Top Causes of Knee Pain: Why It Happens and What to Do

Knee pain is incredibly common, affecting about 25% of adults and leading to millions of doctor visits each year. Whether it’s a sharp twinge after a game of pickleball or a constant ache that makes stairs tough, knee pain often stems from a handful of culprits. Drawing from trusted sources like Mayo Clinic, Cleveland Clinic, and Johns Hopkins, here are the top causes—and why they matter.

1.  Osteoarthritis (The Most Common Cause)

Often called “wear-and-tear” arthritis, osteoarthritis is the leading reason for chronic knee pain, especially in adults over 50. Cartilage that cushions the joint breaks down over time, causing bones to rub together. This leads to pain, stiffness, swelling, and reduced mobility. Risk factors include age, previous injuries, obesity, and repetitive stress. It’s progressive but manageable with early intervention.

2.  Injuries (Acute or Traumatic)

Sudden twists, falls, or impacts can damage ligaments (like ACL or MCL tears), cartilage (meniscus tears), or cause sprains/strains. These are common in sports, accidents, or everyday mishaps. Symptoms include immediate swelling, instability, or a “pop” sensation. Meniscus tears and ligament injuries rank high among active adults.

3.  Overuse and Repetitive Strain

Doing the same motions too often—running, jumping, squatting, or even prolonged kneeling—leads to conditions like patellofemoral pain syndrome (“runner’s knee”), iliotibial band syndrome (ITBS), or tendinitis (inflammation of tendons around the knee). This is frequent in athletes, manual workers, or those with high-activity lifestyles.

4.  Bursitis

Small fluid-filled sacs (bursae) cushion the knee, but overuse, prolonged pressure, or infection can inflame them (e.g., prepatellar or pes anserine bursitis). It causes localized swelling, warmth, and pain, often without major trauma.

5.  Tendinitis (e.g., Patellar or Quadriceps Tendinitis)

Inflammation of the tendons connecting muscles to bone, usually from overuse. “Jumper’s knee” (patellar tendinitis) is a classic example in sports involving jumping or quick stops.

Other notable causes include gout (crystal buildup causing sudden, intense pain), rheumatoid arthritis (autoimmune inflammation), Baker’s cysts, or mechanical issues like misalignment. Obesity adds extra load on knees, worsening many of these problems.

When to Seek Help and What Comes Next

Mild pain often improves with rest, ice, compression, elevation (RICE), over-the-counter anti-inflammatories, weight management, and strengthening exercises. But see a doctor if pain persists >6 weeks, worsens with activity, causes instability, swelling, or limits daily life—early evaluation prevents bigger issues.

Knee pain doesn’t have to sideline you forever. Many causes respond well to conservative care, injections, physical therapy, or, when needed, advanced options like joint replacement.

If knee pain is keeping you from activities you love—like pickleball, walking, or simply moving freely—don’t wait. Contact Dr. Dustin Hambright in Charleston for a thorough evaluation. As a board-certified orthopedic surgeon specializing in hip and knee issues, he provides personalized plans to diagnose the root cause and get you back to an active, pain-free life. Schedule a visit today—relief could be closer than you think.