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Knee Stiffness: Why You Have Knee Stiffness & At-Home Relief to Try

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Last updated March 9, 2022

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Understand your knee stiffness symptoms, including 8 causes & common questions.

Knee stiffness quiz

Take a quiz to find out what's causing your stiffness.

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Knee stiffness symptoms

The knee is the largest and most stressed joint in the entire human body. It is a complex system of bones, cartilage, ligaments, tendons and muscles responsible for weight-bearing and movement. The knees are used for every movement walking, stepping, sitting, and even standing as a result, the knee is susceptible to various conditions that can cause knee stiffness symptoms and discomfort.

Most people, regardless of age, experience knee stiffness symptoms and discomfort at some point in their lives. In fact, knee pain accounts for one-third of musculoskeletal complaints to primary care providers in the U.S.. Older individuals may experience knee pain and discomfort due to multiple age-related conditions, and younger individuals may experience similar symptoms due to sports or other physical activities.

Common accompanying symptoms of knee stiffness

Regardless of the cause, you may also experience other symptoms in addition to knee stiffness symptoms:

  • Pain
  • Swelling
  • Fluid in the joint
  • Redness or warmth to the touch

Usually stiffness in the knee is easily treated and not a sign of serious injury. However, knee stiffness symptoms can be associated with trauma and severe damage.

Other common symptoms that accompany knee stiffness or injury

You may also experience the following if you have injured your knee.

  • Inability to bear weight on the knee
  • Sensation of instability: Or "giving out" of the knee
  • Popping noises upon movement
  • Visible deformity

If you notice stiffness in the knee and any of these associated symptoms, make an appointment with your doctor promptly.

What causes knee stiffness?

Stiffness in the knee happens due to inflammation or injury to the components of the knee. Knee stiffness is always the result of an underlying problem and should always be seen by a physician.

Knee structure

See this image for a visual representation of the many components of the knee and how they connect and work together. 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 meniscal and articular cartilage act as cushions around the bones 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: 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.
  • Fluid: The joint capsule and bursa are fluid filled membranes that lubricate the joint and reduce friction.

Traumatic causes

Stiffness after trauma may be difficult to recognize due to the pain that accompanies traumatic knee events. Usually these knee injuries are not subtle, but in the case that they are, stiffness may be the first symptom.

  • Fracture: A fracture is defined as a broken bone. Patella (kneecap) fractures are most common and are usually the result of a direct, hard blow or a fall, especially in older patients.
  • Sprain: A sprain is defined as a twisting or stretching of a ligament. Any of the four knee ligaments can be sprained in activities that causes bending, twisting, sudden movement, or direct impact. Sports that are often associated with ligament sprain include football, skiing, soccer, and rugby.

Inflammatory causes

Knee stiffness may be a result of inflammation due to the following.

  • Arthritis: Arthritis is a 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 pain.
  • Infection: Inflammation in the knee due to infection is rare but can occur when bacteria enter the knee via a cut or other incision. The fluid-filled bursae and joint capsule can become infected and inflamed. Sometimes, stiffness in an infected knee is also difficult to recognize because this cause is usually more associated with excruciating pain that makes even tiny movements of the knee unbearable.

Environmental causes

Environmental causes may be related to lifestyle or movement habits.

  • Exercise-induced: Muscles that are over-worked without proper conditioning and stretching can become tight and weak. This can make all parts of the leg, including the knee, feel stiff.
  • Positional: Exercise can cause knee stiffness symptoms but being sedentary can lead to stiffness as well. Situations such as long flights or desk jobs in which you are sitting for prolonged periods of time can result in stiff knees.

This list does not constitute medical advice and may not accurately represent what you have.

Knee stiffness quiz

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Septic arthritis

Septic arthritis is also called infectious arthritis. "Arthritis" simply means inflammation of a joint. In septic arthritis, the inflammation is caused by a bacterial, viral, or fungal infection. The most common agent is Staphylococcus aureus, or staph.

