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Condition guide

Knee pain

Is knee pain or stiffness making walking, stairs or getting up from a chair more difficult? Knee osteoarthritis is common, but there are several ways to manage the symptoms and stay active. This guide explains what may be happening, what usually helps and when it is worth getting your knee assessed.
Knee pain

What's happening in the knee joint?

Diagram of the knee joint showing the surfaces affected by osteoarthritis

Does this sound like your knee?

  • Pain when walking, particularly on stairs or hills
  • Stiffness after sitting or first thing in the morning
  • Swelling or a feeling of fullness
  • Clicking, grinding or reduced confidence in the knee
  • Difficulty bending fully, squatting or getting out of a chair

These symptoms can be consistent with knee osteoarthritis, but they can also have other causes. A clinician can often understand the problem from your symptoms and an examination. An X-ray or scan is not always needed.

The knee is one of the joints most commonly affected when pain starts to slow active people down, so it is important to understand the options. The knee joint carries load every day; even small changes in the cartilage, lining of the joint, meniscus or overall mechanics can start to matter.

The knee

It’s a complex joint, and you don’t need to understand everything about how it works, but it helps to know that the smooth surface called cartilage plays an important role during load and movement. It works alongside the meniscus, a cushioning structure between the thigh and shin bones that helps to distribute weight across the joint. Both of these structures can be affected by arthritis, but knee pain can also have other causes, many of which can be managed in a range of conservative ways.

Common symptoms

Stiffness

Stiffness in the knee, especially in the morning or after sitting

Walking further

Discomfort when walking longer distances

Stairs and squatting

Pain when climbing stairs or squatting

Swelling

Mild swelling around the joint

Grinding

A feeling of grinding or reduced smooth movement

Flare-ups

Symptoms fluctuate, with comfortable periods followed by flare-ups

What’s happening: the stages of arthritis

Osteoarthritis is common and progressive, but many people manage it well, particularly when symptoms are understood early and the right treatments are considered. Stages describe how the joint looks on an X-ray; pain and damage do not always match, and your symptoms matter more than the stage.

Stage 1, doubtful

Stage 1, doubtful

Minimal disruption, but already 10% cartilage loss, which starts the cascade of worsening damage within the joint.
Stage 2, mild

Stage 2, mild

Joint-space narrowing. The cartilage begins breaking down with the bone roughening underneath.
Stage 3, moderate

Stage 3, moderate

Joint space is now reduced with gaps in the cartilage forming through to the bone, causing greater pain on movement.
Stage 4, severe

Stage 4, severe

Joint space is greatly reduced and 60% of the cartilage is now lost, with roughened bone surface visible.

How knee arthritis is assessed

NICE recommends exercise as a core treatment for osteoarthritis. Getting an image or scan straight away is not always needed, and arthritis symptoms can sometimes overlap with other health issues, so it is always best to seek professional advice.

Symptom history

A clinician will usually begin by discussing your symptoms: when the pain occurs, what it stops you doing and how it has changed over time.

Physical examination

A clinician will assess how the joint moves, its strength and stability, any swelling or tenderness, and your walking pattern.

X-ray if needed

A standing X-ray can show joint-space narrowing and bony change. A scan straight away is not always needed to start treatment.

Further imaging

Ultrasound or MRI may be used in selected cases, usually guided by a specialist when the picture is unclear.

What helps: movement, support and the right treatment at the right time

Knee pain can have several causes, and you may not know exactly what is happening inside the joint. Osteoarthritis is one common cause, particularly when pain is accompanied by stiffness, swelling or difficulty with activities such as walking, using stairs or getting up from a chair.

There is no single treatment that is right for every painful knee. The best approach will depend on your symptoms, general health, activity levels and how much the problem is affecting everyday life. Treatment often begins with ways to improve strength, reduce irritation and help you keep moving with greater confidence.

A good place to start is with approaches that help you stay active and control pain with as few side effects as possible.

Movement and strengthening

Exercise is central to knee osteoarthritis care. Strength around the quadriceps, hips and calf can help the knee feel more supported and capable. Low-impact activities such as walking, cycling or swimming can also help maintain movement.

Weight management

Small changes in load, footwear, pacing and training volume can make the joint more manageable without needing to stop being active. Where relevant, gradual weight loss may also reduce the load on the knee and make walking and exercise easier.

Physiotherapy is key

A good physiotherapist looks at the whole picture: strength, balance, swelling, walking pattern, confidence and function. They can also guide you on which exercises are appropriate and how to progress them safely.

Treatments and choices

These approaches can be supported by other treatments, such as injections, bracing or cold compression therapy, at the right time. A clinician can help you decide which options may suit your symptoms and stage of arthritis.

FAQs about knee arthritis

The questions people ask most often when knee pain starts getting in the way.

What is knee arthritis?

Knee arthritis usually refers to knee osteoarthritis, a condition where the cartilage that covers the ends of the bones in the knee gradually wears down.

Cartilage normally allows the joint to move smoothly and absorb load during walking and activity. As this cartilage becomes thinner, the joint can become stiff, irritated and painful.

Osteoarthritis is one of the most common causes of knee pain in adults and often develops slowly over time.

What are the early symptoms of knee arthritis?

Early symptoms of knee osteoarthritis can develop gradually and may vary between people.

