Table of ContentsView AllTable of ContentsInner Knee PainKneecap PainOuter Knee PainReferred Knee PainDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Inner Knee Pain
Kneecap Pain
Outer Knee Pain
Referred Knee Pain
Diagnosis
Treatment
Twisting your knee can cause different types of pain depending on which structure of the knee is affected. While this type of injury most commonly affectsligamentsor C-shaped pieces of cartilage known as themeniscus, muscles, bones, and nerves can also be affected. In addition to pain, there may also be knee weakness, instability, swelling, and locking of the knee.
Knee pain on the inner side may be due to a medial collateral ligament (MCL)sprain, while pain on the outer side may be due to a lateral collateral ligament (LCL) sprain. Pain in the center of the knee may be due to apatellar (kneecap)injury, while shooting pains in the knee may be the result ofreferred painoriginating from somewhere else in the body.
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Pain on the Inner Side of the Knee
Pain felt on the inside of the knee usually involves one of two structures known as the medial meniscus and the medial collateral ligament (MCL).
Medial Meniscus Tear
Meniscus are crescent-shaped bands of rubbery cartilage attached to thetibia(shinbone). They act as shock absorbers and help stabilize the knee. Those situated on the inner side of the knee—one for each knee joint—are called medial meniscus.
Ameniscus tearis one of the most common reasons for inner knee pain after a twisting injury. Symptoms of a medial meniscus tear include:
How to Strengthen Knees
MCL Sprain
A ligament is a fibrous band of tissue that attaches muscles to bones. The medial collateral ligament (MCL) is one of four ligaments that keep the knee joint stable. The MCL runs from the end of thefemur(thigh bone) to the top of the tibia on the inside of the knee joint.
When the MCL is severely twisted, it can lead to a sprain. Symptoms ofMCL spraininclude:
Knee Pain and OsteoarthritisThe twisting of a knee can also aggravate a pre-existing condition, such as kneeosteoarthritis(“wear-and-tear arthritis”).With osteoarthritis, there may bebone spursand a significant loss of knee cartilage. If the knee is twisted, the scraping of bones can cause immediate pain and prolongedinflammationwith swelling, redness, tenderness, and stiffness.
Knee Pain and Osteoarthritis
The twisting of a knee can also aggravate a pre-existing condition, such as kneeosteoarthritis(“wear-and-tear arthritis”).With osteoarthritis, there may bebone spursand a significant loss of knee cartilage. If the knee is twisted, the scraping of bones can cause immediate pain and prolongedinflammationwith swelling, redness, tenderness, and stiffness.
The twisting of a knee can also aggravate a pre-existing condition, such as kneeosteoarthritis(“wear-and-tear arthritis”).
With osteoarthritis, there may bebone spursand a significant loss of knee cartilage. If the knee is twisted, the scraping of bones can cause immediate pain and prolongedinflammationwith swelling, redness, tenderness, and stiffness.
Pain Around the Kneecap
The patella, also known as the kneecap, is a rounded triangular bone that covers and protects the surface of the knee joint. If you experience pain in and around the patella after twisting it, it may be due to one of two things:
Patellar Dislocation
Patellar dislocationoccurs when the kneecap either partially or completely slips out of the groove that it rests in. This type of injury most frequently affects adolescents (especially young female athletes due to the distinct structure of their knees).
Symptoms of patellar dislocation include:
Synovial Plica Syndrome
Synovial plica syndrome (SPS) is a condition in which thesynovial plicae(inward-folding tissue that lines the knee joint) become inflamed. While commonly thought of as anoveruse injuryof the knee, SPS can occasionally occur after a twisting knee injury.
Symptoms of SPS include:
Pain on the Outside of Knee
Lateral Meniscus Tear
Lateral meniscus are those situated on the outer side of the knee. A tear of the lateral meniscus can cause symptoms including:
LCL Sprain
The lateral collateral ligament (LCL) is situated on the outer side of the knee, running from the top part of thefibula(the bone on the outside of the lower leg) to the outside part of the femur. The LCL helps stabilize the outer side of the knee joint.
An LCL sprain occurs if the leg moves into avarus(bow-legged) position.
Symptoms include:
It is uncommon for a twisting injury to cause anLCL tear, but it has been known to occur. LCL tears are most commonly the result of a blow to the outer knee.
Pain felt in the knee doesn’t always originate in the knee. On occasion, the pain may be referred, meaning originating from a nerve injury somewhere else in the body.
Also known asradiculopathy, referred pain occurs when a nerve is compressed (pinched), causing nerve signals to misfire. The misfiring can trigger nerve pain elsewhere along the nerve route.
If the knee is involved, the hip or spine is usually where the nerve compression occurs.
