Knee Pain When Walking: What Causes It and When Should You See a Specialist?
Knee pain when walking is common, but it should not automatically be accepted as a normal part of getting older. Understanding what may be causing your symptoms can help you decide when it is time to seek advice.
Knee pain when walking can develop for many different reasons, from a minor injury or overuse to osteoarthritis, a meniscal tear or problems affecting the ligaments and tendons around the knee.
For some people, symptoms settle with rest, exercise or physiotherapy. For others, particularly when pain persists or begins affecting everyday activities, an assessment by a specialist may be helpful.
Understanding what might be causing your knee pain can help you decide when professional advice is appropriate.
Why does my knee hurt when I walk?
The knee is a complex joint that allows the leg to bend, straighten and bear the body's weight. It is made up of bones, cartilage, ligaments, tendons and other soft tissues.
Walking places repeated loads through the knee. If one of these structures becomes injured, inflamed or worn, you may notice pain when putting weight through the leg.
The location and nature of your pain can sometimes provide clues about the possible cause. You might experience:
- Pain at the front of the knee
- Pain on the inside or outside of the knee
- Pain behind the knee
- Pain when climbing stairs or walking uphill
- Pain when getting up from a chair
- Stiffness after sitting for a long time
- Swelling after walking or exercise
- Clicking, catching or locking
- A feeling that the knee is giving way
Symptoms can overlap between different conditions, so an accurate diagnosis is important before deciding on treatment.
What can cause knee pain when walking?
Knee osteoarthritis
One of the most common causes of persistent knee pain is osteoarthritis. The tissues within the joint become damaged and the protective cartilage gradually becomes thinner, which can cause pain, stiffness and reduced movement.
Typical symptoms include pain that is worse with walking or prolonged standing, stiffness after rest, difficulty walking longer distances, pain on stairs, swelling, reduced movement and grinding or creaking sensations.
Knee arthritis does not necessarily mean you need a knee replacement. Many people can manage their symptoms with non-surgical treatment.
Meniscal tears
The menisci are two pieces of cartilage inside the knee that help distribute load and provide stability. A tear can occur during a sporting injury or twisting movement, while degenerative tears may develop gradually.
A meniscal problem may cause pain when walking, particularly during twisting or changes of direction, and some people also experience clicking, catching or locking.
Not every meniscal tear requires surgery. Treatment depends on the type and location of the tear, symptoms, activity levels and other problems within the knee.
Ligament injuries
Ligaments help stabilise the knee and can be injured during sports, falls or sudden twisting movements. A significant injury may cause swelling, pain and a feeling that the knee is unstable or giving way.
Some ligament injuries can be managed with rehabilitation, while others may require surgery, particularly where instability persists.
Tendon problems
Tendons connect muscles to bones. Repetitive activities such as running, jumping and certain sports can place stress on these tissues.
Patellar tendinopathy, for example, affects the tendon connecting the kneecap to the shin bone and can cause pain at the front of the knee during loaded activities.
Bursitis
Small fluid-filled sacs called bursae help reduce friction around the knee. If a bursa becomes inflamed, it can cause pain and swelling, particularly when kneeling or putting pressure on the affected area.
Previous knee injury
A previous injury can increase the likelihood of knee problems later in life. Damage to cartilage, ligaments or other structures may alter how forces are distributed through the joint and, in some cases, contribute to osteoarthritis.
Why does my knee hurt when I walk but not when I rest?
Some knee conditions cause relatively little discomfort when you are sitting or resting but become painful when the joint is placed under load.
Walking repeatedly transfers your body weight through the knee. If the joint is affected by arthritis, a meniscal problem or another condition, this increased load can trigger pain.
If your walking distance is gradually becoming shorter because of knee pain, it is worth discussing this with a healthcare professional.
When should you see a knee specialist?
Not every episode of knee pain requires specialist consultation. A minor injury may improve with time and appropriate self-care.
You should consider seeking medical advice if:
- Your knee pain has lasted for several weeks
- The pain is getting progressively worse
- You are struggling to walk normally
- You are avoiding activities because of your knee
- Your knee is repeatedly swelling
- Your knee locks or catches
- Your knee feels unstable or gives way
- You have persistent pain following an injury
- Pain is affecting your sleep
- You are relying increasingly on painkillers
- You can no longer do activities that are important to you
When should knee pain be assessed urgently?
Seek more urgent medical assessment if you have severe pain following a significant injury, cannot put weight through the leg, or the knee is very swollen, hot or red, particularly if you also feel unwell.
What happens when you see a knee specialist?
Assessment usually begins with a detailed discussion about where the pain is, when it started, whether it followed an injury and which activities make it worse.
Your knee will then be examined to assess movement, stability, tenderness and other signs that may help identify the underlying problem.
Depending on your symptoms, you may need imaging such as an X-ray or MRI scan. An X-ray can be particularly useful when osteoarthritis is suspected, while an MRI can provide more detailed information about structures such as the menisci, ligaments and cartilage.
Does knee pain always mean I need surgery?
No. Surgery is only one potential treatment option and many patients can be managed without an operation.
Depending on the diagnosis, treatment might include:
- Physiotherapy and targeted exercises
- Activity modification
- Weight management where appropriate
- Pain relief or anti-inflammatory medication
- Joint injections
- Treatment of an underlying injury
- Keyhole knee surgery in selected cases
- Knee replacement for severe arthritis
The most appropriate treatment depends on the cause of your pain and how significantly it is affecting your life.
Knee replacement is generally considered when severe arthritis is causing persistent pain and disability and non-surgical treatments are no longer providing sufficient relief. The decision is based on symptoms and quality of life as well as imaging.
Learn more about knee replacementWhat can you do about knee pain while waiting?
If your knee pain is relatively mild and there has been no significant injury, staying appropriately active is often preferable to complete rest.
Low-impact activities such as walking on comfortable surfaces, cycling or swimming may be easier to tolerate than high-impact exercise. Physiotherapy can also be useful for strengthening the muscles around the knee and improving movement.
If a particular activity consistently causes significant pain or swelling, it is sensible to reduce or modify it until you have received appropriate advice.
Questions about knee pain when walking
Why does my knee hurt when I walk but not when I sit?
Walking places weight through the knee and can aggravate problems such as osteoarthritis, meniscal tears or other conditions affecting the joint. An assessment can help determine the cause.
How long should knee pain last before I see a doctor?
If knee pain does not improve over several weeks, is getting worse or is interfering with normal activities, it is sensible to seek medical advice.
Can knee arthritis be treated without surgery?
Yes. Depending on the severity of your symptoms, treatments such as exercise, physiotherapy, weight management, medication and injections may help manage knee arthritis.
Does a meniscal tear always need surgery?
No. Many meniscal tears can initially be managed with non-surgical treatment. Surgery may be considered in selected patients depending on symptoms and the nature of the tear.
When is knee replacement necessary?
Knee replacement may be considered when severe arthritis causes ongoing pain and significant limitations in daily life, particularly when non-surgical treatments are no longer providing adequate relief.
Should I keep walking if I have knee pain?
In many cases, gentle activity is beneficial, but this depends on the underlying cause. If walking causes significant pain, swelling or instability, seek professional advice rather than pushing through the symptoms.
Is knee pain limiting how far you can walk?
A specialist assessment can help establish what is causing your symptoms and discuss appropriate treatment options, including non-surgical care and surgery where suitable.