Common early signs include:

– stiffness in the knee, especially in the morning or after sitting

– discomfort when walking longer distances

– pain when climbing stairs or squatting

– mild swelling around the joint

– a feeling of grinding or reduced smooth movement in the knee

Symptoms often fluctuate, with periods where the knee feels relatively comfortable followed by flare-ups.

Where is knee arthritis pain usually felt?

Pain from knee arthritis is often felt around the front or inside of the knee joint, although it can vary.

Some people experience:

– pain behind the kneecap

– discomfort along the inner side of the knee

– aching around the whole joint after activity

Because the knee carries body weight during walking and movement, pain may worsen after standing, walking longer distances or using stairs.

Can exercise help knee arthritis?

Yes. Exercise and strengthening are among the most important parts of managing knee osteoarthritis.

Strengthening the muscles around the knee can help:

– support the joint

– reduce pressure on damaged cartilage

– improve stability and walking ability

– reduce pain during daily activity

Many people benefit from guidance from a physiotherapist or musculoskeletal specialist when starting an exercise programme.

What treatments are available for knee arthritis?

Treatment usually follows a step-by-step approach.

This may include:

– physiotherapy and strengthening exercises

– weight management and activity modification

– short-term pain relief medications when needed

– supportive treatments such as bracing or cold therapy

– injection therapies for joint pain

– surgical assessment in more advanced cases

The goal of treatment is usually to reduce pain and help people remain active for as long as possible.

When are knee injections considered for arthritis?

Injection therapies may be considered when knee pain continues despite physiotherapy and conservative treatments.

They are often used when:

– pain is limiting walking or activity

– symptoms flare due to inflammation inside the joint

– patients want to delay or avoid surgery

Injections are normally delivered directly into the joint by clinicians experienced in musculoskeletal care.

What types of injections are used for knee arthritis?

Several types of injections may be used depending on the symptoms and stage of osteoarthritis.

Common options include:

– corticosteroid injections to reduce joint inflammation

– hyaluronic acid injections to support joint lubrication

– other regenerative or biologic treatments in specialist clinics

– newer gel-type or polymer injections, although these are still relatively new

A clinician can help determine whether injection therapy is appropriate and which option may be most suitable.

Can hyaluronic acid injections help knee arthritis?

Hyaluronic acid occurs naturally within healthy joint fluid and helps the joint move smoothly.

In osteoarthritis the quality of this fluid can change. Hyaluronic acid injections aim to improve lubrication and cushioning within the joint.

Some patients experience improvements in pain and mobility following treatment, particularly when injections are combined with strengthening and rehabilitation.

Can knee arthritis be cured?

There is currently no cure for osteoarthritis, but many treatments can help manage symptoms effectively.

Most treatment plans aim to:

– maintain joint movement

– strengthen the muscles around the knee

– reduce inflammation and pain

– support activity and mobility

Many people live active lives with knee osteoarthritis when symptoms are managed appropriately.

Is there a best injection for knee arthritis?

Every patient is different. There is no one-size-fits-all approach, and the most suitable option will depend on your symptoms and the stage of arthritis.

However, Cingal represents the highest chance of success across all options (92%).

A clinician can explain the likely benefits, limitations and alternatives of each option for your knee.

What to do next

If knee pain is continuing to affect your movement, activity or everyday life, you may want to understand the additional treatment options available. Some people are looking for greater support during daily activity, while others want to explore treatments for persistent arthritis pain.

Many physiotherapists and clinicians use such options to help progress your movement and rehabilitation.

We only work with leading technologies and manufacturers, who are trusted nationally within the NHS and private clinics and endorsed by clinical specialists.

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Making informed choices about knee pain

Knee pain is not always straightforward, and similar symptoms can have different causes. Speaking to a qualified healthcare professional is important. They can consider how your pain behaves, how the knee moves, your medical history and what you want to get back to doing, rather than focusing on one scan result or one treatment alone.

Your own research matters too. Clear, reliable information can help you understand the choices available, ask better questions and play an active part in decisions about your care.

Where Joint Pain Freedom can help

Joint Pain Freedom works directly with a large number of experienced clinicians and specialist clinics. Whether you are ready for an assessment or simply want help making sense of the options, we can help you locate your nearest Joint Pain Freedom Centre of Excellence or offer sensible, clinically focused guidance.

Sensible next steps to consider

If knee pain is starting to affect day-to-day movement, the next step is not guessing; it is understanding your options properly. Learning as much as possible before seeing a specialist can be a good thing, as long as the information is sound. Websites like this one, and others like Versus Arthritis and Arthritis UK, give trusted advice.

Your own research may include reading about physiotherapy, braces and injection pathways, but the key is to seek specialist advice and not allow the joint to deteriorate further.

Important: this guide is educational and does not replace a clinical assessment. Persistent swelling, hot red joints, sudden severe pain, fever, significant injury, or unexplained night pain should be assessed promptly.

Useful downloads

Talking about your joint pain
Patient guides

Talking about your joint pain

Questions to take to your appointment, covering your symptoms, your treatment options and what matters most to you.

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Cingal Overview Guide
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Manufactured by world leader in joint care treatments, Anika. Learn more about breakthrough injection Cingal

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Monovisc Overview Guide
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