Causes of Knee Pain by Location

Where your knee pain occurs can hint at why it's happening

The location of knee pain can say a lot about its possible causes. For example, a healthcare provider may consider certain diagnoses if the pain is on the inside of the knee versus the outside. Likewise, they may rule certain causes in or out if the pain is felt under the kneecap while bending the knee or at the top of the knee when walking upstairs.

To better understand why the location of knee pain can be so telling, it helps to learn about the structures of the knee and the various conditions that can affect them.

This article takes a concise look at the anatomy of the knee joint and describes the processes and conditions that cause pain in the different aspects (parts) of the knee.

Normal Knee Joint

Normal knee joint
The structure of a normal knee joint. Stocktrek Images/Getty Images

The knee is one of the most complex joints in the human body. The knee joins the femur (thigh bone) with the tibia (shin bone). Adjacent and attached to the tibia is the fibula. The kneecap itself is known as the patella.

Between the femur and tibia are two C-shaped pieces of cartilage, called the meniscus, that function as shock absorbers. There are also fluid-filled sacs, called bursae, between the bones of the knees that ensure smooth movement.

The knee joint is surrounded by a membrane, called the synovium, that produces a thick fluid, called synovial fluid, that helps keep the meniscus slippery.

The knee bones are connected with fibrous bands of tissues known as ligaments that provide the knee with stability. The ligaments that support the knee are:

Tendons connect the knee bones to the muscles of the leg to move the knee joint.

Pain Located at the Top of the Knee

Pain at the top of the knee, particularly pain felt when walking down a flight of stairs, is often the result of:

  • Bursitis: This is the inflammation of the bursae commonly caused by an acute knee injury, a repetitive overuse injury, or a systemic (whole-body) inflammatory condition like rheumatoid arthritis or gout.
  • Chondromalacia: This is the deterioration of the patella, also known as "runner's knee," most commonly caused by repetitive stress.
  • Knee osteoarthritis: Thi is a non-inflammatory form of arthritis, also known as "wear-and-tear" arthritis. Arthritis in the patellofemoral compartment of the knee capsule, between the patella and femur, commonly causes upper knee pain.
  • Patella tracking syndrome: This is a condition often due to a traumatic injury that causes the patella to shift out of place as the leg is bent or straightened.

Pain Located at the Bottom of the Knee

Knee Osteoarthritis, Illustration
BSIP/UIG / Getty Images

Pain at the bottom part of the knee is commonly associated with four conditions:

  • Osgood-Schlatter disease: This is a condition common in children in which the tendons of the knees pull on the knee's growth plate during rapid growth spurts.
  • Osteochondritis dissecans: This is an uncommon disorder that causes the knee meniscus starts to loosen and, in some cases, detach from the bone.
  • Patellar tendonitis: This is the inflammation of the tendon of the kneecap, also known as "jumper's knee," that commonly occurs in athletes who jump or run
  • Patellofemoral instability: This is a condition, once known as traumatic patellar dislocation, in which the patella gets moved out of the groove that connects it to the bottom of the femur.

Pain Located in the Inner Knee

Doctor examining senior mans knee in examination room
Hero Images / Getty Images

Pain on the inside (medial aspect) of the knee can occur for a number of different reasons, including:

  • Bursitis: This is a form of bursitis called pes anserine bursitis that occurs in between the tibia and the tendons of the hamstring muscle.
  • Knee osteoarthritis: This occurs when arthritis develops in the medial compartment of the knee.
  • Medial collateral ligament injuries: Also known as an MCL tear, this is often caused by sudden turning, twisting, or "cutting" motions in sports like skiing, football, basketball, and volleyball.
  • Medial meniscus tears: This is usually a sport-related injury caused when you forcefully twist or rotate the knee, such as occurs during football or soccer.

Pain Located in the Outer Knee

Pain on the outside (lateral aspect) of the knee may be caused by:

  • Knee osteoarthritis: This can occur when arthritis develops in the lateral compartment of the knee.
  • Iliotibial band syndrome: This is a condition common in distance runners and impact cyclists in which the strong band of tissues that starts at the hip and runs along the outer thigh (called the iliotibial band) is injured.
  • Lateral collateral ligament injuries: Also known as an LCL tear, this is most commonly caused by a direct blow to the inside of the knee.
  • Lateral meniscus tear: This is when the cartilage on the lateral aspect of the knee is torn, often the result of excessive weight bearing and twisting knee motions, such as occurs with skiing or basketball.

Pain Located in the Middle of the Knee

Pain in the middle (anterior aspect) of the knee, including under the kneecap, may be the result of the following conditions:

  • Anterior cruciate ligament tear: Also known as an ACL tear, this is an injury that can occur during sports, motor vehicle collisions, severe falls, and work-related injuries.
  • Tricompartment osteoarthritis: This is a form of osteoarthritis in which all three compartments of the knee (medial, lateral, and patellofemoral) have arthritis.

Pain Located at the Back of the Knee

Pain at the back (posterior aspect) of the knee is commonly caused by things like:

  • Baker's cyst: This is a fluid-filled sac that occurs when excess synovial fluid sees through the back of the knee capsule (due to things like severe osteoarthritis or an injury of the meniscus).
  • Posterior cruciate ligament injuries: Also known as a PCL tear, this usually occurs when the knee is directly hit, such as during contact sports like soccer, football, or rugby.

A Word From Verywell

It is never a good idea to ignore knee pain that is severe or persistent. The cause of the pain can encompass everything from an injury to an infection to an autoimmune disease like rheumatoid arthritis.

As a rule of thumb, see a healthcare provider if your knee pain was caused by a forceful impact or is causing significant swelling, pain, redness, or warmth around the joint.

Frequently Asked Questions

  • What is the most common reason for knee pain?

    Knee osteoarthritis (a.k.a. "wear-and-tear arthritis") is regarded as the most common cause of knee pain, according to a study in ISRN Family Medicine. Of 8,877 people who sought treatment for knee pain, 44.9% had knee osteoarthritis.

  • What is knee arthritis pain like?

    Knee arthritis pain is often felt during or after movement and can sometimes be sharp, particularly when pressure is placed on the joint. Even prolonged standing can cause pain. The knee pain can sometimes get better or worse depending on the weather.

  • How do I know if my knee pain is serious?

    According to the American Academy of Orthopaedic Surgeons, you should seek medical care if:

    • You have severe knee pain.
    • You hear a popping sound or feel your knee give out at the time of an injury.
    • You cannot move your knee.
    • You start limping and cannot bear weight on the knee.
    • You have knee swelling after a blow to the knee.

5 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.
  1. Saavedra MA, Navarro-Zarza JE, Villasenor-Ovies P, et al. Clinical anatomy of the knee. Reumatol Clin. 2012 Dec-2013 Jan;8 Suppl 2:39-45. doi:10.1016/j.reuma.2012.10.002

  2. Bunt CW, Jonas CE, Chang JG. Knee pain in adults and adolescents: the initial evaluation. Am Fam Physician. 2018 Nov 1;98(9):576-85.

  3. Frese T, Peyton L, Mahlmeister J, Sandholzer H. Knee pain as the reason for encounter in general practice. ISRN Family Med. 2013;2013:930825. doi:10.5402/2013/930825

  4. American Academy of Orthopaedic Surgeons. Arthritis of the knee.

  5. American Academy of Orthopaedic Surgeons. Common knee injuries.

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.