Why Do I Have Knee Pain When Going Up Stairs?

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Many things can cause knee pain when going upstairs. Two of the most common are chondromalacia patella (overuse injury) and arthritis.

These conditions can take a seemingly benign task like stair climbing and turn it into a challenging endeavor. Fortunately, increasing your knowledge of each issue can help you treat the condition and reduce your pain.

This article explains chondromalacia patella and knee arthritis symptoms, causes, diagnoses, and treatment.

Sportswoman with hurt leg sitting on ground

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Chondromalacia Patella

Chondromalacia patella, also called "runner's knee," occurs when the smooth, slippery cartilage that lines the back of your knee cap (patella) begins to soften and break down. When it functions correctly, as your knee bends and straightens, the patella slides up and down in a groove at the bottom of your upper leg bone (called the femoral groove).

But people with chondromalacia patella experience increased amounts of rubbing and friction. This extra friction occurs due to this cartilage breakdown, and it can irritate your joint.

Symptoms

One of the hallmark signs of chondromalacia patella is a dull, achy pain centered in the area behind the knee cap. This condition can also cause soreness below, inside, or outside your patella as well.

A primary complaint of those with this condition is soreness when doing certain activities, like:

  • Going up the stairs
  • Squatting
  • Walking downhill
  • Running
  • Standing up after a more extended period of sitting

Causes and Risk Factors

Several different risk factors can make you more likely to develop chondromalacia patella. These include:

  • Having excess weight
  • People with less muscle mass
  • Those with a previous knee injury

Chondromalacia patella is also more frequently seen in individuals who participate in endurance sports like running or biking. In this situation, muscular imbalances cause the kneecap to track improperly in the femoral groove, leading to repetitive rubbing and irritation. 

Recap

Chondromalacia patella is a condition where the patella begins to wear out and break down. As the patella wears down, it creates friction, resulting in joint pain. As a result, people with chondromalacia patella may have trouble with activities that require knee use, such as climbing stairs.

Arthritis

As the cartilage breakdown progresses, the space between the bones in the knee (tibia, fibula, and patella) diminishes. When this happens, damage to one or several of them can develop, referred to as arthritis.

While there are many different varieties of this condition, the most prevalent is osteoarthritis (OA), a degenerative (wear-and-tear) form of arthritis.

Symptoms

Both chondromalacia patella and arthritis can make climbing the stairs, walking, and squatting quite painful. However, several other symptoms can help you distinguish between the two conditions.

Signs of knee OA include:

  • Pain in the knee
  • Stiffness
  • Swelling
  • Limited mobility
  • Knee popping or locking

Osteoarthritis typically occurs in middle- and older-aged individuals. In addition, knee stiffness and swelling (particularly in the morning and after long periods of sitting down) can make it difficult to bend or straighten the knee. This stiffness can cause the first few steps of the day to be sore and challenging.

Causes and Risk Factors

Multiple different factors can put you at a greater risk of developing arthritis. These include:

  • Excess weight
  • A previous injury to their knee
  • Those who play sports that place repetitive stresses on the knee joint
  • Being a woman
  • Genetics

Recap

Knee arthritis can cause pain when going up stairs. That's because of the degenerative effects of arthritis that result in friction and damage to the kneecap. However, you can usually distinguish arthritis from chondromalacia patella because, in addition to pain with activity, arthritis commonly also causes swelling, stiffness, and popping.

Diagnosis

When you see a doctor about knee pain that occurs when you climb the stairs, the first thing they will do is a physical exam. In addition, they will review your medical history and all of your symptoms.

Arthritis

When diagnosing osteoarthritis, doctors typically use an X-ray to visualize the space between the bones at the knee joint. An X-ray also allows them to see any damage that may have occurred to the bone itself.

If a doctor suspects another form of this condition, like rheumatoid or psoriatic arthritis (autoimmune forms), they may also do a blood draw to confirm their diagnosis.

Chondromalacia Patella

In the case of chondromalacia patella, you can't see the damage to the cartilage on an X-Ray. As such, a magnetic resonance imaging (MRI) is usually necessary to properly diagnose this condition.

Treatment

Both chondromalacia patella and arthritis are well-managed with conservative measures initially, especially when the symptoms are mild to moderate. The suggestions below may help relieve the pain you feel when going up stairs.

Chondromalacia Patella

Chondromalacia patella is common in people who participate in repetitive activities like running. Therefore, rest can play a significant role in reducing the pain associated with this condition. In addition, the following therapies may help:

  • Icing your knee
  • Over-the-counter (OTC) or prescription pain medication
  • Physical therapy
  • Losing weight
  • Modifying your footwear

Physical therapy can help build up strength and flexibility in your leg muscles. In addition, this work can help reduce the forces placed on the knee itself and improve the tracking of your knee cap. Your therapist may also work with you to modify your running or biking form to reduce your knee pain.

Arthritis

Like chondromalacia, you can improve arthritis pain using the RICE principle (rest, ice, compression, elevation). In addition, the following may benefit knee arthritis:

  • OTC pain medication
  • Staying active
  • Physical therapy
  • Orthotics in your shoes
  • Maintaining a healthy weight

Bed rest or remaining sedentary is rarely an effective solution. Instead, try riding a stationary bike with minimal resistance or going for a short walk. These activities can help loosen up a stiff knee and improve your overall soreness.

Physical therapy strengthens your supporting hip and knee muscles and improves overall flexibility.

Unfortunately, in some cases, conservative treatment is not effective in relieving your symptoms. In that case, surgery may be necessary. Surgery for knee arthritis may involve a partial or total knee replacement. Outpatient therapy is needed afterward.

Recap

Treatment for knee pain may differ slightly, depending on the cause. For both chondromalacia patella and arthritis, rest, ice, OTC pain medication, and orthotics may help. With arthritis, staying active is essential to keep the joints mobile. If these at-home therapies don't help, your doctor may advise surgery.

Summary

Arthritis and chondromalacia patella commonly cause knee pain. A healthcare provider diagnoses these conditions through imaging techniques, like X-rays and MRIs. Treatment may vary slightly depending on the cause, but typically rest, ice, and physical therapy help both conditions. If you have arthritis, continued movement is vital to maintain mobility in the joints.

Frequently Asked Questions

  • How can you manage stairs with knee arthritis?

    Strengthening your leg muscles can improve your mobility and make it easier to handle stairs when you have arthritis. Exercise, proper nutrition, and reducing inflammation are the best ways to strengthen those muscles.

  • How long does it take to recover from chondromalacia patella?

    Depending on the severity of the injury and your overall health, you might make a full recovery in weeks or months. However, about half of those who experience chondromalacia patella continue to have pain and symptoms for two to eight years.

  • Why does my outer knees ache when I walk up stairs?

    Repetitive stress on the knee can cause patellofemoral pain syndrome, also known as chondromalacia patella or runner’s knee. It refers to the breakdown of cartilage under the knee cap.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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