What is back knee pain due to

Knee pain

The knee joint does heavy work every day. When running, climbing stairs and even sitting, strong forces act on our largest joint in the body. A well-constructed anatomy guarantees a literally smooth sequence of movements in everyday life. Knee pain affects the quality of life all the more uncomfortably. Find out more about the different types of knee joint pain and where these can occur with which symptoms. In this way, you and your doctor can get to the bottom of the causes of your knee problems and begin the best possible treatment.

Types of knee pain

Often times, when your knees are sore, you will notice a specific spot where the pain is showing. When the symptoms occur, it can also provide information about what is wrong in the joint. In order to better understand and treat your pain, it is classified as follows:

  • place: on the front or back, on the inner or outer side of the knee
  • Duration: acute pain that sets in suddenly and subsides after a few hours or days or chronic pain that builds up slowly and lasts for more than six weeks to three months
  • context: under load or at rest - when running (longer), while sitting, at rest, only at night, during or after certain movements, with bent or stretched knees

Symptoms of knee joint pain

Depending on the cause of the knee joint pain, these can be felt differently.

Acute pain in the knee are shown by:

  • shooting in
  • stabbing
  • oppressive
  • dull
  • convulsive or
  • pulling pains.

Often there are also Restrictions on movement of the knee or feelings of blockage or instability in the knee joint.

External characteristics can also be:

  • inflammatory swelling
  • Redness
  • Overheating and
  • Effusions in the knee joint area.

Chronic pain express themselves with similar symptoms, but usually develop continuously over a period of months or years and increase in intensity over time.

Where can knee pain occur?

Front knee pain

Knee pain in the front and in the areas around the knee joint towards the upper and lower legs can have these causes:

  • The Kneecap (Patella) itself is affected, for example if it shifts, is asymmetrically malformed (patellar dysplasia) or has been dislocated (patellar luxation).
  • The two Tapes (Patellar and quadriceps tendons), which stabilize the kneecap horizontally, can lead to pain, for example from overstretching or straining.
  • Athletes often suffer from patellar tendon syndrome, the Overload of the patellar tendon below the kneecap.
  • Arthrosis behind the kneecap (retropatella arthrosis) or in the knee joint gap can be responsible for knee problems if the bones rub against each other there.
  • Bursitis can be painful in the front of the knee.

Front view of the kneecap and ligamentous apparatus of the knee

Pain in the back of the knee

If there is pain in the back of the knee joint, it is known as popliteal pain. The reasons for this are:

  • Damage to the Ribbons, for example the cruciate ligaments.
  • There may also be a so-called Baker's cyst. It collects Joint capsular fluid in a cyst in the back bursa of the knee joint - the knee swells and the back of the knee is painful and tight, especially when stretching or flexing the joint.
  • The posterior meniscus may be damaged and the pain is sharp.
  • Knee osteoarthritis can also cause pain in the hollow of the knee; this pain is rather dull along the back of the thigh.
  • A rare cause of back knee pain can be thrombosis, in which the leg also swells and turns red or bluish in color. If some risk factors (such as lack of exercise, obesity, blood clotting disorders or varicose veins) apply to you, then popliteal pain should also be clarified with your doctor in these directions.

The inside of the knee joint hurts

Pain on the inside of the knee joint is known as internal knee joint pain or medial knee pain:

  • These usually concern the internal knee joint gap as well as the inner thighs and lower legs with the surrounding soft tissues.
  • Often they occur when there is damage to the medial meniscus or a Inner ligament injury of the knee.
  • Also one arthrosis or inflamed Bursa on the inside of the knee joint can be responsible for internal knee pain.
  • Other possible causes of discomfort on the inside of the knee are misalignments such as the bow legs.

The knee joint viewed from the side © bilderzwerg / Fotolia

The outside of the knee hurts

External knee pain is also known as lateral knee pain. They affect the outer ligament and fibula head, the outer knee joint space and the outer thighs and lower legs including the surrounding soft tissues. These complaints are triggered by:

  • a Ligament injury of the knee or injuries to the external meniscus,
  • Misalignments of the knee, such as knock knees,
  • a wear (Osteoarthritis) of the external knee joint space,
  • constant overstressing of the knee in athletes such as long-distance runners and cyclists. This leads to irritated or worn tendons in the knee and the so-called runner's knee.


Why do knee joint problems occur?

