What Causes Pain Behind the Knee?
Pain behind the knee can be uncomfortable and may make everyday activities such as walking, bending the knee or climbing stairs more difficult.
The back of the knee contains several important structures, including muscles, tendons, ligaments, blood vessels and the knee joint itself. As a result, pain in this area can have several possible causes.
The type of pain, when it occurs and whether you have other symptoms can provide useful information. Persistent or worsening pain should be assessed to determine the underlying cause.
Common Causes of Pain Behind the Knee
- Hamstring or Calf Muscle Problems
The muscles and tendons around the back of the thigh and lower leg attach near the knee.
Strains or irritation can cause discomfort behind the knee, particularly after exercise, running or sudden changes in activity.
Symptoms may include:
- Pain during movement
- Tenderness
- Muscle tightness
- Discomfort when stretching
- Pain after physical activity
- Baker’s Cyst
A Baker’s cyst is a fluid-filled swelling that develops behind the knee.
It may occur when excess fluid collects within the knee and can be associated with conditions such as osteoarthritis or meniscus problems.
Some people may notice:
- A feeling of fullness behind the knee
- Swelling
- Tightness when bending the knee
- Discomfort when straightening the leg
A healthcare professional can assess the cause of swelling behind the knee and determine whether further investigation is appropriate.
- Knee Osteoarthritis
Osteoarthritis can affect different parts of the knee and may cause pain, stiffness and swelling.
Although pain is often felt around the front or sides of the knee, some people may experience discomfort towards the back of the joint.
Symptoms may become more noticeable during activities that place increased load on the knee.
- Meniscus Problems
The menisci are pieces of cartilage located within the knee joint.
A meniscus tear may cause:
- Knee pain
- Swelling
- Clicking
- Catching
- Locking
- Difficulty fully bending or straightening the knee
Depending on the location of the tear, discomfort may be felt in different areas of the knee.
- Tendon Problems
Irritation involving the tendons around the knee can cause localised pain, including discomfort towards the back of the joint.
Symptoms may be associated with repetitive activity or an increase in exercise.
- Ligament Injuries
Ligaments provide stability to the knee. An injury may cause pain and instability, particularly following a twisting or sporting injury.
A significant ligament injury may also be accompanied by swelling or difficulty bearing weight.
Why Does the Back of My Knee Hurt When I Bend It?
Pain during knee bending can occur for several reasons.
Bending the knee places different demands on the muscles, tendons and structures within the joint. Conditions such as a Baker’s cyst, meniscus problem, arthritis or muscle-related injury may become more noticeable during bending.
Because these conditions can have similar symptoms, an assessment is recommended when pain persists.
Why Does the Back of My Knee Hurt When Walking?
Walking repeatedly loads the knee joint and surrounding tissues.
Pain behind the knee while walking may be associated with:
- Muscle or tendon irritation
- Arthritis
- Meniscus problems
- A Baker’s cyst
- Previous knee injury
If the pain is persistent or progressively affecting your ability to walk, seek medical advice.
Pain Behind the Knee After Exercise
A sudden increase in running, walking, gym training or other physical activity can place additional stress on the muscles and tissues around the knee.
If pain develops after exercise:
- Reduce or modify the activity that aggravates the symptoms
- Avoid pushing through significant pain
- Allow time for recovery
- Consider professional assessment if symptoms persist
Returning to exercise should be gradual and appropriate to the underlying condition.
When Should You Seek Medical Advice?
Arrange an assessment if you experience:
- Persistent pain behind the knee
- Swelling that does not improve
- Difficulty walking
- Recurrent knee locking or catching
- Knee instability or giving way
- Reduced range of motion
- Symptoms following an injury
- Pain that interferes with everyday activities
Seek urgent medical attention if:
You develop sudden significant swelling or pain in the calf or leg, particularly if it is associated with warmth, redness, shortness of breath or chest pain. These symptoms can have causes unrelated to the knee and require urgent medical assessment.
How Is Pain Behind the Knee Diagnosed?
Your healthcare professional will usually begin by asking about:
- When the pain started
- Whether there was an injury
- Your activity levels
- Where exactly the pain occurs
- What movements make it better or worse
- Previous knee problems
A physical examination may assess movement, stability, muscle strength and areas of tenderness.
Depending on the findings, imaging such as an X-ray or MRI may be recommended.
Treatment Options
Treatment depends on the underlying cause.
Depending on your diagnosis, management may include:
- Activity modification
- Physiotherapy
- Strengthening exercises
- Stretching and mobility exercises
- Pain management
- Weight management where appropriate
- Bracing in selected circumstances
- Further orthopaedic assessment
Surgery is not necessary for every cause of pain behind the knee. If surgery is being considered, the potential benefits and risks should be discussed as part of an individual assessment.
Frequently Asked Questions
- Is pain behind the knee serious?
Pain behind the knee has many possible causes. Some are relatively minor, while others require medical assessment. Persistent, severe or worsening symptoms should be evaluated.
- Can arthritis cause pain behind the knee?
Yes. Knee osteoarthritis can cause pain in different areas of the joint, including towards the back of the knee in some people.
- Can a Baker’s cyst cause pain behind the knee?
Yes. A Baker’s cyst can cause swelling, tightness or discomfort behind the knee, particularly when bending or straightening the joint.
- Should I exercise with pain behind my knee?
It depends on the cause and severity of the pain. Avoid activities that significantly worsen symptoms and seek professional advice if pain persists or is associated with swelling, locking or instability.
- When should I see an orthopaedic specialist?
Consider an assessment if pain persists, limits your activities, follows an injury or is associated with swelling, locking or instability.
Looking After Your Knees
Maintaining strength, flexibility and general fitness can support knee function.
Helpful habits may include:
- Staying physically active
- Gradually increasing exercise intensity
- Strengthening the muscles around the knee and hip
- Wearing suitable footwear
- Allowing adequate recovery between demanding activities
- Seeking advice when persistent symptoms develop
Book an Orthopaedic Consultation
Persistent knee pain can have several possible causes, and identifying the underlying problem is an important part of choosing appropriate management.
Dr Parminder J. Singh provides assessment and management of a wide range of hip and knee conditions, with treatment recommendations tailored to each patient’s individual circumstances.
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