Pain Behind the Knee: Causes and How to Treat Back of Knee Pain

Pain Behind the Knee: Causes, How to Treat It and When to See a Doctor

Pain behind the knee can have a serious impact on your daily activities. Sharp pain at the back of your knee can affect walking and cause discomfort when standing or walking up stairs. Pain and swelling behind the knee can also cause stiffness in your knee joint, inflammation, and possibly, a lump at the back of your knee.

There are many reasons for mild to severe pain behind the knee. For example, a ligament tear, a pulled muscle, fracture to a bone in your knee, or wear and tear can also cause varying degrees of pain behind the knee. The knee pain can cause you to limp, make it difficult to walk, or you may not be able to bend your knee at all.

Knowing how to treat pain behind the knee requires knowing what is causing it. However, usually, hot and cold treatments can help to restore mobility to your knee joint and ease the pain. In some cases, if the leg pain behind the knee is caused by blood clot or cyst, you need to get it checked out by a doctor.

In this article, you will learn about the various reasons why you could have pain at the back of your knee.

Symptoms of Pain Behind the Knee

Pain behind the knee is sometimes referred to as posterior knee pain. Your knee joint is made up of ligaments, tendons, cartilage, muscles, and bones.

According to Dr. Matthew Hoffman on WebMD, the knee is one of the most complex joints in the body. Tendons connect the thigh bone and shin bone to your leg muscles. These work together to provide stability and movement to your knee.1

For example, your hamstring is at the back of your thigh and helps to flex the knee. However, a pulled hamstring will cause pain in your thigh and at the back of your knee.

Dr. Jerry R. Balentine on MedicineNet says that damage to the ligaments and tendons in your knee can cause bones to rub together and result in inflammation, redness, and pain around the back of the knee or kneecap. This can make walking difficult, and instability in the knee joint could result in more pain and damage. In some cases, the pain can be so disabling and severe that it is impossible to put any weight on your leg.2

Causes of Pain Behind the Knee

Let’s look in more detail at the various reasons why you could be suffering from aches and pains behind your knee or at the back of your leg.

Hamstring injury and pain at the back of the knee

An injury to your hamstring is a very common reason for sharp pains at the back of your knee.

Your hamstring starts at the bottom of your pelvic bone and crosses the back of the knee and ends at the lower leg. Doctors from the American Academy of Orthopedic Surgeons say that your hamstring helps you bend your knee.

Hamstring injuries can result in pulling the hamstring muscle or completely tearing it. This can result in pain at the back of your leg below your knee. You may also notice bruising of your leg and may find it difficult to walk for a few weeks.3

Dr. Tyler Wheeler on WebMD says that you can prevent hamstring injuries by warming up before exercising. You should also strengthen your glutes which make up your buttocks to prevent extra strain on your hamstring muscles.

At the end of the article, you can find out how to treat a pulled or torn hamstring and help ease the pain behind your knee.

Ligament tear

Excruciating pain in the back of your knee can often be the result of a torn ligament in the knee joint.

Dr. Sabrina Felson on WebMD says that your knee contains 4 main ligaments that can cause behind the knee pain if they get injured.4 These are:

  • Anterior cruciate ligament (ACL) injury is a common reason for knee pain.
  • Posterior cruciate ligament (PCL) can be injured if there is extreme trauma on the knee.
  • Lateral collateral ligament (LCL).
  • Medial collateral ligament (MCL).

Injuring any of your knee ligaments will result in pain that is often sharp and severe. This can result in swelling behind the knee or around the kneecap and you may find it difficult to put any weight on your knee joint. In fact, you may hear a popping sound if the ligament tears. As the ligament injury heals, you might have a wobbly sensation in the knee.4

Depending on the severity of the ACL or PCL injury, you may need surgery to restore strength and movement to the knee joint.

Posterolateral corner injury causing behind the knee pain

Experiencing stiffness and pain behind the knee could be due to injuries to the delicate structures in the knee. These types of injuries are referred to as posterolateral corner (PLC) injuries.

According to the journal Revista Brasileira de Ortopedia, PLC injuries are common if the ligaments of the knee have been damaged by trauma. This can result in severe pain and inability to put pressure or weight on the damaged knee. In some cases, PLC injuries occur without damaging any of the knee ligaments.5

Compressed nerve

Feeling constant pain behind knee cap could be caused by a compressed nerve in your knee joint.

Nerves from your lumbar region and nerves in your leg can cause varying degrees of pain if they get pinched or trapped.

Dr. Minoo Hadjari Hallis on Medscape says that some pinched nerves behind the knee can cause weakness in the knee joint. Also, trapped nerves in your leg can be a reason for knee pain and/or a tingling sensation in the lower legs or feet.6

According to the Journal of the Canadian Chiropractic Association, physical therapy can help to release entrapped nerves and ease the pain behind the knee that they cause.7

Back of the knee pain caused by Baker’s cyst

A Baker’s cyst will cause a lump at the back of your knee along with pain and discomfort.

