My knee hurts but I didn't injure it. Why?

No injury does not mean no cause

Many people expect knee pain to follow a fall or a twist, so pain that appears on its own feels worrying. In practice, most knee pain seen in clinic has no single injury behind it. Tissues become sore when the load on them rises faster than they can adapt.

Think back over the past few weeks. A new gym programme, more padel, a long trip with lots of walking, more stairs at work, or a few extra kilos can all be enough.

Common causes without an injury

• Patellofemoral pain: an ache around the kneecap on stairs, squats or after sitting, common in active young adults
• Tendinopathy: pain in a tendon such as the patellar tendon below the kneecap, linked to jumping or heavy leg training
• Knee osteoarthritis: a gradual ache with stiffness after rest, more common from the forties onwards
• Degenerative meniscus tear: the meniscus can tear with an ordinary squat or turn in middle age, often with pain on the inner side
• Bursitis: a soft, sore swelling over or below the kneecap, sometimes after kneeling
• Gout, pseudogout or inflammatory arthritis: a hot, swollen, very painful knee that flares without warning
• Pain from the hip or lower back felt in the knee

What you can do now

If the knee is not hot or very swollen, reduce whatever seems to trigger it for two to three weeks rather than stopping all movement. Keep walking within comfort, and start gentle strengthening for the thigh and hip muscles. Simple pain relief advised by your pharmacist can help you stay active.

When to have it examined

Go to an emergency department the same day if the knee suddenly becomes hot, red and swollen, especially with fever or if you feel unwell. Book an appointment if pain lasts more than four to six weeks, keeps returning, wakes you at night, or the knee swells, locks or gives way.

At Aman Hospital in Doha, Dr. Gelber examines the knee, hip and back, and arranges imaging or blood tests only when the findings call for them.