Aching knees can be caused by damage to knee cartilage, ligaments, tendons, or other muscle tissues. The most common cause of achy knee pain include a meniscal injury, patellofemoral pain syndrome, or runner's knee. Read on for more information on causes and treatment options.
Dull, achy knee pain symptoms
The knee is the largest and most stressed joint in the body. It is a complex system of bones, cartilage, ligaments, tendons, and muscles responsible for weight-bearing and movement.
The knees are used for walking, stepping, sitting, even standing as a result, the knee is susceptible to various conditions that can cause dull or achy pain.
Common accompanying symptoms of dull, achy knee pain
Dull, achy knee pain is often a sign of a chronic condition. Associated symptoms are very similar to those of temporary/acute conditions such as:
- Redness or warmth to the touch
- Inability to fully extend or flex the knee
- A sensation of instability or "giving out" of the knee
- Popping noises upon movement
- Inability to bear weight on the knee especially after strenuous activity
Nevertheless, chronic knee pain is very different from acute pain and also requires evaluation from your physician.
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Causes of dull, achy knee pain
Unlike acute conditions, dull achy knee pain is not usually the result of one singular incident. It is often the result of multiple causes that involve stress, inflammation or untreated injury to the multiple components of the knee.
The components of the knee include:
- Bones: The femur (thigh bone), patella (kneecap) and tibia (shin bone). The actual knee joint works to keep these bones securely in place.
- Cartilage: The meniscular and articular cartilage act as cushions around the bones of the knee that reduce friction during movement and help the bones move smoothly against each other. There is a medial meniscus on the inner side of the knee and a lateral meniscus on the outer side of the knee.
- Ligaments: The knee has four ligaments that connect bones to other bones and promote stability. They are the medial collateral, lateral collateral, posterior cruciate and anterior cruciate ligaments. These ligaments prevent the side-to-side movement of the femur as well as excessive backward and forward movement of the femur and tibia.
- Tendons: Tendons are like ligaments but connect bone to muscle (instead of bone to bone). The patellar tendon is the largest tendon of the knee and attaches the quadriceps to the patella and then the patella to the tibia.
- Fluids: The joint capsule and bursa are fluid-filled membranes that lubricate the joint and reduce friction.
If any component of the knee is not working properly, the other parts of the knee will try to compensate and the resultant stress will inevitably result in chronic issues. Furthermore, since the knee is so susceptible to injury the bones of the knee can become fractured, ligaments and tendons can become sprained or torn, and cartilage can twist it is important to address problems early to prevent problems in the future.
Arthritis is the general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Arthritis can affect the bones and fluid-filled areas of the knee resulting in significant irritation that can cause chronic stiffness, discomfort, and dull, achy pain.
Musculoskeletal causes of dull, achy knee pain may be related to the following:
- Biomechanics Problems in the way in which the parts of the knee work together due to weakness in the gait while walking or form while running can result in chronic knee pain, especially if not followed-up. Such problems can result in conditions such as Iliotibial band syndrome that can cause dull, achy knee pain.
- Mechanical: Issues in the knee such as loose bones or cartilage in the joint space and dislocations of the actual kneecap can also result in chronic knee issues and pain.
This list does not constitute medical advice and may not accurately represent what you have.
Jumper's knee (patellar tendonitis)
Jumper's knee is also called patellar tendinitis or patellar tendinopathy. It is an inflammation of the patellar tendon, which runs from the bottom of the patella – or kneecap – to the top of the shinbone.
It is most often an overuse injury seen in athletes, especially those in sports involving jumping, but it can affect anyone. Strenuous physical activity without warming up first, or tightness and inflexibility in the muscles of the thighs, can put additional strain on the patellar tendon.
Symptoms include pain just below the kneecap. At first it may only appear during exercise, but later becomes chronic as the tendon becomes more damaged and inflamed. Eventually the pain interferes with normal movement.
It is important to get treatment, as the condition will not heal on its own and will only get worse through forced movement.
Diagnosis is made through patient history, physical examination, and imaging such as ultrasound or x-ray.
Treatment involves rest; pain relievers; physical therapy to return flexibility to the tendon; and sometimes corticosteroid injections or surgery.
Top Symptoms: pain in one knee, spontaneous knee pain, knee pain that gets worse when going up stairs, knee stiffness, knee pain that gets worse when squatting
Urgency: Primary care doctor
The menisci are the two pieces of cartilage serving as shock absorbers in the knee, between the lower end of the thighbone and the top of the shinbone. A torn meniscus is commonly referred to as "torn cartilage" in the knee.
Damage to a meniscus often happens along with another injury to the knee, especially when there is any forceful, twisting movement or a direct hit such as a tackle.
Older people may tear a meniscus through normal activity if the cartilage has become thin and worn due to aging.
