Musculoskeletal Symptom

Knee pain

Knee pain is one of the most common musculoskeletal complaints, affecting people across all ages and activity levels. From runner's knee and ligament injuries to osteoarthritis and patellar tendinopathy, most knee pain responds well to physiotherapy, exercise and appropriate manual therapy.

See therapies that may help

What is Knee pain?

The knee involves three bones (femur, tibia, patella), two menisci, four main ligaments, and multiple tendons and bursae — any of which can be a source of pain. Common presentations include: patellofemoral pain syndrome (runner's knee); patellar tendinopathy; IT band syndrome; osteoarthritis; ligament injuries (ACL, MCL); and meniscal injuries.

Signs and symptoms

Knee pain symptoms vary by cause:

Pain location — front, inner, outer or back of the knee helps identify the structure involved
Activity-related pain — specific activities that reproduce pain indicate loading the structure cannot tolerate
Swelling — immediate post-injury swelling suggests structural damage; delayed or mild swelling suggests inflammation
Locking or giving way — suggests meniscal or ligamentous involvement
Stiffness — particularly in the morning or after sitting

How therapy can help

Most knee pain responds well to conservative management:

Physiotherapy — the mainstay of knee pain management; strengthening the quadriceps and hip abductors, addressing movement patterns and graded return to activity
Sports therapy and osteopathy — manual therapy for soft tissue and joint components
Acupuncture — evidence for pain relief in knee OA and tendinopathy
Massage therapy — for soft tissue components and muscle tension contributing to knee pain

Seeking help

A physiotherapist is the appropriate first contact for most knee pain. Imaging may be needed for significant trauma, suspected structural damage, or pain not responding as expected. For knee OA that has not responded to conservative management, orthopaedic referral is appropriate.

Therapies that may help with Knee pain

Therapy	Evidence	Notes
Physiotherapist	strong	Core use for knee pain.
Sports Therapist	strong	Core use for knee pain.
Acupuncturist	moderate	Good evidence for knee OA; NICE-recommended.
Chiropodist	moderate	Foot mechanics and orthotics frequently address knee pain.
Chiropractor	moderate	Commonly used for knee pain via gait and spinal assessment.
Clinical Pilates Practitioner	moderate	Quadriceps strengthening for knee pain.
Fascial Stretch Therapist	moderate	Fascial stretch therapy for knee pain.
Hydrotherapist	moderate	Hydrotherapy for knee pain.
Massage Therapist	moderate	Commonly used for knee pain.
Osteopath	moderate	Commonly used for knee pain.
Pilates Practitioner	strong	Core use for knee pain.
Alexander Technique Practitioner	moderate	Used for knee pain with postural/gait contributors.
Bowen Technique Practitioner	moderate	Bowen for knee pain.
Cognitive Behavioural Therapist	moderate	CBT for chronic knee pain distress.
Emmet Technique Practitioner	moderate	Emmett technique for knee pain.
Foot Health Therapist	moderate	Foot mechanics for knee pain.
Mindfulness Practitioner	moderate	Mindfulness for chronic knee pain.
Myofascial Release Practitioner	moderate	Myofascial release for knee pain.
Rolfing Practitioner	moderate	Rolfing for knee pain.
Shiatsu Practitioner	moderate	Used for knee pain.
Structural Integration Practitioner	moderate	Used for knee pain via lower limb alignment.
Thai Masseuse	moderate	Thai massage for knee pain.
Yoga Therapist	moderate	Yoga for knee pain and strength.
Body Stress Release Practitioner	limited	Used for knee pain.

Frequently asked questions

Should I rest or exercise with knee pain?

For most knee conditions, appropriate exercise is more beneficial than rest. Quadriceps weakness is a major contributor to many knee pain presentations, and strengthening exercises often produce significant improvement. A physiotherapist can guide activity appropriate to your condition.

What is runner's knee?

Runner's knee (patellofemoral pain syndrome) refers to pain around or behind the kneecap, typically provoked by running, squatting or stairs. It is extremely common in runners and is usually caused by muscle imbalances, training load and biomechanical factors. It responds well to physiotherapy.

Can knee pain be caused by problems elsewhere?

Yes — hip weakness and ankle stiffness both commonly contribute to knee pain by altering load distribution. A good physiotherapy assessment considers the whole lower limb rather than only the knee itself.

Does knee pain always mean arthritis?

No — knee pain has many causes across all ages. A physiotherapist or GP can help identify the cause through clinical assessment.

When does knee pain require surgery?

Surgery is considered for significant ligament tears, refractory meniscal symptoms, and severe OA that has not responded to conservative management. The majority of knee pain does not require surgery and responds well to physiotherapy and exercise.

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Also known as

Knee pain