- SPECIALIST ORTHOPAEDIC SURGEON | MELBOURNE, VIC | ALBURY NSW |
- 03 9421 6133
Chronic Knee Pain
Understanding persistent knee symptoms, what causes them, and how they can be managed
Chronic knee pain refers to ongoing or recurring pain in the knee that lasts longer than 3 months. It may develop gradually or result from an injury that fails to heal properly. Unlike acute pain, which often improves with rest and time, chronic knee pain tends to persist, impact daily activities, and may signal an underlying joint or soft tissue problem that requires medical attention.
Chronic knee pain is a common issue affecting people of all ages, from active individuals with overuse injuries to older adults experiencing degenerative joint conditions. If left unaddressed, it can lead to reduced mobility, muscle weakness, and long-term functional limitations.
This page provides a comprehensive overview of what causes chronic knee pain, how it is diagnosed, and what treatment options may help reduce symptoms and improve quality of life.
Around 2.1 million Australians (1 in 11 people) have osteoarthritis, with a 58% increase expected by 2032 due to population ageing and rising obesity rates
Common symptoms of chronic knee pain
Hip osteoarthritis is a common condition that occurs when the protective cartilage that lines the surfaces of the hip joint begins to wear down over time. This cartilage normally allows smooth, pain-free movement. As it gradually breaks down, the bones in the joint may rub against each other, leading to pain, stiffness, inflammation, and reduced mobility.
Osteoarthritis of the hip tends to develop slowly and can affect one or both hips. While it is more common in people over the age of 50, it can also occur in younger individuals, particularly if there has been previous injury, joint abnormality, or a family history of arthritis.
Common symptoms of chronic knee pain
Symptoms may vary depending on the underlying cause but typically include:
- Persistent or recurrent pain in or around the knee joint
- Swelling or stiffness, especially after activity or prolonged sitting
- Clicking, locking, or catching sensations
- Reduced range of motion or difficulty bending the knee fully
- Instability or the feeling that the knee may give way
- Pain when climbing stairs, squatting, or walking long distances
Pain may be localised to the front (anterior knee), inner or outer side, or deep within the joint. It may be sharp, dull, aching, or throbbing, and worsen with activity or weather changes.
What causes chronic knee pain?
There are many possible causes of long-term knee pain. Common causes include:
- Osteoarthritis- A degenerative joint condition where the cartilage that cushions the joint gradually wears down, leading to pain, stiffness, and inflammation.
- Meniscal tears – Damage to the cartilage between the femur and tibia may cause mechanical symptoms such as clicking, catching, or joint line pain. These tears may persist after injury or develop over time with wear.
- Patellofemoral pain syndrome – Often felt as pain around the front of the knee or behind the kneecap, especially with stairs, squatting, or prolonged sitting. It is often related to muscle imbalance, alignment issues, or overuse.
- Tendonitis or tendinopathy – Inflammation or degeneration of tendons around the knee, such as the patellar tendon (“jumper’s knee”) or quadriceps tendon, causing pain with activity.
- Ligament injuries – Previous injuries to the ACL, MCL, or other knee ligaments can lead to instability, ongoing pain, or joint wear over time.
- Bursitis – Inflammation of small fluid-filled sacs (bursae) near the knee joint, often due to repeated pressure or trauma.
- Plica syndrome – An inflamed or thickened fold of joint lining (plica) can cause friction and discomfort, especially with repetitive movement.
- Chondral defects or cartilage damage – Injury to the smooth cartilage lining the knee can result in localised pain, swelling, or mechanical symptoms.
How is chronic knee pain diagnosed?
Dr Jason Hockings will conduct a thorough evaluation to determine the cause of your symptoms. This typically includes:
Imaging tests may include:
- X-rays to check for joint space narrowing, bone spurs (osteophytes), and other arthritic changes
- MRI scans if soft tissue structures such as the labrum or cartilage need further evaluation
- Medical history and physical examination: Assessing the pattern of pain, previous injuries, joint stability, and range of motion.
- Imaging tests:
- X-rays to assess joint space, bone alignment, and signs of arthritis
- MRI scans to evaluate soft tissue structures such as cartilage, menisci, ligaments, and tendons
- CT scans in selected cases to assess bone alignment or plan surgery
Accurate diagnosis is key to creating a targeted treatment plan and preventing further joint damage.
Non-surgical treatment options
Many causes of chronic knee pain can be successfully managed without surgery, particularly in the early stages or for mild to moderate symptoms. These options may include:
- Physiotherapy: To strengthen muscles, improve flexibility, correct movement patterns, and reduce joint stress.
- Activity modification: Avoiding high-impact activities that worsen symptoms while maintaining general fitness.
- Weight management: Reducing load on the knee can significantly improve symptoms in those who are overweight.
- Pain relief medication: Paracetamol or anti-inflammatory medications, where appropriate.
- Radiofrequency ablation (RFA): A non-surgical procedure that may help reduce knee pain by targeting sensory nerves involved in pain transmission (used in specific cases of osteoarthritis).
- Joint injections:
- Corticosteroid injections to reduce inflammation
- Hyaluronic acid (viscosupplementation) for joint lubrication in osteoarthritis
- Platelet-rich plasma (PRP) in select cases of tendinopathy or cartilage wear
Dr Hockings will discuss the most appropriate non-operative options based on your diagnosis and lifestyle.
When is surgery considered?
If chronic knee pain does not improve with conservative treatment or if there is significant structural damage, surgery may be recommended. Surgical options depend on the underlying cause and may include
- Knee arthroscopy: A minimally invasive procedure to treat meniscal tears, remove loose bodies, address cartilage damage, or release inflamed tissue.
- Ligament reconstruction: For instability or unhealed ligament injuries (e.g., ACL reconstruction).
- Realignment procedures: Such as tibial tubercle osteotomy for patellar instability or knee osteotomy for realigning the leg in early arthritis
- Partial or total knee replacement: In cases of advanced osteoarthritis where other treatments are no longer effective.
All surgical decisions are made collaboratively, based on your goals, activity level, and imaging findings.
Managing chronic knee pain long-term
Chronic knee pain can be managed effectively with the right treatment plan, lifestyle adjustments, and ongoing care. Key elements of long-term management include:
- Staying active with low-impact exercise (e.g., swimming, cycling, walking)
- Maintaining a healthy weight
- Following your rehabilitation program and home exercises
- Attending regular follow-up reviews to monitor progress
With early diagnosis and a tailored treatment plan, many people are able to reduce their knee pain and return to an active, independent lifestyle.
If you’re living with persistent knee pain that isn’t improving, a comprehensive assessment with Dr Jason Hockings can help uncover the cause and guide the most appropriate treatment for your needs.
If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.