Symptoms include pain, stiffness, and swelling. The knee will simply not work correctly and may catch, lock up, or give way.
Diagnosis is made through patient history, physical examination, simple motion tests, and imaging such as x-ray or MRI.
Depending on the exact form of the injury, the tear may be allowed to heal on its own with supportive care such as rest, ice, and nonsteroidal anti-inflammatory pain medication. In other cases, arthroscopic surgery followed by rehabilitation may be needed.
Top Symptoms: pain in one knee, knee stiffness, knee instability, pain in the inside of the knee, swollen knee
Urgency: Primary care doctor
Patellofemoral pain syndrome
Patellofemoral pain syndrome (PFPS) is also called runner's knee, jumper's knee, anterior knee pain, chondromalacia patella, and patellofemoral joint syndrome.
Overuse through training for sports is a common cause, especially if there is a misalignment in the knee joint or a previous knee injury. This wears away the cartilage beneath the kneecap and causes pain on exercising.
It is most common in females and in young adults who are active in sports, but can affect anyone.
Symptoms include dull pain at the front of the knee and around the kneecap (patella) while running, squatting, or climbing stairs, or after prolonged sitting with knees bent.
Diagnosis is made through physical examination and through x-rays, CT scan, and/or MRI.
Treatment most often involves rest; over-the-counter pain relievers; low-impact exercise such as swimming or bicycling; physical therapy to strengthen and stabilize the knee; and orthotics (shoe inserts) to help correct a misaligned stride.
Surgery is needed only for severe cases, and is done through arthroscopy to remove any fragments of damaged cartilage.
Top Symptoms: knee pain, pain in one knee, knee pain that gets worse when going up stairs, dull, achy knee pain, knee pain that gets worse when squatting
Symptoms that always occur with patellofemoral pain syndrome: knee pain
Urgency: Primary care doctor
Iliotibial (it) band syndrome ('runner's knee')
Iliotibial band syndrome is also called ITBS or IT syndrome. The iliotibial band is a long, thick piece of connective tissue that begins at the top of the hip bone, runs down the outside of the leg, and attaches at the side of the knee.
ITBS is an overuse syndrome. Athletes in heavy training are susceptible to it, especially runners and cyclists. Pain and inflammation result if the far end of the iliotibial band constantly rubs against the outside of the knee joint.
Symptoms include pain on the outside of the knee, especially while running or while sitting with the knee flexed.
Diagnosis is made through patient history and physical examination, with simple stretching tests to identify the exact location of the pain. An MRI is sometimes ordered.
Treatment involves rest; ice; over-the-counter nonsteroidal anti-inflammatory drugs; stretching exercises for the iliotibial band; strengthening of the upper leg muscles; and, if needed, changes in the way the person strides or trains. Corticosteroid injections can be helpful and surgery may be tried in some cases.
Top Symptoms: knee pain, pain in one knee, dull, achy knee pain, knee pain that gets worse when going down stairs, sharp knee pain
Symptoms that always occur with iliotibial (it) band syndrome ('runner's knee'): knee pain
Urgency: Primary care doctor
Infrapatellar bursitis is an inflammation of the bursa, or small cushioning sacs, beneath the patella, or kneecap. The condition may affect either the superficial bursa or the deep bursa.
Superficial infrapatellar bursitis is found in those whose work requires them to kneel on hard surfaces, and so it is known as housemaid's knee, clergyman's knee, parson's knee, or vicar's knee.
Deep infrapatellar bursitis can occur from chronic overuse, as with sports training and other hard physical work.
Either form of the condition can also be caused by hemorrhage, infection, traumatic injury, or inflammatory diseases such as arthropathy. Some cases may be idiopathic, meaning they occur in a particular individual for no clear reason.
Symptoms include swelling of the knee and pain below the kneecap.
Diagnosis is made through patient history and physical examination as well as x-ray, CT scan, or MRI.
Treatment involves rest; heat; nonsteroidal anti-inflammatory drugs to reduce pain and swelling; a knee brace; and sometimes corticosteroid injections into the knee.
Top Symptoms: pain in one knee, spontaneous knee pain, dull, achy knee pain, knee pain that gets worse when going up stairs, knee pain that gets worse when squatting
Baker's cyst (popliteal cyst)
A Baker's cyst, also called as Popliteal cyst, is a fluid-filled mass that causes a bulge and a feeling of tightness behind the knee. The pain can get worse when the knee is fully flexed or extended.
Top Symptoms: calf pain, swollen knee, knee pain that gets worse when squatting, knee instability, dull, achy knee pain
Symptoms that always occur with baker's cyst (popliteal cyst): lump on the back of the knee, constant knee lump
Urgency: Primary care doctor
Arthritis is inflammation of one or more of the joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.
