Pain in Back of Knee – What is Causing It?

Knee pain is a common and sometimes debilitating problem – but why do your knees hurt and what is causing that nagging pain in the back of your knee? We’ll delve into the common causes of knee pain and explore how to get relief from discomfort in the back of the knee. So, if you’re wondering why your back or knee hurts, buckle up – we’re about to embark on a journey to answer this question!



Arthritis is one of the most common causes of pain in the back of the knee. It’s an inflammatory type of degenerative joint disease. Arthritis is a general term that can refer to more than 100 different types, but the two most common forms are osteoarthritis, which results from wear and tear on the body’s joints, and rheumatoid arthritis, an autoimmune disorder in which the immune system attacks healthy cells by mistake.

Osteoarthritis typically affects just one joint – often at first just a finger or two – and gradually spreads to other joints within that same hand or foot. Eventually, it can spread even further — including to the knee joint — as bones grind restless against each other due to gradual breakdown. In contrast, rheumatoid arthritis may affect several joints at once as an immune system response that causes inflammation in synovial tissue around joints.

A few other types include lupus which is an autoimmune disorder that can manifest itself through a variety of scaly patches on the skin and psoriatic arthritis linked with psoriasis— a red inflamed skin patch with silver-white scaly lesions—and resulting in joint pain symptoms similar to RA (which is a lot more limited than RA and generally doesn’t affect other joints).

There are also juvenile forms of arthritis that cause swelling around small joints like wrists or elbows for young adults with arthritis symptoms such as warm tenderness around those areas.

In terms of treatments for bone-related arthritis issues, medications include traditional over-the-counter drugs such as aspirin or ibuprofen but these only take away some temporary edge from the discomfort symptoms — not eradicate it per se; so any who require long-term solutions should also use prescription strength pain medicines accompanied by physical therapy exercises or/and possible surgery for severe cases if deemed necessary by doctor’s examination results. But overall anyone experiencing any form-related discomfort (especially the back part) pertaining to their knee should get a proper checkup done.

Posterior Cruciate Ligament Injury

Posterior cruciate ligament (PCL) injury is less common than, but as likely to cause pain in the back of the knee as, an anterior cruciate ligament (ACL) injury. The PCL is responsible for supporting the knee joint and allowing movement while maintaining joint stability. An indirect hard blow to the front of your knee can result in a posterior cruciate ligament injury, as can be involved in a car accident where your knees hit the dashboard with enough pressure.

When you experience an acute posterolateral corner injury or a PCL tear, you may feel an extremely sharp pain in combination with swelling and stiffness behind your knee joint–these are common signs of an injured PCL.

After an initial period of rest, you will likely doctor-prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Depending on the severity of cartilage damage discovered through imaging tests like x-rays and MRIs, surgery might be recommended to help properly align your knee joints for better stability so that it doesn’t cause any recurrences of pain.

If you are feeling sudden pain or discomfort behind your knees during physical activities like running or sports, it’s best to visit a medical professional who can diagnose the source of your pain and help determine if it could be due to a PCL injury or something else entirely. With proper diagnosis and treatment — either via rest, medications, or surgery — you will be able to enjoy a life free from discomfort once more!

Anterior Cruciate Ligament Injury

Anterior Cruciate Ligament (ACL) injuries are common in physical activities that involve a lot of sudden changes of direction or jumping. The ACL is one of four ligaments that stabilize the knee joint. An ACL injury can range from a strain where the ligament is slightly stretched and painful, to a tear where one or both ends of the ligament are torn away from the bone.

ACL injuries usually occur when an individual takes off on one leg to jump, lands suddenly on another leg, and twists either unintentionally or intentionally in mid-air while they have their weight on one leg, this action can cause a lot of stress and strain on the ligaments causing them to tear due to overstretching.

A strain can also happen when playing contact sports such as soccer or football when making quick direction changes with heavy pressure placed onto the ACL.

The best way to treat ACL injuries is with rest, applying cold compresses, pain medications, and physical therapy. Severe ACL tears may need arthroscopic surgery called ACL reconstruction which repairs or replaces the torn ligament with another tendon-like material taken from somewhere else in your body such as your own hamstring muscle, patellar tendon, or quadriceps tendon.

Surgery and rigid bracing may be recommended by doctors following more serious tears which often require months of intensive rehabilitation to regain full strength and stability in order for your return to normal activities.

Meniscus Tear

A meniscus tear can cause pain in the back of the knee and may often occur within a few days of activity. This type of injury is particularly common in athletes as well as others who engage in vigorous physical activity.

