What is pain behind the knee?

Since the knee is the largest and most complex joint in the body, it makes sense that it might hurt sometimes. Although knee pain is a common complaint, it is less common behind the knee.
Pain in the back of the knee is called posterior knee pain, and it can have a variety of causes. Occasionally, posterior knee pain is "referred" from the front of the knee or the spine.
Symptoms of pain behind the knee
Since several conditions can cause pain behind the knee, the symptoms can vary. The most common symptoms include:
Varying types of pain
The pain can be sharp, dull, or burning. It may come on suddenly or gradually. It may be constant, or it may occur when you put weight on the leg or when you bend the knee. This information can help a doctor diagnose your knee problem.
Swelling or stiffness
The knee may look swollen or misshapen. You may be unable to bend the knee, or your knee may pop, lock up, or collapse when you put weight on it. These symptoms usually indicate that you have sustained an injury, but there are other possibilities as well.
Redness or warmth
Under certain circumstances, the back of your knee could feel hot to the touch, or redness could be visible. You might also have a fever. These symptoms would point to a different cause than if you only have pain.
Causes of pain behind the knee
Pain behind the knee can be simple or difficult to diagnose, depending upon the cause. Here are some of the most common causes of posterior knee pain:
Baker's cyst
A lump-like swelling behind the knee is characteristic of Baker's cyst, making it fairly easy to diagnose. This type of cyst is also called a popliteal cyst because it is located in the popliteal fossa, a small hollow at the back of the knee.
It forms when synovial fluid gathers at the back of the knee. Injury or stress from arthritis can trigger the accumulation of fluid.
Different forms of arthritis
Arthritis is the generic name given to diseases that affect the joint. Arthritis can cause pain anywhere in the knee joint, including the back.
Knee pain is most often associated with osteoarthritis, the type that is related to aging or overuse. Knee pain can also occur with rheumatoid arthritis, but it will occur in both knees at once.
Gout is a type of arthritis that first attacks the big toe, but later attacks may strike the knees. Septic or infectious arthritis is caused by an infection that lodges in a joint, usually a knee.
Infection
Besides infection in the knee joint (infectious arthritis), posterior knee pain could result from several other infections, including:
- Skin infection (cellulitis)
- Infection in the bone (osteomyelitis)
- Infection of one of the fluid-filled sacs called bursae (septic bursitis)
These infections have different causes and symptoms, although pain, redness, heat, and swelling are typical of most infections.
Injury
Damage to a muscle, tendon, ligament, or other connective tissue could cause posterior knee pain. Such injuries can be acute or caused by overuse. Hamstring injuries, meniscus tears, and injuries to the posterior cruciate ligament (PCL) are three injuries that may cause pain in the back of the knee.
Tumor
It is rare that knee pain is caused by a tumor, but both malignant and benign tumors can occur near the knee. Three types of cancer that could cause posterior knee pain are:
- Liposarcoma, cancer that grows in fat tissue and can occur behind the knee
- Osteosarcoma, cancer that can appear in the long bones of the leg
- Synovial sarcoma, a misnamed cancer occurring in large joints that doesn't actually occur in synovial fluid
Deep vein thrombosis
Deep vein thrombosis (DVT) is caused by a blood clot deep in a vein. In most cases, the clot is in the pelvis, thigh, or calf, but it can cause pain anywhere in the leg, including the back of the knee.
DVT can be a life-threatening condition. If part of the blood clot breaks loose and travels to the lungs, it can block blood flow. If the clot stays in place, it can damage the valves in the veins, causing pain, swelling, ulcers, and serious symptoms.

SLIDESHOW
Exercises for Knee Osteoarthritis and Joint Pain See SlideshowWhen to see the doctor for pain behind the knee
Most posterior knee pain calls for a visit to the doctor. If you have signs of an infection or DVT, you should go immediately. You should also go immediately for severe pain.
If your symptoms are less urgent, your doctor is still the best one to guide your recovery. In the meantime, you can temporarily manage your pain with over-the-counter medications like ibuprofen. For knee injuries, you may use the RICE protocol: rest, ice, compress, and elevate.
Diagnosis of pain behind the knee
A physical exam is of primary importance in diagnosing posterior knee pain from injury or arthritis. The doctor will manipulate the legs to check rotation, flexion, and stability and to see which movements cause pain.
The doctor may also use imaging procedures such as ultrasound, X-ray, CT, arthrography, and MRI. Sometimes, the doctor will draw fluid from the knee for laboratory examination.
The doctor will use physical examination, lab studies, and imaging if they suspect an infection, tumor, or DVT. A doctor can usually diagnose a Baker's cyst by sight, but they may confirm the diagnosis with an imaging procedure.
Treatment for pain behind the knee
Treatment for posterior knee pain depends on the diagnosis. Damage from injury, wear and tear, or arthritis may be treated with rest, medications, physical therapy, injections, or surgery.
Some Baker's cysts go away on their own, and some require treatment, possibly including draining the cyst.
Other causes of pain behind the knee, such as infection, tumors, or DVT, will require highly individualized treatment following diagnosis.
What are the most common knee injuries?
Although knee injuries can happen to anyone, some activities and demographics are higher risk than others, such as:
- Athletes, especially in high-impact sports
- Runners, especially if wearing improper footwear
- People who are overweight
- People who sit too long in uncomfortable positions
Knee injuries left untreated can potentially lead to a number of complications, like:
- Ligament instability
- Meniscus injury
- Osteoarthritis
- Gait problems
Understanding the signs of a serious knee injury can help you know when it’s time to seek treatment from a health professional.
Signs of a knee injury
The first sign of a knee injury that most people feel is pain. Though the pain may be severe, often there is only a very mild stiffness or discomfort around the knee joint, especially while making certain repetitive motions with it.
