Why Do I Have Knee Pain Walking Down Stairs?

Some individuals experience knee pain when going down stairs. It can be mild and occur periodically, or the pain can be excruciating and frequent. There are different causes of this feeling. The three most common are:

  • Patellofemoral pain syndrome
  • Chondromalacia patella
  • Osteoarthritis
woman in pain on the stairs

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Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is also known as jumper’s knee or runner’s knee. This is a condition that is known to cause pain around or under the kneecap. This condition can happen in one or both of the knees. Both children and adults can experience PFPS.

Symptoms

Some of the most common symptoms of PFPS include:

  • Tenderness to the touch of the knee
  • Cracking or grinding sounds when the knee is bent or straightened
  • Pain around the kneecap
  • Dull or aching pain in the front of the knee
  • Pain after sitting for a period of time with the knees bent

These symptoms begin gradually and may get worse over time.

Causes and Risk Factors

Some of the causes of PFPS include:

  • Weak thigh muscles
  • Tight hamstrings
  • Poor foot support
  • An injury
  • Overuse during exercise and movement
  • A kneecap that is too high in the knee joint

Chondromalacia Patella

Chondromalacia patella is the breakdown and softening of the cartilage on the patella—or underside of the kneecap. Pain occurs when the thigh bone and knee rub together.

Symptoms

Some of the symptoms of chondromalacia patella include:

  • Dull pain behind, below, and on the sides of the kneecap
  • Feeling of grinding when going down the stairs, running downhill, or doing squats or knee bends
  • Pain standing up after sitting for a period of time

Causes and Risk Factors

Chondromalacia patella occurs when there is:

  • Abnormal kneecap positioning
  • Muscle weakness or tightness around the knee
  • Flat feet
  • Too much movement that involves the knee

Individuals who are at risk of getting chondromalacia patella include people who:

  • Had an injury, dislocation, or fracture that is related to the kneecap
  • Are overweight
  • Exercise often such as bicyclists and runners

Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis. More common in older people, osteoarthritis happens when tissues in the joints start to break down over time. OA of the knee is common.

Depending on the severity of OA, some individuals have a lot of pain, while it doesn’t affect the day-to-day activities of others. When OA in the knee occurs, the cartilage in the knee joint wears away gradually, and the protective space between the bone decreases. Because the cartilage and protective space have decreased, this can result in the bones rubbing together, which creates pain and damage. Although OA develops slowly, it can worsen over time.

Symptoms

The symptoms of OA include:

  • Swelling around the joints
  • Giving out of the knee
  • Muscle weakness around the joints
  • Limited range of motion
  • Aches and pains during an extended amount of activity
  • Cracking sounds of the knees

Causes and Risk Factors

OA was long believed to be caused by the wearing down of joints over time. Scientists now see OA as a disease of the joint. Some of the causes of OA include:

  • Advancement of age
  • Joint injury
  • Overuse of the same joint
  • Weak muscles
  • Obesity due to the stress on the joints
  • Inflammation
  • Genetics

Women are more likely to develop OA than men.

When to See a Doctor

If you’re constantly having knee pain walking down stairs, it’s important to see a healthcare professional to receive treatment before it gets worse.

Diagnosis

To determine the diagnosis and best treatment for knee pain, the doctor will administer several different tests. Some include a blood test, X-ray, MRI, and/or physically touch the knee to determine the tenderness or mild swelling.

Treatment

One of the most common at-home treatments for knee pain is known as RICE:

  • Rest: Reduce activity
  • Ice: For 20 minutes, three times a day
  • Compression: Gently wrap or bandage your knee
  • Elevate: Keep your foot above heart level

Before you start any at-home treatments, contact your healthcare professional.

Patellofemoral Pain Syndrome

The treatment for PFPS includes:

  • Stretching and strengthening exercises
  • Elevation of the leg
  • Cold packs
  • Compression knee wrap
  • Pausing on running until the pain is gone
  • Wearing proper shoes and additional arch support if necessary

Physical therapy is another option. Contact your healthcare professional to determine a proper treatment based on the specific condition.

Chondromalacia Patella

When a person has chondromalacia patella, their cartilage can heal. The inflammation caused must subside. Common treatments are:

  • Rest
  • Physical therapy
  • Nonsteroidal anti-inflammatory medication

If improvement occurs, activity can be increased gradually. Low-impact activities—like swimming—can help. Physical therapy is also an option.

If these treatments don’t work, surgery may be explored. Contact your healthcare professional to discuss the proper treatment based on the specific condition.

Osteoarthritis

Although there is no cure for OA, the following are known to help ease pain:

  • Physical therapy
  • Medication
  • Assistive devices
  • Exercise
  • Weight loss

Joint replacement surgery is also an option. Medications may include nonsteroidal anti-inflammatory drugs such as aspirin, naproxen, or ibuprofen.

Another option is platelet-rich plasma (PRP). This is an injection of proteins given by a doctor that ease inflammation and pain. Exercise addressing cardiovascular options, balance, and range of motion can also ease the pain of OA. Contact your healthcare professional to discuss the proper treatment based on the specific condition.

Coping

If you saw a doctor and are still experiencing knee pain walking down stairs, these techniques may help:

  • Use the whole foot: Stepping on the toes is known to cause pain and compress the knee.
  • Activate the gluteus muscles: Do this by pushing off from the outer heel. This puts less strain on the knee.

Understanding the cause of knee pain will ultimately help you cope. It is important to speak with your doctor to get the best advice and treatment regarding knee pain.

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Article Sources
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  3. Cleveland Clinic. Knee pain (chondromalacia patella). Updated October 6, 2014.

  4. National Institute of Arthritis and Musculoskeletal and Skin Disease. Osteoarthritis. Updated October 2019.

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  8. AposHealth. Knee pain going down stairs? Here’s what you need to know. Updated July 31, 2020.