These agents reach the joints either from another infection in the body, or from a traumatic injury that contaminates the wounded joint.

Risk factors include existing joint disease or injury; a weakened immune system; and damaged skin. All of these things allow infectious agents to get a foothold.

Symptoms include severe pain in the affected joints, along with redness and swelling. The knees are most often affected but septic arthritis can occur in any joint.

The infection can damage cartilage and bone very quickly, so anyone with these symptoms should see a medical provider as soon as possible.

Diagnosis is made through a sample of the joint fluid; blood tests; and x-ray or CT scan of the joint.

Treatment involves draining the infected fluid from the joint, either with a needle or with surgery, followed by antibiotics.

Septic arthritis is also called infectious arthritis. "Arthritis" simply means inflammation of a joint. In septic arthritis, the inflammation is caused by a bacterial, viral, or fungal infection. The most common agent is Staphylococcus aureus, or staph.

These agents reach the joints either from another infection in the body, or from a traumatic injury that contaminates the wounded joint.

Risk factors include existing joint disease or injury; a weakened immune system; and damaged skin. All of these things allow infectious agents to get a foothold.

Symptoms include severe pain in the affected joints, along with redness and swelling. The knees are most often affected but septic arthritis can occur in any joint.

The infection can damage cartilage and bone very quickly, so anyone with these symptoms should see a medical provider as soon as possible.

Diagnosis is made through a sample of the joint fluid; blood tests; and x-ray or CT scan of the joint.

Treatment involves draining the infected fluid from the joint, either with a needle or with surgery, followed by antibiotics.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Osteochondritis dissecans

Osteochondritis dissecans, also called OCD, is a joint condition. It occurs when there is not enough blood flow within the end of a bone, under the protective cartilage. These bone layers begin to die and separate from the main bone, taking the cartilage with them.

The exact cause is not known. It may be due to overtraining a young person before the bone is entirely mature, which can interfere with blood supply.

Most susceptible are children and teenagers. The condition is found most often in only one joint, usually the ankle, knee, or elbow. However, any joint can be affected and there may be more than one.

Symptoms include swelling and pain in the joint during exercise, and sometimes "locking" of the joint. Osteochondritis dissecans may lead to osteoarthritis if not treated.

Diagnosis is made through patient history, physical examination, and imaging.

Treatment first involves rest because in children who are still growing, the bone and cartilage may heal spontaneously. If there are loose pieces of bone within a joint, surgery may be necessary.

Rarity: Rare

Top Symptoms: pain in one knee, knee stiffness, knee instability, knee pain that gets worse during a run, pop in the knee

Urgency: Primary care doctor

Meniscal injury

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.

Rarity: Common

Top Symptoms: pain in one knee, knee stiffness, knee instability, pain in the inside of the knee, swollen knee

Urgency: Primary care doctor

Medial plica syndrome

Medial plica syndrome is a condition of the knee in which a thickened band of tissue in the knee is inflamed and causes pain and swelling. It is often triggered by running or athletic activities.

Medial plica syndrome can be treated at home at first. If the symptoms persist or get worse, evaluation by a healthcare provider or physical therapist may be needed.

Lupus

Lupus, also called systemic lupus erythematosus or SLE, is an autoimmune disease. It causes the body's protective system to attack its own tissues the way it would normally attack an invading substance or microbe.

The disease can take different forms depending on what system or organ is being attacked.

Symptoms may come and go, and may be mild or temporarily flare up. They include a butterfly-shaped rash spreading from the bridge of the nose over both cheeks; fatigue; fever; joint pain; chest pain; mental confusion; sensitivity to sunlight; and Raynaud phenomenon, where fingers and toes turn white when exposed to cold.

There is no cure for lupus, though symptoms can be treated to improve quality of life.

Diagnosis is made through a combination of tests, since the signs of lupus vary greatly. Blood tests, urine tests, kidney and liver tests, and antibody testing will all be done.

