Understanding Pain Behind Knee: Causes, Diagnosis, and Treatment

Experiencing pain behind the knee can be a bewildering and concerning issue, leaving many individuals seeking an understanding of the potential causes and solutions. The knee plays an integral part in our everyday movement, a complex structure built up of various components that can each be subjected to strain or damage. From the sudden sharp pain of an injury to persistent nagging discomfort, the reasons behind such symptoms can vary widely. This comprehensive guide offers insight into the numerous possible causes, diagnosis methods and treatment options for pain behind the knee, from common conditions like arthritis or a meniscus tear to a less common baker’s cyst or hamstring injury.

Causes of Pain Behind the Knee

Baker’s Cyst

Pain experienced behind the knee is often associated with a Baker’s cyst, commonly known as popliteal cyst. This fluid-filled cyst develops due to an increase in synovial fluid, a lubricant within the knee joint, often induced by joint inflammation or damage. Underlying conditions such as arthritis or a cartilage tear may trigger the formation of this cyst. Symptoms typically include swelling behind the knee (especially noticeable when standing), pain in the knee and calf, and a tight feeling when extending or bending the knee.

Meniscus Tear

Another common source of pain at the back of the knee is a meniscus tear. The menisci, two wedge-shaped cartilage pieces, facilitate shock absorption between your thigh bone and shinbone. They can be easily injured, particularly during activities involving the knee’s twisting or rotation. Symptoms can vary, but a meniscus tear usually presents as a popping sensation during injury, pain and swelling that worsens with movement, challenges in fully straightening the knee, and instances of the knee locking up or feeling unstable.


Arthritis, particularly osteoarthritis, can also cause pain behind the knee. This degenerative condition deteriorates the knee cartilage over time. Symptoms can either develop gradually or appear abruptly and commonly involve persistent knee pain, knee swelling and stiffness, restricted range of motion, and difficulties in walking or climbing stairs due to joint stiffness.

Hamstring Injury

Pain behind the knee may also result from a hamstring injury. The hamstring comprises three muscles extending from the hip to the knee at the back of the thigh. Straining or pulling these muscles during activities involving running, jumping, or sudden stopping and starting can lead to considerable pain. Symptoms vary in severity and often include a sudden, sharp pain during exercise, a snapping or popping sensation at injury time, pain and tenderness at the back of the thigh and knee, swelling shortly after the injury, bruising or discoloration on the backside of the leg, and difficulty bending the knee or moving the leg.

Symptoms and Diagnosis

Baker’s Cyst

Further exploring Baker’s cyst, it’s a fluid-filled swelling presenting at the back of the knee. Knee joint issues like arthritis or a meniscal tear can provoke its onset. Symptoms associated with a Baker’s cyst notably include a bulge or swelling at the knee’s back (more noticeable while standing), ranging scales of pain, knee stiffness particularly while extending it, and difficulty in bending the knee.

Diagnosis of a Baker’s cyst typically initiates with a physical examination by a healthcare professional. They may ask questions relating to your symptoms and medical history, in addition to examining the knee for signs of swelling or redness. To provide a detailed view of the affected area and differentiate the cyst from other conditions such as tumors or aneurysms, additional imaging tests like X-rays, MRI, or ultrasounds might be recommended.

Hamstring Tendinitis

Hamstring tendinitis is characterized by inflammation and irritation of the tendons connecting your hamstring muscles to the bones. Pain from the condition often presents at the back of the knee. Hamstring tendinitis usually arises due to overuse from activities like running, walking, or cycling. The symptoms of this condition can include:

  • Pain behind the knee
  • Knee stiffness especially after a period of inactivity
  • Pain intensifies with physical activities.

For the diagnosis, a medical professional may conduct a thorough physical exam to assess pain and mobility. This is often sufficient to diagnose hamstring tendinitis. However, if the symptoms persist or if the doctor suspects a different condition, they might use imaging tests like an MRI or ultrasound.


Potentially behind the pain you’re experiencing in your knee could be arthritis, which comes in several forms including osteoarthritis, rheumatoid arthritis, and gout. Some signs that arthritis might be at play include:

  • A persistent pain sensation in the back of your knee
  • Possible swelling and inflammation
  • Reduced mobility in your knee joint
  • A feeling of warmth emanating from the joint area

To pinpoint arthritis as the source of the issue, your doctor may conduct a physical examination, scrutinizing the affected knee for redness, swelling, and pain. They may also order blood tests to identify any potential antibodies or chemicals typically associated with arthritis. For further clarity on the state of the bones and soft tissues in the knee, imaging tests such as X-rays or MRI scans might be required.

A person holding their knee, experiencing pain

Treatment Options

Addressing Pain in the Knee: Available Treatment Approaches

The discomfort you’re feeling behind the knee could originate from various conditions including knee injuries, overuse, arthritis, or certain diseases. This makes an accurate diagnosis and subsequent treatment crucial. Encouragingly, there’s a spectrum of treatments accessible — both surgical and non-invasive. Learning about these options positions you to partner effectively with your healthcare provider when deciding the optimal management approach for your situation.

Rest and Shifts in Lifestyle

An early recommendation for managing pain behind the knee typically revolves around rest and lifestyle changes. If the pain is attributable to minor injuries or knee overuse, it’s beneficial to allow the body to heal naturally with adequate rest. Applying a cold compress can also be advantageous, as it helps to mitigate inflammation and pain during this period.

Altering certain aspects of your lifestyle can be instrumental in this process as well. For instance, if you’re overweight, losing some pounds can reduce the strain on your knee joint. Changing your exercise routine can also have a positive impact. Consider switching out high-impact activities for less body-stressing alternatives such as swimming or cycling to avoid exacerbating the issue with your knee.

Physical Therapy

Physical therapy can be another effective treatment, particularly for conditions such as baker’s cysts and tendonitis. The exercises implemented during physical therapy can help strengthen the muscles surrounding the knee, increase flexibility, and reduce pain. The therapy may also use techniques such as heat and cold therapy, electrical nerve stimulation, and massage to help relieve symptoms.


Medications, both over-the-counter and prescription, can be used to manage knee pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, can help reduce inflammation and pain. In some cases, stronger pain relievers may be prescribed depending on the severity of the pain.


For more persistent pain, injections may be appropriate. Corticosteroid injections can reduce inflammation within the knee joint and provide relief for several weeks or months. Another option, hyaluronic acid injections, may be used to replace naturally occurring substances in the knee that have depleted over time due to conditions like osteoarthritis.


Arthroscopy is a minimally invasive surgical procedure where a surgeon examines and possibly treat the inside of the knee using a tiny camera, called an arthroscope. Through this procedure, the surgeon can remove or repair damaged tissues, such as torn meniscus or ligaments. This can relieve the pain and improve knee mobility.

While these treatments can provide relief from pain behind the knee, it’s crucial to remember that each person’s treatment plan should be individualized. What works for one person may not work for another, and it often takes a combination of treatments to effectively manage knee pain. Always consult with healthcare professionals before starting any new treatment.

Image of a person holding their knee indicating pain behind it

Understanding the causes, symptoms, and treatment options for pain behind the knee is the first step towards managing and potentially resolving such issues. Whether the discomfort is rooted in a physical injury like a meniscus tear or a non-traumatic condition like arthritis, correct diagnosis is an essential part of the journey to recovery. With a range of treatment options outlined, from surgical procedures to conservative methods such as rest, medication, and physical therapy, this guide aims to provide you with the knowledge you need to take proactive measures against knee pain. Moreover, it underscores the significance of lifestyle modifications in recovery and the prevention of further pain. With this knowledge, the power to understand and manage your health is in your hands.