The cyst that forms at the back of your knee is usually caused by arthritis or tearing a cartilage. This results in a buildup of fluid that causes a lump behind your knee.

Doctors from the Mayo Clinic say that the swelling behind your knee can be a cause of knee pain. You will probably find it difficult to flex the knee and your symptoms may be worse after physical activity. To treat a Baker’s cyst, doctors usually drain the fluid to reduce the swelling and ease knee discomfort.8

Gastrocnemius tendinosis

Leg pain behind your knee could be due to damage or injury to the main muscle in your calf.

Your main calf muscle is called the gastrocnemius and is located at the back of your legs. Repetitive strain on the gastrocnemius can result in muscle stiffness or tightness which can be felt at the back of the knee joint.

According to the European Journal of Radiology, gastrocnemius tendinosis or tendinopathy is a potential cause of posterior knee pain. This can sometimes be aggravated by damage to the ACL and result in various degrees of pain behind the knee. A person with gastrocnemius tendinosis will usually experience stiffness in the knee joint.9

As with many conditions that affect the knee joint, physiotherapy can help to relieve pain and restore movement to the sore knee joint.

Tennis leg causing muscle pain and swelling behind the knee

A condition called “tennis leg” can also cause pain in the back of your leg behind the knee.

Tennis leg is associated with damage to the gastrocnemius where damage to the muscle and the soleus muscle in the calf causes a buildup of fluid.

According to the journal Radiology Case Reports, tennis leg is often a result of sports injuries. Damage to the calf muscles can cause swelling and pain in the posterior knee.10

Blood clot

There are some occasions when pain behind the knee can be caused by a blood clot in your lower leg.

Deep vein thrombosis (DVT) is when a blood clot develops deep in a leg vein. According to doctors from the National Health Service (NHS), being inactive for long periods of time, being overweight, or having heart and lung disease can put you at greater risk of developing DVT.11

Some of the symptoms of DVT include pain and swelling in your calf muscle, aches in the back of your leg below the knee, and reddish skin. You may notice that the pain is worse when you bend your foot upward.11

Torn knee cartilage

Another type of injury that can cause pain and swelling behind the knee is tearing cartilage tissue in your knee.

According to Dr. Benjamin Wedro on MedicineNet, knee cartilage (meniscus) tears are common among sports people. Cartilage in the knee can tear easily causing pain if a person suddenly pivots and stops. It is also common among weightlifters who squat and lift heavy weights, basketball and tennis players. Age can also put a person at risk of damaging the knee cartilage.12

Doctors from the American Academy of Orthopedic Surgeons report that some of the common symptoms of tearing cartilage in the knee are pain in the knee, swelling around the knee joint, and difficulty moving the knee.13

Popliteus injury and pain behind the knee

Injuring your popliteus tendon or muscle can be a cause of pain behind the knee that makes the knee joint unstable.

According to the British Journal of Sports Medicine, popliteus injuries are not common. However, they can occur if a person lands awkwardly on their knee, or due to a trauma that damages the popliteus tendon or muscle. This will also cause swelling and the area behind the knee will be tender to touch.14

Back of Knee Pain – Treatment Methods

In many cases, home remedies are enough to treat back of knee pain and help speed up recovery. Here are some of the most popular methods that doctors recommend.

R.I.C.E. for back of knee pain relief

Successful recovery of damage to tendons, ligaments or muscles in your knee joint depends on proper first aid treatment. The best first-aid treatment of muscle tears or pulled ligaments is the R.I.C.E. method.

Dr. William Blahd on WebMD says that the RICE method can be used to relieve pain behind the knee as well as swelling and stiffness. RICE is an acronym for Rest, Ice, Compression, and Elevation.15

How to use R.I.C.E. method to relieve pain behind the knee:

This is how to soothe pain from the back of your knee with the RICE method:

  1. Rest the affected knee by stopping any activity that causes pain or soreness. Placing a small pillow under your knee can help to reduce knee pain when lying down.
  2. Ice the affected knee with a cold pack immediately after sustaining an injury to your knee. Apply for 10 to 20 minutes 3 or 4 times a day to reduce swelling and prevent bruising.
  3. Compress the injured knee joint by wrapping an elastic bandage around the knee. The bandage shouldn’t be so tight that you have tingling or swelling below the bandage.
  4. Elevate your injured knee to keep your knee above the level of your heart.

Dr. Blahd says that ice should be used for the first 48 to 72 hours to reduce swelling. When the swelling has reduced, you can apply heat to help increase blood circulation and accelerate healing.

