Knee pain: what the location can suggest

Why the location matters

The knee brings together three bones (thighbone, shinbone, kneecap), menisci, ligaments and tendons. According to the Hospital for Special Surgery (HSS) in New York, osteoarthritis can affect one side, both sides or the front of the knee, but pain in a particular spot points to particular causes. The NHS, the UK health service, reminds us not to self-diagnose: the medical examination remains the reference.

Two questions also help: did the pain start after a blow, a twist or an effort, or with no obvious cause? And does it affect one knee or both?

Pain at the front of the knee

According to HSS, most kneecap pain comes from the joint between the kneecap and the thighbone: doctors call this patellofemoral pain syndrome, meaning the kneecap rubs and gets irritated against the thighbone when the joint is overloaded, often from running (see runner's knee), squatting or stairs. Osteoarthritis can also affect this joint. Less commonly, a small fold of the lining inside the knee (a "plica") gets pinched and irritated.

According to the NHS, pain between the kneecap and shin after repeated running or jumping suggests tendonitis. In teenagers and young adults, pain with swelling below the kneecap may be Osgood-Schlatter disease. Read more: runner's knee and tendinopathy.

Pain on the inside of the knee

According to HSS, pain on the inner side may come from:

• the ligament on the inner edge of the knee (medial collateral ligament), after a twist, a blow or overuse;
• osteoarthritis, which most commonly affects the inner part of the joint (see knee osteoarthritis);
• the medial meniscus.

The NHS notes that osteoarthritis tends to cause pain and stiffness in both knees, with mild swelling, and is more common with age. Read more: knee osteoarthritis, understanding the pain.

Pain on the outside of the knee

According to HSS, a frequent cause is iliotibial band syndrome: this band of tissue, running from the hip to the outside of the knee, becomes irritated with running or cycling, often with weak glute muscles. Other possible causes: osteoarthritis of the outer compartment, a lateral meniscus tear or a lateral collateral ligament injury. See also runner's knee.

Pain behind the knee

According to HSS, a common cause is overuse of a muscle, tendon or ligament, for example in running or cycling. Another cause is a Baker's cyst (popliteal cyst), a fluid-filled sac often linked to osteoarthritis. Less commonly: a tear at the back of the meniscus, a compressed nerve, or a deep vein thrombosis (blood clot in a vein).

What to do day to day?

The NHS says knee pain can often be treated at home and you should start to feel better in a few days:

• Go easy on the knee for the first few days by limiting long periods of standing, then gradually walk more.
• Ice, wrapped in a tea towel, for up to 20 minutes every 2 to 3 hours.
• A painkiller such as paracetamol, or ibuprofen gel or tablets: ask your pharmacist for advice.
• Physiotherapy may be suggested by your doctor depending on the cause.

Warning signs: when to seek help without delay

Go to the emergency department if:

• the pain is very strong and sudden, for example after a fall or a twist;
• you cannot move it or put weight on it;
• it is badly swollen or has changed shape;
• it locks, gives way or clicks painfully (painless clicking is normal);
• you have a fever or chills, with a red or hot knee;
• you have calf pain and swelling with shortness of breath or chest pain (a possible sign that a clot has travelled to the lungs).

See your doctor if:

• the pain does not improve within a few weeks;
• you think you have a blood clot but have no breathlessness or chest pain (swollen, painful calf, red or darkened skin): seek advice the same day;
• the knee is warm, red and swells when you kneel.

These situations are the exception. According to the NHS, knee pain can often be treated at home, and you should start to feel better in a few days.

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Looking beyond the knee

The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (X-ray, MRI, reports) and the list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals who follow you, including your physiotherapist or orthopaedic specialist.

Which approaches can play a part at Centre Algos?

Depending on your situation, several approaches can be combined, alongside your medical follow-up:

• Naturopathy: sleep, stress, diet, weight and daily rhythm, to work on the habits that can influence pain.
• Cupping: applied to the thigh and around the knee, it can help release muscle tension.
• Functional biology and micronutrition: an assessment to identify possible nutritional imbalances, to be discussed with your doctor.

Everyone responds differently: the aim is to help you live your days better, without promising a result.

When to seek advice

Sources and further reading

• Hospital for Special Surgery, "Knee Pain" (updated 24 April 2024): causes by location (front, inside, outside, back), swelling, when to see a doctor.
• NHS, "Knee pain" (reviewed 21 December 2023, next review 21 December 2026): home care, urgent signs, table of causes after an injury or with no injury.
• NHS, "DVT (deep vein thrombosis)" (reviewed 30 April 2026): symptoms of a blood clot and when to get urgent help.