Other important warning signs of a serious knee injury include:
Pain while climbing stairs
Pain while climbing up the stairs is indicative of a torn meniscus, whereas pain while going down the stairs is a sign your kneecap is pushing painfully against the femur bone in the leg.
Swelling
Some kinds of swelling can stop you from bearing weight on your knee or bending it at all, whereas you may have no problem whatsoever walking in other cases. Either way, a swollen knee shouldn’t be ignored.
Immediate pain
Sometimes the injury shows itself right away, such as a sharp pain in the middle of exercising. In this case, the pain and swelling will happen immediately, suggesting a torn ligament or even a bone fracture has occurred.
Gradual pain
Some injuries appear a few hours or even days after the injury actually took place. An overuse injury, for example, develops little by little in response to prolonged pressure and is often a sign of cartilage or meniscal tearing.
Some more signs to look for are:
- Redness
- Bruising
- Popping sounds
- Feeling unstable
Seek medical attention if you notice any of these symptoms.
Types of knee injuries
Some kinds of knee pain go away with a little rest, but some injuries are more serious. The most common types of knee injuries are:
Stress fractures
Fractures can happen with any bone in the knee joint. They can occur as a result of trauma, but osteoporosis can also cause fractures.
Dislocation
The bones of the knee joint may sometimes fall completely or partially out of alignment. Some people, due to their specific bone structure, may be more prone to this kind of injury than others. The most common cause of knee dislocation is trauma.
Anterior cruciate ligament (ACL) injury
Athletes who often quickly change direction or jump will often have ACL injuries. Many hear it "pop" when the ligament is either torn or strained.
Meniscal tearing
The menisci are two cartilages that protect the joint from stress as you walk. Though the menisci are often damaged during sports activity, they can also wear down as a result of aging or arthritis.
Tendonitis
Tendonitis in the knees is sometimes known as"jumper’s knee" because it often affects athletes who jump regularly. There are two tendons involved in the knee joint, around the quadriceps and patellar bones, and both can be stretched, torn, or worn down with time.
Diagnosing knee injuries
Doctors have many tools at their disposal to aid in the diagnosis of knee injuries. For instance, they’ll often collect your medical history and ask you questions about your activity level. X-rays, ultrasounds, and MRI scans can also provide a clear picture of your knee joint for an accurate diagnosis.
Treatments for knee injuries
Some mild knee injuries are treated using the R.I.C.E. method, which stands for rest, ice, compression, and elevation.
Other cases may require physical therapy to strengthen the joint and restore its range of motion. Surgery is reserved for the most serious knee injuries and may be either minimally invasive or involve a total replacement of the joint.
Subscribe to MedicineNet's General Health Newsletter
By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.
Health Solutions From Our Sponsors
Arthritis Foundation: "When Knee Pain May Mean Arthritis."
Bupa: "Pain behind the knee (posterior knee pain)."
CDC: "Cellulitis: All You Need to Know."
CDC: "Venous thromboembolism."
Current Reviews in Musculoskeletal Medicine: "Posterior knee pain."
Johns Hopkins: "Liposarcoma."
Johns Hopkins: "Osteosarcoma."
Mount Sinai: "Baker cyst."
NYU Langone Health: "Types of Bone and Joint Infections."
Stanford Health Care: "Septic Bursitis."
University Health News Daily: "Pain Behind Knee: Injury vs. Disease-Related Causes."
Top What Can Cause Pain Behind the Knee Related Articles
Arthritis in Knee: 4 Stages of Osteoarthritis
Painful joint swelling is called arthritis. Osteoarthritis is due to wear and tear of the joints over many years. Arthritis maye develop in any joint, including the fingers, hips and knees. Usually, patients with arthritis feel pain in their joints even after moderate movements. There are four stages of osteoarthritis of the knee.Baker's Cyst
A Baker's 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's cysts can be caused by virtually any type of joint swelling (arthritis).What Exercises and Activities Should You Not Do if You Have Bad Knees?
When you have knee pain, working out can be stressful. Exercises that you should not do if you have bad knees include leg extensions, squats, lunges, and possibly running.How Do You Relieve Pain In The Back Of Your Knee?
Learn what medical treatments can help relieve pain in the back of your knee and help you manage pain in the back of your knee.Knee Bursitis
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms and signs 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 anti-inflammatory and pain medications.Knee Injury and Meniscus Tears
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.Knee Pain
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.Knee Replacement
Find out what to expect with knee replacement surgery in this WebMD slideshow.OA of the Knee Exercises
Learn about osteoarthritis and exercises that relieve knee osteoarthritis pain, stiffness and strengthen the knee joint and surrounding muscles through this picture slideshow.Pain Management: All About Your Knees
They do their job so well that you might take them for granted. Learn how they're put together, what can go wrong with them, and what you can do about it when something does.Knee Pain Dos and Don'ts
Your knees go through a lot in the course of a day, and sometimes they can run into trouble. Here are a few things you can do when knee pain hits.Knee Replacement Surgery and Recovery Time
During total knee replacement surgery, the diseased knee joint is replaced with artificial material. The risks include blood clots in the legs, urinary tract infection, nausea and vomiting, chronic knee pain, nerve damage, and infection.What Are the Different Types of Knee Injections?
Knee injection is a procedure in which medications are injected into the knee joint to treat the pain due to various causes. There are different types of knee injections. The most common type of intra-articular knee injection is corticosteroids. Other agents used are hyaluronic acid, infliximab, Botox (botulinum neurotoxin), and platelet-rich plasma (PRP). Knee injection is a relatively quick procedure and may be performed under local anesthesia to avoid pain.What Exercise Can I Do with Knee Bursitis?
What is knee bursitis? Learn which exercises can help ease symptoms.