Knee joint pain can be attributed to a wide variety of causes. These include illnesses, injuries, misalignments and excessive or incorrect strain on the knee. You can get an overview of the causes of knee pain here:

  • The wear of the articular cartilage, i.e. osteoarthritis of the knee joint, in which the joint surfaces painfully rub against each other.
  • Inflammation of the knee joint, like thatKnee arthritis (also: gonarthritis). A distinction is made between rheumatoid arthritis (joint rheumatism), infection-related and post-traumatic arthritis.
  • Excessive and improper strain on the knee joint, among other things through being overweight or exercising excessively.
  • Muscle shortening in the thigh and lower leg cause constant tension on the knee joint, making optimal mobility difficult.
  • Knee injuries and knee misalignments such as knock knees or bow legs can be permanent due to the uneven load on the knee lead to an increasing restriction of movement. Pain then initially only occurs under stress and later also in a state of rest.
  • The stiff knee, where the knee has very limited mobility and is very painful.
  • If the stabilizing ligaments of the knee joint are damaged, knee instability also occurs.
  • Damage to the Tapes, for example a partial or complete cruciate ligament tear (cruciate ligament rupture) or a meniscus tear, leads to acute and shooting pain at the moment of the rupture (tear). If the meniscus is damaged by wear and tear (degenerative wear), knee pain occurs on the inside or outside of the knee, depending on which meniscus is affected.

Menisci and cruciate ligaments in the knee joint, view from above © bilderzwerg / Fotolia

Diagnosis of knee pain

In order to be able to treat knee joint pain properly, it is first important to clearly identify the cause of the knee pain. In the first and most important step, you will be examined by the treating doctor, either your family doctor or an orthopedic specialist. He can do different Movement testsperform with you. Most of the time you lie on a treatment couch and the doctor guides your legs one after the other into certain standardized positions. The doctor can refine his diagnosis depending on when exactly you are in pain or whether the movement is even possible.

After the thorough physical exam, introduce you to the doctor Anamnesis interview. To make a diagnosis, the doctor needs all the information about your pain and has the following questions for you:

  • How does the knee pain feel exactly?
  • Where exactly in the knee (front, back of the knee, inside or outside) are you observing the pain?
  • Since when do you notice your knee pain?
  • Is the pain worse under exertion or at rest?
  • Have you already had an injury or an accident?
  • Do you have certain pre-existing conditions?

Following this, you will usually be presented with adiagnostic imaging examined. This can be done using x-rays, ultrasound (sonography) or magnetic resonance imaging (MRT). In this way, the doctor can assess your bony structures of the knee joint as well as the ligaments, menisci and articular cartilage more precisely.

If an inflammation of the knee joint is suspected, a joint puncture can also be performed. Joint fluid is taken from the joint capsule for further laboratory analysis.

Treatment of knee pain

Depending on the cause of the pain in the knee joint, different therapy options are available. If you have acute pain, take a break and watch closely where and when the pain occurs. Cooling with an ice pack can provide initial relief.

Conservative therapy

In most cases, treatment is initially carried out with conservative, i.e. non-surgical, measures. This includes in particular the physical therapy and the medical therapy with anti-inflammatory and analgesic drugs. The therapist and attending physician adapt both measures individually to your complaints. Specially made orthopedic shoe insoles can also help relieve pressure on the knee joints in the event of misalignment of the feet and thus reduce pain.

Another important component of your knee health is a good balance between rest and exercise. With every flexion and extension of the knee, the important cartilage layer is supplied with nutrients from the synovial fluid. Gently move your knee joints once you can do this without any major pain. In this way you “lubricate” your joints and make them fit for everyday life.

Surgical treatment of knee pain

If the conservative measures do not bring you relief from the pain in the knee joint, knee surgery may be considered. One of the minimally invasive procedures is Knee arthroscopy(Arthroscopy), in which the keyhole technique can be used to repair a malalignment of the kneecap, damaged ligaments or menisci in the knee. In cartilage cell transplantation, cartilage cells are grown from an endogenous piece of cartilage and inserted into the knee joint cartilage.

If all of these joint-preserving therapy options have failed, the last step is to consider implanting an artificial knee joint. Joint replacement, i.e. a knee endoprosthesis, is particularly suitable for osteoarthritis of the knee. Depending on the disease, the knee surgeon chooses a partial prosthesis (e.g. a sled joint) or a full prosthesis, which will also be Knee replacement (Total endoprosthesis) called. This knee replacement replaces the joint head and the joint socket of the affected knee.

A knee prosthesis as a joint replacement © alexonline / Fotolia

Knee operations are usually performed as an inpatient and under partial or general anesthesia. You will then stay in the hospital for 6 to 10 days. A knee operation is usually followed by rehabilitation measures and aftercare programs so that you can quickly find your way back to your everyday life - with more mobility and quality of life. Your doctor will review and discuss this treatment option with you.