Top Symptoms: pain in both knees, knee stiffness, knee instability, swollen knee, morning joint stiffness
Symptoms that always occur with knee arthritis: pain in both knees
Urgency: Primary care doctor
Knee bursitis (pes anserine bursitis)
Pes anserinus means "goose's foot. In this case it refers to the appearance of the three pes anserinus tendons which lie together at the inside of the knee, about two inches below the level of the kneecap.
Pes anserine bursae are small cushion-like structures which lie between the tibia, or shinbone, and the pes anserinus tendons. Inflammation of these bursae is called pes anserine bursitis.
Bursitis is most often caused by overuse. Pes anserine bursitis is found in runners, especially when training without sufficient warmup. It can also occur where there is osteoarthritis of the knee; a knee that turns outward; or obesity.
Symptoms include pain, tenderness, and swelling of the bursa, especially with climbing stairs or other exercise.
Diagnosis is made through physical examination and x-ray.
Treatment involves rest; ice; nonsteroidal anti-inflammatory drugs for pain and swelling; physical therapy; and sometimes corticosteroid injections into the injured bursa. Surgery may be done if conservative measures do not help.
Top Symptoms: pain in one knee, knee pain that gets worse when going up stairs, spontaneous knee pain, knee pain that gets worse when going down stairs, knee pain that gets worse when standing up
Symptoms that always occur with knee bursitis (pes anserine bursitis): pain in one knee
Repeated kneecap dislocation (patellar subluxation)
Recurrent patellar subluxation is the continued instability of the kneecap, which causes anterior knee pain and usually occurs laterally. It occurs unpredictably with varying durations.
Top Symptoms: pain in one knee, dull, achy knee pain, pain in the front of the knee, pain in the inside of the knee, swollen knee
Symptoms that always occur with repeated kneecap dislocation (patellar subluxation): kneecap dislocation
Urgency: Primary care doctor
This condition is a common cause of knee pain amount children and adolescents who play sports, and usually affects children 16 and younger. Osgood-Schlatter Disease usually develops due to overuse of the large quadriceps (quad) muscle which makes up the front of the thigh. The muscle pulls on the kneecap and the kneecap (patellar) ligament, which attaches to the upper part of the shin bone (tibia). With overuse, redness and soreness may develop in the knee.
Top Symptoms: knee pain, knee pain that gets worse when squatting, pain in one knee, knee pain that gets worse when kneeling, knee pain that gets worse during a run
Symptoms that always occur with osgood-schlatter disease: knee pain
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Dull, achy knee pain treatments and relief
Chronic pain requires professional medical attention. There are a variety of measures that can be taken with advice from a medical professional described below, including treatments that can be done at home.
Treatment depends on your specific diagnosis and the extent of your symptoms and may include one or all of the following:
- Physical therapy or rehabilitation: Your physician may prescribe stretching exercises or a physical therapy/rehabilitation program to help you restore range of motion, strength, and stability to your knee. A physical therapist can assess problems with your walking gait, running pattern, and other musculoskeletal issues and develop a rehabilitation plan that is best for you.
- Non-inflammatory medications: Your physician may prescribe this type of medication to combat arthritic processes that are causing chronic knee pain.
- Surgery: If at-home remedies and medication options from your physician do not provide relief, you and your physician may look into surgical options.
In addition to your physician's treatment suggestions above, there are many measures you can take in your daily life to prevent the development of chronic pain:
- Maintain a healthy weight: The knees bear all of the body's weight, so extra pounds can cause unnecessary stress and strain, increasing the risk of injury.
- Be strong and flexible: The quadriceps and hamstring muscles provide support to the knee joint, so keeping them strong, conditioned, and flexible will benefit the functioning of the knee as a whole.
- Practice technique: If you participate in competitive sports and practice often, ensure that your techniques and movements are not putting unnecessary stress on your knees. Work with a coach to ensure that when your run, jump or move side-to-side, your knee is in the best position to prevent injury.
- Listen to your body: If you find yourself experiencing mild or transient knee pain after certain activities, listen to your body and take a break! Rest, ice and elevate your knee once you first notice symptoms and make an appointment with your physician promptly.
Questions your doctor may ask about dull, achy knee pain
- Is the knee pain affecting one or both knees?
- Do you often feel your knees buckling?
- Where is your knee pain?
- What is your body mass?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Blahd WH, Romito K, eds. Knee Problems and Injuries. University of Michigan: Michigan Medicine. Updated November 20, 2017. UofM Health Link
- Khaund R, Flynn SH. Iliotibial Band Syndrome: A Common Source of Knee Pain. American Family Physician. 2005;71(8):1545-1550. AAFP Link
- Medications for Treatment of Knee Pain and Arthritis. Arthritis Foundation. Arthritis Foundation Link
- Hurley M, Dickson K, Hallett R, et al. The Health Benefits of Exercise for People with Chronic Hip and Knee Pain From Osteoarthritis. Published April 17, 2018. Cochrane Link