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February 6, 2012
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Knee Pain

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Your Knee Pain: Is It Chondromalacia?

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD

Find out more about the causes, treatment, and various symptoms of knee pain.Chondromalacia, technically termed chondromalacia patellae, is the most common cause of chronic knee pain. The condition is also called the patellofemoral syndrome.

Softening of the cartilage beneath the knee cap (the patella) results in small areas of breakdown and pain around the knee. Instead of gliding smoothly over the knee, the knee cap rubs against the thigh bone (the femur) when the knee moves. The changes can range from mild to complete erosion of the cartilage.

Chondromalacia commonly occurs in females. Girls in their teens are at elevated risk because the cartilage of the knee is subjected to excessive and uneven pressure due to the structural changes that accompany rapid growth.


Top Searched Knee Pain Terms:

causes, inner knee pain, osteoarthritis, treatment, injuries, arthritis
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Knee pain facts

  • The knee joint has three compartments: medial, lateral, and patellofemoral.
  • Causes of knee pain include injury, degeneration, arthritis, infrequently infection, and rarely bone tumors.
  • Ligaments within the knee (cruciate ligaments) and on the inner and outer sides of the knee (collateral ligaments) stabilize the joint.
  • Surgical repair of ligament injury can involve suturing, grafting, and synthetic graft repair. Some patients require total knee replacement.
  • Routine X-rays do not reveal meniscus tears but can be used to exclude other problems of the bones and other tissues. Arthroscopy and MRI studies are used most frequently to diagnose knee ailments; occasionally, a needle aspiration of fluid is done.
  • The knee joint is one of the most commonly involved joints in rheumatic diseases (over 100 disease types). Rheumatic diseases are immune diseases that affect various tissues of the body, including the joints, by causing arthritis (pain, swelling, stiffness, and limited joint movements).

How is the knee designed, and what is its function?

The knee is a joint that has three compartments. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (patella) joins the femur to form a third compartment called the patellofemoral joint. The thighbone (femur) meets the large shinbone (tibia), forming the main knee joint.

The knee joint is surrounded by a joint capsule with ligaments strapping the inside and outside of the joint (collateral ligaments) as well as crossing within the joint (cruciate ligaments). These ligaments provide stability and strength to the knee joint.

The meniscus is a thickened cartilage pad between the two joints formed by the femur and tibia. The meniscus acts as a smooth surface for motion and absorbs the load of the body above the knee when standing. The knee joint is surrounded by fluid-filled sacs called bursae, which serve as gliding surfaces that reduce friction of the tendons. Below the kneecap, there is a large tendon (patellar tendon) which attaches to the front of the tibia bone. There are large blood vessels passing through the area behind the knee (referred to as the popliteal space). The large muscles of the thigh move the knee. In the front of the thigh, the quadriceps muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee. The knee also rotates slightly under guidance of specific muscles of the thigh.

Alt tag for image
Picture of the knee joint


The knee functions to allow movement of the leg and is critical to normal walking. The knee flexes normally to a maximum of 135 degrees and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding surfaces for the tendons to reduce the force of friction as these tendons move. The knee is a weight-bearing joint. Each meniscus serves to evenly load the surface during weight-bearing and also aids in disbursing joint fluid for joint lubrication.

The goal of this article is to give the reader an overview of causes of knee pain. Most of the topics covered in this article are further expanded in detail as separate articles. For example, bursitis, types of arthritis, total knee replacement, and others are covered in articles devoted to knee pain-related topics that include specifics on diagnosis, tests, treatments, and other details.



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  • Related Diseases & Conditions

    • Rheumatoid Arthritis
      • Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
    • Gout
      • Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the blood, recurring attacks of joint inflammation (arthritis), deposits of hard lumps of uric acid in and around the joints, and decreased kidney function and kidney stones.
    • Torn Meniscus
      • A torn meniscus (knee cartilage) may be caused by suddenly stopping, sharply twisting, or deep squatting or kneeling when lifting heavy weight. Symptoms of a meniscal tear include pain with running or walking long distances, popping when climbing stairs, a giving way sensation, locking, or swelling. Treatment depends upon the severity, location, and underlying disease of the knee joint.
    • Osteoarthritis
      • Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
    • Arthritis
      • Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
    • Baker Cyst
      • A Baker cyst, also called a popliteal cyst, is swelling caused by knee joint fluid protruding to the back of the knee (popliteal area of the knee). Not uncommon, baker cysts can be caused by virtually any type of joint swelling (arthritis). They are often resolved with removal of excess knee fluid in conjunction with cortisone injections.
    • Bursitis
      • Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
    • Bursitis of the Knee
      • Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
    • Chondromalacia Patella (Patellofemoral Syndrome)
      • Chondromalacia patella (housemaid's knee or secretary's knee) results from misalignment of the kneecap as it slides over the lower end of the thigh bone. Symptoms include tightness or fullness in the knee area, swelling, and mild discomfort. Treatment includes the use of anti-inflammatory medications, in addition to stretching, strengthening and icing the knee.
    • Sprains and Strains
      • An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
    • Chronic Pain
      • Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
    • Pseudogout
      • Pseudogout, a form of arthritis, results when deposits of crystals collect in and around the joints. Symptoms of pseudogout include pain, stiffness, warmth, and joint swelling of the knees, ankles, hips, shoulders, and/or wrists. Treatment for pseudogout aims to decrease inflammation through the use of nonsteroidal antiinflammatory drugs, ice, and rest.
    • Reactive Arthritis
      • Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
    • Nonsteroidal Anti-inflammatory Drugs and Ulcers
      • Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
    • Iliotibial Band Syndrome
      • Iliotibial band syndrome is an overuse injury of the thigh and knee. Symptoms include knee pain and possible swelling. Treatment may involve anti-inflammatory medications, physical therapy, ultrasound, and the use of orthotics.
    • Osgood-Schlatter Disease
      • Osgood-Schlatter disease, a painful inflammation just below the knee but above the shin, typically affects adolescent boys. Symptoms include localized pain, inflammation, swelling, and calcification. Osgood-Schlatter disease typically goes away over time, however, symptoms can be helped with antiinflammatory and pain-relieving medications, ice, and rest.
    • Knee Injury
      • Knee injuries, especially meniscus tears, are common in contact sports. Symptoms and signs of a torn meniscus include knee pain, swelling, a popping sound, and difficulty bending the leg. Treatment may involve resting, icing, compressing, and elevating the knee, in addition to wearing a knee brace, taking anti-inflammatory medications, and stretching the knee.
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Symptom Checker: Your Guide to Symptoms & Signs: Pinpoint Your Pain



Knee Pain

Introduction to Chronic Pain

You know it at once. It may be the fiery sensation of a burn moments after your finger touches the stove. Or it's a dull ache above your brow after a day of stress and tension. Or you may recognize it as a sharp pierce in your back after you lift something heavy.

It is pain. In its most benign form, it warns us that something isn't quite right, that we should take medicine or see a doctor. At its worst, however, pain robs us of our productivity, our well-being, and, for many of us suffering from extended illness, our very lives. Pain is a complex perception that differs enormously among individual patients, even those who appear to have identical injuries or illnesses.

In 1931, the French medical missionary Dr. Albert Schweitzer wrote, "Pain is a more terrible lord of mankind than even death itself." Today, pain has become the universal disorder, a serious and costly public health issue, and a challenge for famil...

Read the Chronic Pain article »







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