Knee Pain: Causes and Treatment Options
Knee pain has many sources: joint wear, tendons, meniscus injury, bursitis, or pain referred from the hip or spine. A clear exam comes first. Most people start with activity changes and therapy. Injections and nerve procedures are reserved for selected, persistent patterns.
Quick Answer: Knee Pain
- Sort the source: joint, tendon, meniscus, bursitis, or referred spine/hip pain.
- Keep moving with joint-friendly activity; avoid complete shutdown.
- Physical therapy and load management are first-line for many causes.
- Steroid injections may help inflammatory flares; they do not rebuild cartilage.
- Genicular nerve RFA is an option for selected arthritis-related pain after evaluation.
- Fever with a hot knee, trauma with deformity, or clot signs need urgent care.
Common Causes of Knee Pain
- Osteoarthritis: cartilage wear with activity-related pain and stiffness.
- Meniscus or ligament injury: often after twist or load; swelling or catching may occur.
- Patellofemoral pain: front-of-knee pain with stairs or prolonged sitting.
- Tendon or bursal irritation: including patellar or pes anserine patterns.
- Referred pain: hip arthritis or lumbar nerve irritation can land in the knee.
Related reading: arthritis treatment and steroid injections for arthritis.
Knee Pain That Travels Down to the Ankle
Pain felt in the knee that travels down the shin toward the ankle is not always from the knee joint itself. Irritation of low-back nerve roots (often around L4–L5) can send pain into the thigh, knee, and down toward the ankle. Hip problems can also refer pain into the knee and upper shin. Your exam compares the knee, hip, and spine so the plan targets the real driver.
Red Flags
- Hot, red, very swollen knee with fever (infection concern).
- Inability to bear weight after a fall or twist; visible deformity.
- Rapid calf swelling or breathlessness (clot or other emergency concern).
- Progressive neurologic loss if a spine source is suspected.
How Knee Pain Is Evaluated
Your doctor maps pain location, swelling, range of motion, ligament stability, and gait. X-rays show joint space and alignment. MRI is used selectively for meniscus, ligament, or unclear soft-tissue injury. Spine exam is added when symptoms suggest referred pain. EMG/NCS, if needed for a nerve question, are referred out.
First-Line Care
Reduce deep squats, repetitive stairs, and prolonged kneeling that flare symptoms, while keeping walking, cycling, or pool exercise when tolerated. Physical therapy builds quadriceps and hip strength and improves load sharing. Weight management, when relevant, lowers joint demand. Oral anti-inflammatory medicines may help short flares when safe for your stomach, kidneys, and heart.
Chiropractors and physical therapists can be partners for kinetic-chain and spine contributors to knee load.
Injections
Steroid shots into the knee can calm inflammatory flares for a while. These are FDA-approved medicines used in the joint for inflammation. They are not a disease-modifying treatment [Source]. Hyaluronic acid (viscosupplementation) has mixed evidence across guidelines.
Platelet-rich plasma (PRP) is made from your own blood. PRP is offered when appropriate. Evidence for knee arthritis is mixed, and it is not FDA approved for specific knee conditions.
Genicular Nerve Procedures
When arthritis pain lasts and surgery is not wanted yet, genicular nerve blocks can test whether knee sensory nerves carry the pain. If short-term relief is clear, radiofrequency ablation of those nerves may be considered [Source] [Source]. This quieting of pain signals does not repair cartilage. See also radiofrequency ablation.
Genicular artery embolization (GAE) is a newer image-guided option studied for mild to moderate knee osteoarthritis when excess blood flow in the knee lining may drive pain [Source]. Interventional radiologists perform GAE; tiny particles reduce that abnormal vessel flow. It differs from genicular nerve radiofrequency ablation, which quiets selected sensory nerves after test blocks and does not change blood flow, and from steroid or PRP injections into the joint. Evidence for GAE is still developing, and it is not a routine first step. GAE is not offered at our offices; we can talk through how it compares with the options available here.
Ice after activity, supportive shoes, and avoiding deep knee bends on hard floors can reduce day-to-day flares. If the knee gives way, use care on stairs and ask about bracing while you rebuild strength.
