrome and Iliotibial band syndrome (also called ITB syndrome).

Other causes of knee pain such as osteoarthritis, bursitis, broken knee bones, broken knee cap, knee cap dislocations, anterior cruciate ligament (ACL) injury and other soft tissue knee injuries are covered on other pages.

The knee is the largest joint in your body. Your upper leg bone (femur) and lower leg bones (tibia and fibula) are connected by ligaments, tendons and muscles to help stabilise your knee as it goes through its normal range of movement.

Patellofemoral or anterior knee pain

Patellofemoral or anterior knee pain is a term used to describe pain in the front of your knee and around your kneecap (also called the patella). It's sometimes called runner's or jumper's knee because it's common in people who take part in sports – particularly females and young adults. But non-athletes can also get patellofemoral or anterior knee pain. It causes pain and stiffness, making it painful to climb stairs, kneel, sit for long periods and do other normal activities.

You can get pain in the front of your knee because of an injury to the kneecap (such as a fall, a direct blow or sudden twisting) or from overuse of the kneecap tendon, which anchors your thigh muscle to your leg.

Iliotibial band syndrome

Iliotibial band syndrome involves inflammation of the Iliotibial band (IT) on the outside of your knee as it rubs against the outside of your knee joint. It's also known as ITB syndrome or ITBFS and is a common condition for runners. Symptoms include pain over the outside of your knee which comes on gradually and gets worse until you have to stop.

A naturally tight or wide IT band may make you more likely to get iliotibial band syndrome. Weak hip muscles are also a common cause.

Diagnosing knee pain

If you have knee pain that is not going away, it’s important that you see your general practice team or physiotherapist for further assessment. They will ask questions about recent injuries and symptoms you've noticed, such as snapping, popping, locking or feeling like your kneecap is popping out of its groove. Most people with knee pain do not need tests such as X-rays or ultrasound scans, but occasionally these tests may be useful to rule out other knee problems.

Treating knee pain

You can return to the physical activities you enjoy doing once the underlying causes of your knee pain have been addressed. You should keep active and do exercises to restore the strength and flexibility in your knee. Avoid the activities that produce your pain. Your physiotherapist will also mobilise your knee to relieve your pain and restore your kneecap's normal movement.

Self-care for knee pain

If your knee is painful, use the RICE treatment for the first 48 hours.

Review your running shoes if your pain occurred because of running. A podiatrist can advise which sort of shoes will be best and whether orthotics could help.

If you smoke, stopping can give you the best chance of healing.

When returning to running:

Pain relief

Paracetamol (Panadol) can help to reduce your pain. Take it for three to four days according to the instructions on the packet. If pain is still a problem after that, consult your health professional.

You can also use anti-inflammatory pain relief, such as ibuprofen (Nurofen) or diclofenac (Voltaren). These medicines are also called non-steroidal anti-inflammatory drugs, or NSAIDs. As well as relieving pain, they limit inflammation.

But NSAIDs can have some serious side effects, especially if you take them for a long time. Two serious side effects are stomach pain and bleeding from your stomach. Some people with asthma, high blood pressure, kidney failure and heart failure might not even be able to take them for a short time. If you aren't sure if you can take NSAIDs, check with your doctor or pharmacist.

Getting help for knee pain

See a physiotherapist to help relieve your pain and restore normal movement with exercises. They will carefully guide you through a programme to return to your normal activities and prevent your knee pain coming back.

If you've tried all the above treatments and your knee pain is not going away, you should return to your general practice team or physiotherapist, as they may refer you to a musculoskeletal specialist.

Written by HealthInfo clinical advisers. Last reviewed July 2022.


See also:

Knee injuries

Pain relief after an injury

Self-care after an injury

Page reference: 470990

Review key: HIHIL-240273