Knee pain

Knee pain can have many possible causes. It may develop after a specific injury, such as a twist, fall or sporting incident, or gradually because of repeated loading, changes in activity, muscle weakness or reduced movement.

Common problems include irritation of the tendons around the knee, kneecap-related pain, ligament or cartilage injuries and osteoarthritis. Sometimes the way the hip, ankle or foot is moving can also affect how forces are distributed through the knee.

A thorough assessment can help identify the most likely cause and whether treatment, rehabilitation exercises or further medical investigation may be appropriate.

Osteopathic care may help some people experiencing musculoskeletal knee pain. The first step is to understand when the pain started, what activities aggravate it and how it is affecting work, exercise or everyday life.

The assessment may include an examination of the knee as well as relevant areas such as the hip, ankle and lower back. Treatment may include hands-on techniques, movement advice and an individual rehabilitation programme designed around the patient’s symptoms and goals.

Not every knee condition is suitable for osteopathic treatment. Where appropriate, referral to a GP or another healthcare professional may be recommended for further assessment.

Complete rest is not always necessary and, in many cases, carefully managed movement can be helpful. However, the correct level of activity will depend on the cause and severity of the symptoms.

It may be helpful to temporarily reduce activities that noticeably aggravate the knee while continuing with movements that remain comfortable. Rehabilitation exercises can then be introduced and progressed gradually to improve strength, control and confidence.

Severe pain, substantial swelling, locking, repeated giving way or an inability to bear weight should be assessed rather than exercised through.

Many knee problems can initially be assessed through a detailed history and physical examination, and a scan is not always required.

Imaging may be considered when there has been significant trauma, the diagnosis remains unclear, symptoms are not improving as expected or the examination suggests that further investigation is needed.

Osteopathic assessment does not replace medical imaging when it is clinically necessary. Where appropriate, the patient may be advised to speak to their GP or another healthcare professional.

Urgent medical advice should be sought if the knee is extremely painful, badly swollen or has changed shape, or if it is not possible to move the knee or place weight through the leg.

Prompt advice should also be sought if the knee repeatedly gives way, becomes locked, or is hot, red and swollen alongside a fever or feeling generally unwell. These symptoms may require medical investigation rather than routine musculoskeletal treatment.

Following a significant injury, urgent assessment may also be required if there is rapid swelling, numbness, pins and needles or an inability to straighten the knee.

The time it takes for knee pain to improve varies widely. Some people may notice an improvement almost immediately after reducing an aggravating activity or receiving appropriate advice or treatment, while other problems settle gradually over several days or weeks.

Longer-standing pain, osteoarthritis or more significant injuries may take several months and often require a progressive rehabilitation programme. Recovery is not always completely straightforward, and symptoms may occasionally flare as activity levels increase.

An assessment can help identify the likely cause, provide a more realistic timescale and guide a safe return to normal activity.