Dr. Amit Sharma & our minimally invasive pain & spine team.
When spine and knee findings both exist, treat the clearer driver first. Some people need a short knee plan and a separate spine plan rather than one shot meant to fix everything.
Bring a list of prior injections, surgeries, and medicines to your visit. That history prevents repeat steps that already failed and highlights safer next options.
If swelling rises quickly after activity, rest, elevate, and note whether the joint feels warm. Warmth with fever is different from routine post-exercise fluid and should be checked sooner.
When Orthopedic Surgery Is Discussed
Ongoing locking, unstable ligaments, or advanced arthritis after a fair try of non-surgical care may lead to an orthopedic referral. Talk may include arthroscopy or joint replacement. Pain procedures can still help before or instead of surgery in selected cases.
Knee Pain Care at SpinePain Solutions
At SpinePain Solutions, Dr. Amit Sharma, Chief, Division of Pain Medicine at Good Samaritan University Hospital, evaluates complex knee and referred-spine pain at our Bay Shore, Commack and Farmingdale offices (see office locations). Call 631-310-0000.
Frequently Asked Questions
What causes knee pain?
Common causes include osteoarthritis, meniscus tears, tendon irritation, bursitis, injury, and crystal arthritis. Pain can also be referred from the hip or lumbar spine. A focused exam sorts these patterns.
When is knee pain an emergency?
Go to the ER or urgent care for a hot swollen knee with fever, inability to bear weight after trauma, a visibly deformed joint, sudden locking with severe swelling, or calf swelling with concern for blood clot.
Should I rest completely if my knee hurts?
Usually no. Reduce the activities that flare pain, but keep gentle motion such as walking, cycling, or pool exercise when tolerated. Full shutdown often worsens stiffness.
Do steroid injections reverse knee arthritis?
No. Corticosteroid injections may calm inflammatory flares for a period of time. They do not reverse cartilage loss. Your doctor weighs benefits and risks for your situation.
What is genicular nerve radiofrequency ablation?
Genicular RFA uses heat to quiet selected sensory nerves around the knee after temporary test blocks. It may help selected osteoarthritis pain. It does not rebuild the joint.
Is PRP FDA approved for knee arthritis?
Platelet-rich plasma is made from your own blood. PRP is offered when appropriate. Evidence for knee arthritis is mixed, and it is not FDA approved for specific knee conditions.
Can back problems cause knee pain?
Yes. Lumbar nerve irritation can refer pain into the thigh or knee. Your exam helps decide whether the driver is the knee, the hip, the spine, or more than one source.
What is genicular artery embolization (GAE)?
GAE is an image-guided procedure done by interventional radiologists. Tiny particles are used to reduce excess blood flow in the knee lining that may drive osteoarthritis pain. It is studied mainly for mild to moderate knee osteoarthritis when injections and other care have not been enough. Evidence is still developing. GAE is not offered at our offices; we can talk through how it compares with genicular nerve radiofrequency ablation and injections. GAE targets blood vessels; genicular RFA quiets selected sensory nerves and does not change blood flow.
Where can I get knee pain care on Long Island?
SpinePain Solutions evaluates knee and related spine pain in Bay Shore, Commack and Farmingdale. Call 631-310-0000.
Dr. Amit Sharma & our minimally invasive pain & spine team.
Medical References
- Choi WJ et al. Radiofrequency treatment relieves chronic knee osteoarthritis pain: a double-blind randomized controlled trial. Pain. 2011. PMID 21055873.
- Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019. PMID 31278997.
- Kolasinski SL et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020. PMID 31908163.
- Fogarty AE et al. The Effectiveness of Fluoroscopically Guided Genicular Nerve Radiofrequency Ablation for the Treatment of Chronic Knee Pain Due to Osteoarthritis: A Systematic Review. Am J Phys Med Rehabil. 2022. PMID 35006653.
- Chlorogiannis DD et al. Knee pain improvement after genicular artery embolization for the management of knee osteoarthritis: an updated systematic review and meta-analysis of 21 studies. Radiologie (Heidelb). 2024. PMID 39527285.