Symptoms of referred knee pain may include:
Hip Osteoarthritis
When the saphenous nerve is pinched, the referred pain is mainly felt in the inner knee. There may also be pain and stiffness in the hip joint. The knee pain tends to get worse after spending a long time on your feet or after getting up from sitting or lying down.
Sciatic Nerve Compression
The nerves that exit the spine are called spinal nerve roots. Those emerging from thelower (lumbar) spineare vulnerable to compression due to things like aherniated disc,spinal stenosis, spinal degeneration, or an injury or infection.
The lumbar spinal nerves provide sensations to the lower limb, including the knee. There are five pairs of lumbar spinal nerves, including thesciatic nervewhich emerges from the lowest vertebra, called the L5.
The sciatic nerve runs from the lower back down to the outer thigh and ends at the back of the knee. If the sciatic nerve is pinched, it can sometimes cause shooting knee pains referred to as “kneesciatica.”
Sciatic knee pain is mostly centered around the outside, front, or back of the knee. There may also be a sharp or aching pain in the lower back on the same side of the body.
Diagnosing Knee Pain
Based on the initial findings, the following may be ordered:
Early on after an acute twist injury, theRICE (rest-ice-compression-elevation) protocolcan be used to help control pain and inflammation:
Medications
Over-the-counter medications likeTylenol (acetaminophen)ornonsteroidal anti-inflammatory drugs (NSAIDs)like Advil (ibuprofen) can help ease mild to moderate joint pain following a twisting injury.
For more severe injuries, your healthcare provider may suggest acortisone knee injectionalong with a knee brace to help stabilize the knee.
Physical Therapy
Physical therapy can also assist in reducing the pain and disability associated with many different conditions, including ligament sprains, meniscal tears, hip osteoarthritis, SPS, and sciatic knee pain.
Frequently, exercises focusing on strengthening the knee and hip muscles and improving balance can be used to add support and stability to the injured area. Gentle stretching exercises may also be needed to improve the range of motion in your legs.
Surgery
Surgical intervention may be necessary following a more severe injury or one that cannot be properly addressed using the treatments above. In the case of a meniscal tear, this typically involves repairing or removing the damaged portion of the cartilage.
For severe ligament tears or recurrent patellar dislocations, a graft may need to be arthroscopically placed to add stability to the injured area. Finally, in advanced cases of osteoarthritis, atotal knee replacementmay be performed to remove and replace the damaged portion of the joint.
Summary
Knee pain from a twisted knee can vary depending on which part of the knee is injured. Inner knee pain may be due to a medial meniscus tear or MCL sprain, while outer knee pain may be due to a lateral meniscus tear or LCL sprain.
Kneecap pain may be due to patellar dislocation and an inflammatory condition called synovial plica syndrome (SPS). Referred knee pain can occur when the sciatic nerve in the lumbar spine or the saphenous nerve at the hip joint is compressed.
Top Causes of Knee Pain When Sitting or Bending
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bunt CW, Jonas CE, Chang JG.Knee pain in adults and adolescents: the initial evaluation.Am Fam Physician. 2018;98(9):576-585.Lee PYF, Nixion A, Chandratreya A, Murray JM.Synovial plica syndrome of the knee: a commonly overlooked cause of anterior knee pain.Surg J.2017;3(1):e9-e16. doi:10.1055/s-0037-1598047Grawe B, Schroeder AJ, Kakazu R, Messer MS.Lateral collateral ligament injury about the knee: anatomy, evaluation, and management.J Am Acad Orthop Surg.2018;26(6):e120-e127. doi:10.5435/jaaos-d-16-00028Zhang X, Zhang Z, Wen J, Lu J, Sun Y, Sang D.The effectiveness of therapeutic strategies for patients with radiculopathy: a network meta-analysis.Mol Pain. 2018;14:1744806918768972. doi:10.1177/1744806918768972Sakamoto J, Morimoto Y, Ishii S, et al.Investigation and macroscopic anatomical study of referred pain in patients with hip disease.J Phys Ther Sci.2014 Feb;26(2):203–208. doi:10.1589/jpts.26.203Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus.2019 Oct;11(10):e5934. doi:10.7759/cureus.5934Aguilar-Shea AL, Gallardo-Mayo C, Sanz-Gonzalez R, Paredes I.Sciatica. Management for family physicians.J Family Med Prim Care.2022 Aug;11(8):4174–4179. doi:10.4103/jfmpc.jfmpc_1061_21Michigan Medicine.Rest, ice, compression, and elevation.Jones BQ, Covey C, Marvin Sineath J.Nonsurgical management of knee pain in adults.AFP. 2015;92(10):875-883.