Pain Behind the Knee

Pain behind the knee aka posterior knee pain can be due to a number of problems.

It may develop gradually over time, indicating an underlying knee condition, or it may develop suddenly, usually due to an injury.

There may be a general achy back of knee pain, leg movements may be restricted by swelling or there may be a sharp pain at the back of the knee.

Here we will look at the most common causes of pain behind the knee. By thinking about how your pain started, the common symptoms and how your pain behaves, you can work out what is causing your pain. As you read through each summary, you can decide whether it sounds like your problem or not. If it does, click on the link to find out more about treatment options and the recovery process. If it doesn't sound quite like your pain, simply move on to the next one. 

Causes of Pain Behind The Knee

1) Bakers Cyst

A Bakers cyst is one of the most common causes of pain behind the knee

What is it: Inflammation of the popliteal bursa (fluid filled sac) at the back of the knee. It is the most common cause of pain behind the knee.
Swelling (like a small water balloon), tightness and pain behind the knee
Aggravating Activities:
Bending and straightening the knee, walking, kneeling
Can come on after a blow to the back of the knee but usually comes on gradually. Often associated with arthritis - fluid from the arthritis leaks back into the bursa causing it to swell
Ice, exercises, aspiration, injection, electrotherapy and occasionally surgery
Can take a few months for the pain behind knee to settle down and they have a tendency to recur if not treated properly

Find out more: Bakers Cyst Knee

2) Posterior Cartilage/Meniscus Tear

A meniscus tear can cause pain behind the knee

What is it: Tear at the back of the cartilage lining the joint
Pain behind the knee, swelling, locking, instability, difficulty straightening the knee
Aggravating Activities:
Walking, running, squatting, stairs esp going up
Can occur suddenly with a force through the knee, sudden twisting of the knee or gradually through wear and tear
PRICE, exercises, tubigrip, knee brace and occasionally surgery
Can take months to recover as the meniscus has a poor blood supply, which slows healing 

Find out more: Meniscus Tear

3) Calf Strain/Tear

What is it: Overstretching or tearing of part of the calf muscle
 Pain behind the knee or in the back of the calf, bruising, swelling & difficulty walking
Aggravating Activities: 
Walking, running, pushing down through toes
Can occur suddenly when changing speed or direction or gradually from repetitive running or jumping
 rest, PRICE, heel pads, massage, ultrasound and exercises (but not too soon)
 Usually takes 6-12 weeks to recover

Find out more: Calf Strains

4) Arthritis

Arthritis is a common cause of posterior knee pain

What is it: Changes in the bone usually caused by wear and tear (osteoarthritis) or sometimes by inflammation (rheumatoid arthritis)
Morning stiffness, pain, swelling, clicking/grinding, reduced leg movements
Aggravating Activities:
Worse after prolonged rest, activity, cold weather
Symptoms gradually come on over time. Most common over the age of 50
Exercises, knee brace, heat, ice, acupuncture, weight loss, walking aids, gel knee pads, cushioned footwear, medication, injections
The changes in the bone from arthritis cannot be undone, but treatment aims to reduce pain, improve function and prevent deterioration

Find out more: Arthritis

5) Hamstring Injury

What is it: A tear in one of the hamstring muscles on the back of the thigh
General achy pain in back of knee where hamstring tendon attaches to the bone. Sharp pain behind knee with sudden movements
Aggravating Activities:
Bending the leg, sudden acceleration or deceleration when moving
Sudden onset with an injury
PRICE, exercises, massage, tubigrip
Usually takes 6-12 weeks to fully recover

6) Knee Sprain

A knee sprain can cause pain behind the knee

What is it: Overstretching or tearing one of the ligaments in the knee
General pain, swelling, bruising, occasional giving way and/or decreased movement
Aggravating Activities:
Depends on the severity but can be any physical activity or movement of the knee
Sudden twisting movements or a force through the knee
PRICE, exercises, tubigrip, knee brace
There are three grades of knee sprain depending on how much damage there is. It can take anything from 2 weeks to 3 months to fully recover, depending on the severity of the injury

Find out more: Knee Sprains

7) Deep Vein Thrombosis (DVT)

What is it: A blood clot in one of the deep veins of the leg
Pain behind the knee or in the calf, swelling, redness, warmth, usually only on one leg 
Aggravating Activities: 
Dorsiflexion - pulling your toes up towards you (your foot doing the work not your hands) will increase the pain behind the knee/calf pain
Can start gradually or suddenly, due to periods of inactivity, certain medical conditions, pregnancy, obesity or genetics
 Blood thinning medication (anticoagulants), compression stockings, exercises
 Can take several weeks/months to fully recover and you may need long term treatment

NB A DVT is a potentially life threatening condition. If you are showing symptoms of a DVT seek immediate medical attention

Want to Know More?

To find out more about these common causes of pain behind knee, click on the links above.  However, just because there is pain behind the knee, doesn’t necessarily mean the problem is there. Pain can refer to different places so a problem round the front of the knee can produce a feeling of posterior knee pain.

If you would prefer to diagnose your pain using other specific symptoms such as how the pain started or the specific location of the pain, go to the diagnose your pain section for help working out was is causing your posterior knee pain and to learn what you can do about it. Remember, the best way to accurately diagnose the cause of your pain behind the knee is to see your doctor.

Go to Diagnosis Section or Homepage

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See Also

Diagnosis: What is Causing My Pain?

Knee Braces: Would they help?

How can I strengthen my leg?

Test your flexibility - would stretching help you?

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