Knee pain when walking is commonly caused by osteoarthritis, patellofemoral pain, overuse, or injury. See a doctor if it persists.
Common causes
- Osteoarthritis.
- Patellofemoral pain syndrome (runner’s knee).
- Meniscus or ligament injury.
- Tendinitis.
- Obesity, which adds load to the joint.
Home care
Rest, ice, compression and elevation. Wear supportive shoes and strengthen your quads.
See a doctor
If you have swelling, locking, instability or pain lasting more than a few weeks.
Facts
Every pound of weight adds about 4 pounds of pressure on the knees.
Joint anatomy
The knee joins the thigh bone (femur), shin bone (tibia) and kneecap (patella), cushioned by cartilage and two C shaped menisci, and held by four main ligaments (ACL, PCL, MCL, LCL). Pain during walking can come from any of these structures or the tendons around them.
Wear and tear
- Osteoarthritis: breakdown of cartilage. The CDC reports that about 1 in 4 US adults has arthritis, and knee osteoarthritis is common after age 50.
- Meniscus tears, causing catching, locking or swelling.
- Patellofemoral pain syndrome (“runner’s knee”), pain around or behind the kneecap, worse on stairs and after sitting.
Overuse and inflammation
- Tendinitis, such as patellar tendinitis.
- Bursitis.
- Iliotibial band syndrome, pain on the outside of the knee.
Other medical causes
Rheumatoid arthritis, gout (sudden painful swelling, often of the big toe but also the knee), pseudogout and infection (septic arthritis, which needs urgent care).
Risk factors
Excess body weight increases load. Each pound of weight adds about 4 pounds of pressure on the knees while walking, according to Arthritis Foundation estimates. Weak thigh muscles, flat feet or poor footwear also matter.
Home care
- Rest from aggravating activities, then return gradually.
- Ice for 15 to 20 minutes after activity.
- Over the counter NSAIDs if safe for you.
- Strengthen the quadriceps, hamstrings and hips with physical therapy exercises.
- Low impact exercise: cycling, swimming.
- Supportive shoes.
See a doctor if
Knee pain follows an injury, the knee is hot, red and swollen, you have fever, the knee locks, gives way, or you cannot bear weight. Pain lasting more than 2 weeks needs an evaluation, with X-rays or MRI if needed.
Wear and overuse
Osteoarthritis of the knee affects more than 32 million US adults in some joint, and the knee is among the most common sites. Cartilage wear makes walking painful, with stiffness after rest. Each pound of body weight lost removes about 4 pounds of load from the knee with each step, according to the Arthritis Foundation. Patellofemoral pain syndrome, patellar tendinitis, iliotibial band syndrome, bursitis and meniscus tears are other causes, as are ligament injuries. Weak hip and thigh muscles and poor shoes can contribute.
Self care and red flags
Rest, ice for 15 to 20 minutes, compression, over the counter NSAIDs, a cane on the opposite side and strengthening of the quadriceps, hamstrings and hips help many people. Low impact exercise such as swimming and cycling is encouraged. See a doctor if the knee swells, locks or gives way, you cannot bear weight, the knee looks deformed, or you have fever, redness or warmth, which could indicate infection. Pain lasting more than a few weeks warrants evaluation. Options range from physical therapy and injections to surgery for severe disease.
Based on data from the Arthritis Foundation and the American Academy of Orthopaedic Surgeons
