Knee Pain: Causes, Symptoms, and Treatment

Although knee pain is common with age, it is not necessarily inevitable. There are ways to prevent it as you get older. And if you already have knee pain, there are ways to manage and treat it.

What are the causes of knee pain?

While there are many things that can hurt your knees, arthritis is often to blame. Osteoarthritis, when the protective tissue (also called cartilage) in your knee wears down, is common in older people.

With every step you take, your knees absorb the shock. You can expect your knees to absorb about 1½ times your body weight, which can quickly add up. With regular wear damage and pressure from your knees, the cartilage pads in your knees (called menisci) can weaken.

Once the cartilage wears down, your bones rub against each other. This can lead to swelling, stiffness, and pain.

Nicholas A. DiNubile, MD, bestselling author and orthopedic surgeon at the American Academy of Orthopedic Surgeons, says knee pain isn’t normal, but it’s not unusual as people get older.

“With age it’s very common,” he says. “It’s hard to find someone who has been active as they got older, who doesn’t have that little tightening under their kneecap when they bend and straighten their knee or when they go up and down the stairs.”

Daniel Valaik, MD, orthopedic surgeon and assistant professor at Johns Hopkins University, agrees.

“We mostly think of osteoarthritis as a kind of mechanical wear and tear on the joint,” he says. “It’s like the treads on a car tire. Between 40,000 and 50,000 miles, those treads will simply wear out. Even if you get good tires, they will wear out.

You may be more likely to experience knee pain if you:

Besides osteoarthritis, there could be other reasons for your knee pain. Your knee could hurt from:


Ways to prevent knee pain

There are also ways to stop knee pain before it happens. Things like building muscle, quitting sugary sodas and energy drinks, quitting smoking, and losing weight can all help prevent knee pain. Some suggestions include:

Avoid inflammatory foods. DiNubile says it’s a good idea not to eat inflammatory foods.

“If you eat a lot of processed foods, you tend to have more systemic inflammation, which can affect your joints,” he says. “Nutrition is a factor here.”

This is one of the reasons the Mediterranean diet is used to manage arthritis and joint pain, says DiNubile. The Mediterranean diet is a diet that focuses on fruits and vegetables, whole grains, yogurt, red wine, certain fish, and healthy fats like nuts and olive oil. This diet encourages people to eat anti-inflammatory foods, such as fish, berries, and olive oil, and limits inflammatory foods, such as sugar, red meat, and most dairy products.

Build your muscles. One of the best ways to help your knees is to strengthen your muscles. This relieves some of the pressure on your knees by causing shock to be absorbed by the muscles and also stabilizes your knee joint.

You should try to strengthen your hamstrings and quadriceps – the muscles in your thighs – as well as your core and hip muscles.

Give up sodas and energy drinks. About 80% of the cartilage in your body is made up of water. If you don’t drink enough water, your body has to use water from your cartilage and other areas, which can damage joints like your knees.

By swapping soda and energy drinks for water, you can stay hydrated and protect your joints.

Do not smoke. Smoking can affect your body in many ways. Not only does this increase your risk for diseases like cancer or cardiovascular problems, but smoking can affect joints like the knees. Smoking promotes inflammation in your body, so it can be harder to heal if you hurt your knees.

Losing weight. If you are overweight, losing weight can also help ease your knees. Each additional pound of weight adds about 4 pounds of pressure. For example, if you gain 10 pounds, you are adding about 40 pounds of extra pressure on your knees.


“Losing 10 pounds in people who are really heavy can really slow the progression of arthritis and make them feel better,” says DiNubile.

Valaik accepts and compares the extra weight to carrying a heavy bag.

“It’s like walking around with a 40-50 pound backpack all the time, and that’s just going to lead to arthritis faster,” he says. Losing weight or maintaining a healthy weight is probably the best thing you can do.

What to do in case of knee pain

If you already have knee pain, there are things that can make it worse, including activities such as:

  • Squat or stand on a hard surface for a long time
  • High impact activities, such as running or basketball

If you have a job where you squat or stand on a hard surface for a long time, try wearing gel shoe inserts or padded shoes.

Staying active is important, says DiNubile. Being active regularly helps maintain joint function, such as range of motion and the strength of your knees. Choosing the right activities for you can also help. Repetitive squats, step-ups, and lunges can “set off fireworks in someone with a kneecap problem,” he says.

“If you’re overweight and want to be in good shape, maybe you shouldn’t be running because it puts a lot of extra strain on your knees,” he says.

Valaik recommends swimming and cycling. DiNubile offers activities such as walking, using an elliptical machine, yoga and stretching exercises. If you’ve got a fitness routine you love but it’s starting to hurt, check if there are any changes you can make to keep it going, he says.

When to consult a doctor

You should see a doctor whenever you experience constant, persistent, or severe knee pain. If there’s swelling and you can’t bend or put weight on your knee, it’s probably time to make an appointment, DiNubile says.

“If you have knee pain – real knee pain that doesn’t go away in a few days or a week or two – you should probably see your doctor and determine if something is going on,” says Valaik.

Not all knee pain is the same. This is why it is so important to see a doctor to diagnose it, says DiNubile.

“You have to have a specific diagnosis and then depending on that diagnosis you will have different treatments,” he says. “The most important thing is to have it checked by someone who knows the knees well. Usually it will be an orthopedic surgeon or sports medicine specialist. “



Harvard Health Publishing: “Protect Your Knees Against Aging.”

Cleveland Clinic: “5 Best Ways to Protect Your Joints as You Get Old.”

Arthritis Foundation: Mediterranean diet for osteoarthritis. “

AARP: “6 Ways To Save Your Knees.”

Mayo Clinic: “Knee Pain: Symptoms and Causes.”

Nicholas A. DiNubile, MD, orthopedic surgeon, American Academy of Orthopedic Surgeons; author, FrameWork – Your 7-Step Program for Healthy Muscles, Bones and Joints.

Daniel Valaik, MD, orthopedic surgeon; assistant professor, Johns Hopkins University.

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