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bunt CW, Jonas CE, Chang JG.Knee pain in adults and adolescents: the initial evaluation.Am Fam Physician. 2018;98(9):576-585.Lee PYF, Nixion A, Chandratreya A, Murray JM.Synovial plica syndrome of the knee: a commonly overlooked cause of anterior knee pain.Surg J.2017;3(1):e9-e16. doi:10.1055/s-0037-1598047Grawe B, Schroeder AJ, Kakazu R, Messer MS.Lateral collateral ligament injury about the knee: anatomy, evaluation, and management.J Am Acad Orthop Surg.2018;26(6):e120-e127. doi:10.5435/jaaos-d-16-00028Zhang X, Zhang Z, Wen J, Lu J, Sun Y, Sang D.The effectiveness of therapeutic strategies for patients with radiculopathy: a network meta-analysis.Mol Pain. 2018;14:1744806918768972. doi:10.1177/1744806918768972Sakamoto J, Morimoto Y, Ishii S, et al.Investigation and macroscopic anatomical study of referred pain in patients with hip disease.J Phys Ther Sci.2014 Feb;26(2):203–208. doi:10.1589/jpts.26.203Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus.2019 Oct;11(10):e5934. doi:10.7759/cureus.5934Aguilar-Shea AL, Gallardo-Mayo C, Sanz-Gonzalez R, Paredes I.Sciatica. Management for family physicians.J Family Med Prim Care.2022 Aug;11(8):4174–4179. doi:10.4103/jfmpc.jfmpc_1061_21Michigan Medicine.Rest, ice, compression, and elevation.Jones BQ, Covey C, Marvin Sineath J.Nonsurgical management of knee pain in adults.AFP. 2015;92(10):875-883.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bunt CW, Jonas CE, Chang JG.Knee pain in adults and adolescents: the initial evaluation.Am Fam Physician. 2018;98(9):576-585.Lee PYF, Nixion A, Chandratreya A, Murray JM.Synovial plica syndrome of the knee: a commonly overlooked cause of anterior knee pain.Surg J.2017;3(1):e9-e16. doi:10.1055/s-0037-1598047Grawe B, Schroeder AJ, Kakazu R, Messer MS.Lateral collateral ligament injury about the knee: anatomy, evaluation, and management.J Am Acad Orthop Surg.2018;26(6):e120-e127. doi:10.5435/jaaos-d-16-00028Zhang X, Zhang Z, Wen J, Lu J, Sun Y, Sang D.The effectiveness of therapeutic strategies for patients with radiculopathy: a network meta-analysis.Mol Pain. 2018;14:1744806918768972. doi:10.1177/1744806918768972Sakamoto J, Morimoto Y, Ishii S, et al.Investigation and macroscopic anatomical study of referred pain in patients with hip disease.J Phys Ther Sci.2014 Feb;26(2):203–208. doi:10.1589/jpts.26.203Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus.2019 Oct;11(10):e5934. doi:10.7759/cureus.5934Aguilar-Shea AL, Gallardo-Mayo C, Sanz-Gonzalez R, Paredes I.Sciatica. Management for family physicians.J Family Med Prim Care.2022 Aug;11(8):4174–4179. doi:10.4103/jfmpc.jfmpc_1061_21Michigan Medicine.Rest, ice, compression, and elevation.Jones BQ, Covey C, Marvin Sineath J.Nonsurgical management of knee pain in adults.AFP. 2015;92(10):875-883.
Bunt CW, Jonas CE, Chang JG.Knee pain in adults and adolescents: the initial evaluation.Am Fam Physician. 2018;98(9):576-585.
Lee PYF, Nixion A, Chandratreya A, Murray JM.Synovial plica syndrome of the knee: a commonly overlooked cause of anterior knee pain.Surg J.2017;3(1):e9-e16. doi:10.1055/s-0037-1598047
Grawe B, Schroeder AJ, Kakazu R, Messer MS.Lateral collateral ligament injury about the knee: anatomy, evaluation, and management.J Am Acad Orthop Surg.2018;26(6):e120-e127. doi:10.5435/jaaos-d-16-00028
Zhang X, Zhang Z, Wen J, Lu J, Sun Y, Sang D.The effectiveness of therapeutic strategies for patients with radiculopathy: a network meta-analysis.Mol Pain. 2018;14:1744806918768972. doi:10.1177/1744806918768972
Sakamoto J, Morimoto Y, Ishii S, et al.Investigation and macroscopic anatomical study of referred pain in patients with hip disease.J Phys Ther Sci.2014 Feb;26(2):203–208. doi:10.1589/jpts.26.203
Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus.2019 Oct;11(10):e5934. doi:10.7759/cureus.5934
Aguilar-Shea AL, Gallardo-Mayo C, Sanz-Gonzalez R, Paredes I.Sciatica. Management for family physicians.J Family Med Prim Care.2022 Aug;11(8):4174–4179. doi:10.4103/jfmpc.jfmpc_1061_21
Michigan Medicine.Rest, ice, compression, and elevation.
Jones BQ, Covey C, Marvin Sineath J.Nonsurgical management of knee pain in adults.AFP. 2015;92(10):875-883.
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