Treatment involves some combination of nonsteroidal anti-inflammatory drugs, corticosteroids, and immunosuppressants, along with improved diet, sleep, and stress management to help strengthen the immune system.

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.

Knee stiffness quiz

Take a quiz to find out what's causing your stiffness.

Take knee stiffness quiz

Knee arthritis

Knee arthritis means that there is inflammation and abnormal wear of one or both of the two joints in the knee.

Arthritis in any joint is most often be caused by long-term wear and tear, called osteoarthritis; by an autoimmune condition that attacks the joints, called rheumatoid arthritis; or by an injury, called post-traumatic arthritis.

Symptoms include pain, which becomes worse with use of the joint; limited range of motion, meaning the shoulder joint cannot move as far as it once did; and pain when resting or trying to sleep.

Knee arthritis cannot be cured, but symptoms can be managed to improve quality of life and ease pain and discomfort.

Diagnosis is made through patient history, physical examination, and x-rays. To confirm, an injection of anesthetic may be placed into the joint. If the pain is eased, arthritis is almost certainly the cause.

Treatment involves physical therapy; nonsteroidal anti-inflammatory drugs to ease discomfort and inflammation; and corticosteroid injections into the knee to relieve pain. Surgery and knee joint replacement can be done in some cases.

Rarity: Common

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

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.

Rarity: Rare

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

Knee stiffness treatments and relief

At-home treatments

Treatment for knee stiffness often starts at home with simple lifestyle changes. The RICE (Rest, Ice, Compress, Elevate) mnemonic is an often-used, guide for treating stiffness and swelling of the knee:

  • Rest: Limit weight-bearing of the affected knee or knees as much as possible. Your doctor may suggest crutches.
  • Ice: Put an ice pack on your knee or place your knee in ice water every 15 minutes in order to reduce any swelling.
  • Compression: Protect your knee from unnecessary movement by using a stretchy bandage or compression wrap with a protective brace. Compression like this can also help with swelling.
  • Elevation: Raising your leg and knee above the level of your heart can also help reduce swelling and bruising.

If you find yourself sedentary for many hours of the day, like during work, for example, prevent knee stiffness by getting up to move every 30 minutes or so to help lubricate the knee.

However, if your knee stiffness symptoms are persistent or associated with any of the red-flag symptoms above, seek prompt medical attention.

When to see a doctor

If your knee stiffness is persistent and at-home treatments do not provide relief, you should see your physician. He or she may suggest:

  • Physical therapy: After many knee injuries, your doctor will suggest physical therapy in order to restore range of motion, strength and stability to your knee.
  • Medication: If your severe knee pain is due to inflammatory conditions, your doctor may prescribe antibiotics to treat an infection or anti-inflammatory medications to treat arthritic conditions.
  • Surgery: Fractures and tears of the ligaments and cartilage of the knee often require surgical intervention.

Questions your doctor may ask about knee stiffness

  • Do you feel like your knee is unstable, weak, or giving out?
  • Do you feel like your knee is locking from time to time?
  • What is your body mass?
  • Do you often feel your knees buckling?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Calmbach WL, Hutchens M. Evaluation of Patients Presenting with Knee Pain: Part I. History, Physical Examination, Radiographs, and Laboratory Tests. American Family Physician. 2003;68(5):907-912. AAFP Link
  2. Common Knee Injuries. American Academy of Orthopaedic Surgeons: OrthoInfo. Updated March 2014. OrthoInfo Link
  3. Arthritis and Diseases That Affect the Knee. Arthritis Foundation. Arthritis Foundation Link
  4. Chatra PS. Bursae Around the Knee Joints. The Indian Journal of Radiology & Imaging. 2012;22(1):27-30. NCBI Link
  5. Leopold SS. Osteoarthritis of the Knee. UW Medicine: Orthopaedics and Sports Medicine. Updated February 14, 2011. UW Medicine Link