Knee pain: causes, assessment and next steps
Knee pain can make stairs, walking, getting up from a chair or returning to sport difficult. The useful starting point is to understand what has changed, check for symptoms needing medical attention and agree a manageable next step. The location of pain alone does not establish the diagnosis.
When to get urgent help
Contact NHS 111 urgently if your knee is extremely painful, you cannot move it or put weight through it, it is markedly swollen or misshapen, or it locks, gives way or clicks painfully. A hot, red knee with fever or shivering also needs urgent assessment. Painless clicking on its own is often normal. See the NHS knee pain guidance.
After a serious injury, a visibly deformed limb, loss of feeling, or a foot that becomes unusually cold or blue needs emergency assessment. Do not wait for a routine osteopathy appointment.
New pain and swelling in one calf or thigh may need urgent GP or NHS 111 assessment for a blood clot. If this occurs with chest pain or breathlessness, call 999. Read the NHS advice on DVT.
What might cause knee pain?
A recent injury or change in load. A twist, fall, new running programme or unusually demanding day may irritate a joint, tendon or ligament.
Pain around the kneecap. Patellofemoral pain can be associated with repeated knee bending, stairs or squatting. An assessment helps distinguish this from other problems.
Osteoarthritis. Activity-related pain and stiffness can affect daily tasks. Symptoms, function and examination matter more than an assumption based on age.
Meniscus or ligament problems. An injury, swelling or difficulty straightening the knee may prompt closer assessment. Clicking alone does not prove a meniscus tear.
Other sources. Pain can sometimes be referred from the hip. An inflamed or hot swollen joint needs consideration of causes beyond a simple strain.
These are possibilities, not a checklist for diagnosing yourself. The East Sussex MSK knee resources provide further condition-specific information.
What an assessment can cover
You may be asked how the pain began, whether there was an injury, where it is felt, and whether you have swelling, locking, instability or symptoms elsewhere. Bring relevant information about previous injuries, operations, medical conditions and medicines.
Examination may include knee and hip movement, strength and everyday tasks such as walking or a controlled sit-to-stand, within your comfort and ability. Tell the practitioner if a test feels unsafe or too painful. The aim is to understand the problem and whether care here, physiotherapy or medical assessment is the appropriate next step.
A scan is not automatic. Osteoarthritis is commonly diagnosed clinically; imaging or a specialist opinion may be appropriate when the history or examination suggests another problem or when the result could change management.
Activity and treatment choices
Choose activity you can manage while the problem is assessed. Shorter walks, flatter routes or splitting a task into smaller parts may be more practical than repeatedly testing a painful knee. A fresh injury may need an initial reduction in load; recovery advice should reflect the injury and your circumstances.
A useful treatment plan explains what you can do yourself, whether treatment is likely to help, and when progress will be reviewed. This may involve tailored strengthening, gradual changes in activity, education and, where suitable, hands-on treatment. Ask a pharmacist or GP about pain-relief options that are safe alongside your health conditions and medicines.
For knee osteoarthritis, NICE recommends therapeutic exercise tailored to the person. Manual therapy should only be considered alongside exercise, and evidence does not support it as a treatment on its own. It should not be presented as repairing cartilage. If symptoms substantially affect life despite suitable non-surgical care, discuss further options with your GP or MSK service.
A meniscus problem also needs an individual plan. A finding on a scan does not by itself decide whether an operation is needed. See our guides to meniscus injuries and hip and knee osteoarthritis.
Review progress and choose the next step
Agree a goal you can recognise, such as managing the stairs or walking to the shops. Review function as well as pain: what can you do, how does the knee respond afterwards, and is the plan becoming easier to manage? If progress is limited, reconsider the plan rather than continuing the same approach indefinitely.
See a GP if knee pain has not improved within a few weeks, or sooner if it is worsening, repeatedly swelling or restricting everyday life. New urgent symptoms need prompt assessment even if you already have a treatment plan.
For local NHS physiotherapy, check the East Sussex MSK self-referral criteria. You can also read choosing the right help for muscle and joint pain, hip and thigh pain or what to expect at your first osteopathy appointment.
This guide provides general information and cannot identify the cause of an individual knee problem. Information sources checked: 13 October 2026.
Sources and further information
Reference links checked: 13 October 2026.