Warm compress to treat chronic knee pain

After 2 or 3 days use a warm compress to help get rid of chronic pain at the back of your knee to improve flexibility and strength in your knee.

According to Dr. William Shiel on MedicineNet, moist warm heat can be used a few days after the initial injury. The warmth helps to relax the muscles which then makes it easier to exercise and strengthen the knee muscles, tendons, and ligaments. Heat packs can also be used to relieve knee pain if arthritis is the cause.16

How to make your own heat pack to ease behind the knee pain:

To make your own moist heat pack at home to relieve knee pain, this is what you should do:

  1. Fill a clean cotton sock with dry rice almost to the top, leaving enough room to tie the sock.
  2. Put the sock in a microwave and heat on full power for 1-2 minutes.
  3. Dip a washcloth in hot water and wrap the cotton sock in it.
  4. Hold for 15 minutes to the back of your knee to relieve the pain.
  5. Repeat 3 or 4 times a day to help speed up healing and get rid of behind the knee pain.

Exercises to strengthen knee joints

According to Dr. David Zelman on WebMD, exercise can help to relieve back of knee pain that is caused by an injury or arthritis. Dr. Zelman recommends low-impact cardiac exercises to increase flexibility in your knee.17

Other exercises that are great for strengthening knee joints and alleviating pain are swimming, water aerobics, walking, and stationary cycling.

If you are recovering from an injury that has caused severe pain behind the knee, you should talk to your doctor or qualified physiotherapist for advice on the best types of exercises for your condition.

Other natural remedies for pain relief from sore knee

If you have to manage long-term pain at the back of the knee, you can try some natural pain-relief remedies at home.

Spices and herbs to relieve knee pain

Some herbs and spices have natural pain-relieving properties that can help reduce inflammation in joints and can manage knee pain successfully.

Turmeric. Studies have shown that turmeric has the potential to be used in managing joint pain. A review published in the Journal of Medicinal Food reported that there have been many positive trials showing the potential of turmeric in managing arthritis pain. 18

For more information and precautions on using turmeric for pain relief, please read my article about the best herbs to reduce joint pain.

Other herbs and spices that can help to alleviate pain are ginger, flaxseed, and cayenne pepper.

Essential oils for getting rid of pain behind the knee

There are also some great essential oils for pain relief that you can massage into the area behind your knee to ease the pain. For example:

Chamomile essential oil. Massage oils containing chamomile can help to alleviate pain thanks to its analgesic properties. The journal Molecular Medicine Reports explains that chamomile has anti-inflammatory properties that easily penetrate the skin’s surface.19

Lavender oil. Studies have shown that lavender oil can help to successfully manage joint pain. A study from 2015 found that lavender oil has pain-relieving properties that also help to reduce inflammation and is just as effective as some pharmaceutical drugs for pain relief.20

Other essential oils that you use as anti-inflammatories and can help to get rid of pain behind the knee include peppermint oil, rosemary oil, and helichrysum essential oil.

When to See a Doctor for Pain Behind the Knee

If the home remedies in this article don’t help reduce swelling and pain behind the knee, then you should visit your doctor for professional advice.

Dr. Jerry Balentine on MedicineNet says that you should get your sore knee evaluated by a doctor if you also have the following symptoms:2

  • Swelling at the back of the knee or around the kneecap.
  • Inability to bend your knee, or bending your knee causes severe pain.
  • Extreme discomfort while walking.
  • Pain that interferes with your daily activities.

Read my other related articles:

Article Sources

  1. WebMD. Picture of the knee.
  2. MedicineNet. Knee pain.
  3. AAOS. Hamstring muscle injuries.
  4. WebMD. What are knee ligament injuries?
  5. Rev Bras Ortop. 2015 Jul-Aug; 50(4): 363–370.
  6. Medscape. Nerve entrapment syndromes of the lower extremity.
  7. J Can Chiropr Assoc. 2013 Dec; 57(4): 341–349.
  8. MayoClinic. Baker’s cyst.
  9. Eur J Radiol.2015 Dec;84(12):2579-85.
  10. Radiol Case Rep. 2017 Mar; 12(1): 120–123.
  11. NHS. Deep vein thrombosis.
  12. MedicineNet. Torn meniscus.
  13. AAOS. Meniscus tears.
  14. BJSM. Popliteus tendon rupture.
  15. WebMD. Knee problems and injuries – home treatment.
  16. MedicineNet. Arthritis or injury: Ice or heat.
  17. WebMD. 11 Knee pain dos and don’ts.
  18. J Med Food. 2016 Aug 1; 19(8): 717–729.
  19. Mol Med Report. 2010 Nov 1; 3(6): 895–901.
  20. An Acad Bras Cienc. 2015 Aug;87(2

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