How To Handle Pain Behind The Knee: What You Need To Know
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Knee pain is a frequent topic of discussion, and knowing what to do and what to avoid is important. This article focuses on a specific location: the back of the knee. What does pain in this area mean, and what could be causing it? Let’s start by examining the structures located behind the knee.
Accompanying Symptoms Of Pain Behind The Knee
Pain behind the knee can vary in intensity and cause, often accompanied by additional symptoms that provide clues to its underlying source. Common accompanying symptoms include:
- Difficulty Straightening The Leg: A feeling of stiffness or resistance when extending the knee fully may indicate issues such as a meniscus tear, Baker’s cyst, or hamstring tendon irritation.
- Popping Sensation In The Joint: A sudden or repeated popping sound could indicate ligament involvement, cartilage damage, or meniscus-related issues. It may also suggest instability in the knee joint.
- Pain In The Front Inside Of The Knee: Discomfort in the medial (inner) knee along with pain behind the knee, may be linked to conditions such as pes anserine bursitis, medial meniscus tears, or arthritis.
- Tightness In The Hamstrings: Stiffness or cramping in the hamstring muscles, which run along the back of the thigh, can contribute to pain behind the knee, potentially due to overuse, strain, or nerve involvement.
- Joint Locking Up: A sensation of the knee getting stuck or temporarily unable to move may point to issues such as loose cartilage, a torn meniscus, or advanced arthritis affecting joint mechanics.
Causes Of Pain Behind The Knee
There are many structures behind the knee or affecting the back of the knee, including the following:
- Hamstring muscles, calf muscles, and tendons
- Popliteus and plantaris muscles
- Tibial and other nerves
- Baker’s Cyst
- Meniscus
Let’s look at the potential causes that could lead to pain in the back of the knee.
- Hamstring and Calf Muscle And Tendon Injuries: The hamstring muscles are a group of large muscles that run the length of the upper legs, ending at the knee. The calf muscles are the strong muscles that run behind the lower legs, starting at the knee.
There are tendons in the hamstrings and calf muscles that connect these muscles to the bone just behind the knee. So, pain behind the knee could be caused by an injury or problem in these muscles or tendons. Another indication of this issue might be chronically tight hamstrings or calf muscles that you frequently feel the need to stretch or roll out.
And even further up the line, if you have hamstrings or calf muscles that won’t let go and are always tight, it could be your back, not your hamstrings or your knee, that’s the primary cause of the problem. To learn more about how this works, check out the video below that explains the connection.
- Popliteus and Plantaris Muscle Injuries: The back of the knee is also where deeper muscles, like the popliteus and plantaris, are found. The popliteus muscle crosses from the inside of the bottom back of the knee to the outside top of the knee. The plantaris muscle bridges directly behind the knee and terminates at its tendon, which stretches down to the Achilles tendon at the back of the heel.
If there is a problem with either of these, you will feel pain and tightness deeper in the back of the knee when you massage or put pressure there. With the popliteus muscle, you might also experience knee locking, and addressing this muscle could be the key to unlocking the knee and eliminating the pain in the back of your knee. A useful clinical clue—known as the “boot sign”—occurs when you feel pain or discomfort while removing footwear using the opposite foot, indicating popliteus tendon involvement. - Tibial Or Other Nerve Problems: The tibial and other nerves also run behind the knee. The tibial nerve branches off the sciatic nerve, which starts in the lower back and travels all the way down to the foot. An issue in this nerve, locally or even at the spinal level, could cause pain in the back of your knee.
The spinal nerves that connect to the muscles may be an issue if you have any sort of low-back problem, even if your back isn’t bothering you right now. If it is a nerve issue, you might have numbness, tingling, burning, or electrical sensations in the leg or foot. - Baker’s Cyst: A Baker’s cyst can also cause pain behind the knee. This is just an out pitching of the synovial lining, or the back wall, of the knee joint. If you have a Baker’s cyst, you’ll feel fluid at the back of your knee, and it will get bigger with more activity and smaller with less activity.
The upshot? The knee is a very complex joint with many structures that can become injured and cause pain. The key is first to get a thorough exam and a solid diagnosis of the true cause of the problem.
When You Should Seek Immediate Medical Care
Seek prompt medical care for knee pain if you experience severe pain or swelling, difficulty bearing weight, or notice any visible deformity in the knee. A sudden onset of pain, accompanied by redness and warmth, may suggest an infection or a blood clot, requiring urgent evaluation.
Additionally, if the knee locks, feels unstable, or gives out, this could be a sign of ligament, meniscus or cartilage damage that needs prompt attention. Early medical assessment may help prevent further complications and support recovery.
Diagnosing The Cause Of Knee Discomfort
A thorough evaluation of knee discomfort typically begins with a physical examination and a medical history review. Physicians in the licensed Regenexx network assess swelling, range of motion, and any signs of instability and tenderness. Information about your activity level, recent injuries, and the onset of symptoms is also important in identifying potential causes.
Common imaging techniques include X-rays, which can detect fractures or signs of osteoarthritis; MRI scans to assess soft tissue damage; and CT scans to provide a detailed view of bone and joint structures. These tools help diagnose injuries or underlying conditions affecting the knee.
Conventional Treatment Options
Several conventional treatment options are available for managing knee discomfort, depending on the severity and underlying cause of the condition:
- Rest and activity modification: Reducing activities that place stress on the knee can help alleviate pain and promote healing. This may involve avoiding high-impact exercises or adjusting daily movements.
- Medications: Over-the-counter pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs), can reduce pain and inflammation. In some cases, prescription medications may be recommended.
- Orthotics and bracing: Supports like knee braces or shoe inserts can help stabilize the knee, improve alignment, and reduce strain on the affected area.
- Physical therapy: A tailored rehabilitation program can help improve strength, flexibility, and range of motion in the knee.
- Corticosteroid injections: These can reduce inflammation and pain in the short term, but repeated use may weaken cartilage and worsen joint health over time.
- Surgery: If non-surgical treatments are ineffective, surgical options may be considered. While arthroscopy or knee replacement can address severe conditions, they come with risks such as infection, long recovery times, and potential complications.
Support Knee Function With Procedures Using Regenexx Injectates
Physicians in the licensed Regenexx network offer non-surgical options that may help support knee function and the body’s natural repair processes. The Regenexx approach provides a less invasive option compared to surgery, aiming to address joint health and mobility.
Procedures using Regenexx lab-processed injectates, such as Regenexx-SD (bone marrow concentrate) and Regenexx-SCP (a proprietary platelet-rich plasma formulation), are designed to support tissue health. These image-guided procedures are tailored to each patient’s condition, helping manage symptoms and promote joint stability.
Exploring Non-Surgical Approaches to Joint Care
For individuals seeking non-surgical options, physicians in the licensed Regenexx network offer image-guided procedures designed to support joint function and mobility. Procedures using Regenexx injectates, such as platelet-based and bone marrow concentrate (BMC) injections, may help manage discomfort and promote knee health.
By focusing on interventional orthobiologic approaches, these procedures offer an alternative for those exploring options to maintain knee function and joint health. To determine if this approach aligns with your needs, consult with a physician in the licensed Regenexx network.
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