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Not Sure What’s Causing Your Knee Pain? Here Are 3 Clues

January 09, 2025

Our knees are the largest joints in our body, making them prone to wear, tear and all sorts of aches and pains. From common culprits like arthritis to more unusual injuries, the list of causes can seem endless.

So, how does your health team figure out what’s causing your knee pain?

1. Where your knee pain is located

That’s right, your orthopedist and your realtor have the same mantra: Location, location, location.

“The knee overall is very geographic, meaning that where it hurts tends to be where the problem is,” says Jenna Bernstein, MD, an orthopedic surgeon at Connecticut Orthopedics and The Orthopaedic & Sports Medicine Center in Fairfield County. “The location of the pain definitely starts to focus the surgeon in on where the pain might be coming from.”

For example:

• Front of the knee: Could be patellar tendinitis (jumper’s knee), which usually hurts just below the kneecap.
• Inside of the knee: Could be bursitis, which usually feels tender just below the inside part of the knee.
• At the joint line: Could be a meniscus tear, which usually hurts right where your thigh hinges onto your shin — inside, outside or at the back of the knee.
• Anywhere: Could be a stress fracture, which usually hurts over the area of the affected bone.

> Related: 6 Knee Injuries That Can Cause Arthritis

2. When it swelled up

If you’re knee isn’t swollen, allow yourself a cautious sigh of relief: “When there is no swelling inside of the knee, we often aren’t as concerned about a severe injury,” says Dr. Bernstein.

If you do have swelling, your health team will likely ask some questions about timing.

“When the knee swells immediately after injury, we think of something like an ACL tear. If the knee swells a few hours after injury, something like a meniscus tear becomes a possibility,” says Dr. Bernstein.

> Related: 5 Reasons Why Your Knee Is Swollen

3. How often it comes and goes

Whether your knee pain is constant or intermittent tells your doctor something.

For example: Constant pain, even at rest? Could be a number of things. But if it only hurts when you, say, extend your knee? That’s likely to be a specific tendon issue.

“If pain comes up with only certain motions or activities, that often makes us think something like a tear where a piece of loose tissue is getting caught in the knee,” says Dr. Bernstein.

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What about “sharp” versus “dull” knee pain?

If you’re asking this question, odds are this isn’t your first article about knee pain.

It’s true: Many online sources talk about the difference between sharp, intense pain versus dull, throbbing pain and what it means for your knee injury.

But ultimately, most specialists won’t rely on this information. Unlike pointing to a spot on your leg where it hurts, adjectives like “piercing” or “mild” are just too subjective.

“Pain is experienced differently by different people,” says Dr. Bernstein. “So ‘sharp’ versus ‘dull’ really doesn’t tell us too much about a knee injury.”

What will tell you something: An appointment with an expert, who can find out exactly what your knee pain means.