The meniscus is a cushioning pad found between the two bones of the knee joint. It helps to stabilize, protect and lubricate movement when we walk, run, etc. When the meniscus gets weak from aging or overuse — such as repetitive bending — it can cause a tear.

Other symptoms that may be associated with a meniscus tear include swelling and an inability to fully straighten or flex your affected knee. Pain may be more incited by certain activities and a feeling of locking or catching when you try to move your leg are also another complaint commonly reported among those experiencing this type of injury. The pain will usually become more pronounced after certain movements and more prolonged rest can be beneficial.

Meniscal tears injury are more likely to happen due to age-related weakening or repeated unnatural bending of the knee joint, which makes it more prone to breaking down and becoming painful. Certain activities such as football, running or volleyball walk increase your risk for irritation because they involve repetitive movement with twisting forces on the joint structures.

If you experience severe pain in your knees accompanied by swelling, consultation with a doctor is advised for proper assessment and treatment before continuing any activity that may aggravate it further.

Gastrocnemius Tendonitis

Gastrocnemius Tendonitis is a common cause of pain in the back of the knee. It is an overuse injury that results from the wear and tear of repeatedly contracting muscles in one area. Athletes who play sports that involve sprinting, jumping, or running—like tennis—at high intensity are at a greater risk for developing gastrocnemius tendonitis.

The gastrocnemius muscle and soleus muscle in the lower leg form the Gastrocnemius Tendon. When these muscles are contracted, such as when someone points their toes or runs, it puts pressure on the tendons and can lead to regular micro-tears in a person’s tissue which can cause pain and soreness.

Often times those who suffer from Gastrocnemius tendonitis experience sudden pain in their calf or behind their knee after participating in exercise or physical activity; However, other symptoms can include tightness or swell throughout the area surrounding your calf as well as burning sensations when attempting to move your lower leg, especially while walking up stairs, during sports activities and/or any other physical activity.

While rest is often recommended as an initial step to aid recovery, it may not always be sufficient. In some cases, more aggressive treatments like physical therapy will need to be employed to restore strength and mobility to your lower leg muscles so you can get back into action without worrying about recurring pain.

Baker’s Cyst

Baker’s cyst is a painful cyst that can cause sharp pain in the back of the knee. It is caused by too much synovial fluid buildup in the knee joint. This buildup of fluid causes extra pressure, resulting in a swollen and tender area directly behind the knee joint. Baker’s cysts are common among people who have suffered a knee injury or have an underlying problem such as arthritis or gout.

Symptoms of Baker’s cyst may include pain, swelling, and stiffness in the area behind the knee joint. Physical therapy and/or steroid injections may be recommended to help reduce inflammation and decrease any pain associated with this condition. If these treatments do not provide relief, surgery is sometimes recommended to remove the extra fluid from around the tendon leading from the thigh to the calf.

Recovering from a Baker’s Cyst can be addressed by wearing supportive braces for physical activities or taking anti-inflammatory medications for short periods at a time. Taking breaks from vigorous physical activity can also help prevent flare-ups associated with this condition.

In some cases, corticosteroid options are available to help ease symptoms related to Baker’s Cysts as well as other underlying issues causing such conditions as arthritis or gout which may be contributing to pain in the back of the knee symptoms.

Biceps Femoris Tendonitis

Biceps Femoris Tendonitis, commonly known as a pulled hamstring, is one of the most common causes of pain in the back of the knee. The biceps femoris muscle runs from above the back of the knee and down around the outside of your lower leg. If this tendon becomes inflamed or irritated due to overuse, it can cause sudden pain in the back of your knee.

Tendonitis is usually caused by repetitive activities that work for the same muscle groups. While it can occur in any age group, Biceps Femoris Tendonitis is most common among athletes and those who participate in activities such as running and jumping.

Risk factors include inadequate warm-up prior to activities, over-stretching, and working out too hard without allowing sufficient rest time between workouts or games.

Other symptoms associated with Biceps Femoris Tendonitis include swelling, tenderness in areas around the knee and thigh muscles, and a painful feeling when walking on flat surfaces or running downhill.

Treatment for Biceps Femoris Tendonitis includes resting from activity to allow time for healing; icing affected areas; stretching exercises for increased flexibility; athletic taping techniques; physical therapy exercises such as contraction-force stretching, eccentric therapy, hip strengthening exercises, and hamstring strengthening exercises; anti-inflammatory medications for pain relief; massage therapy; ultrasound treatment; electrical stimulation therapy; laser treatments or even corticosteroid injections depending on patient diagnosis.

In addition to treating symptoms associated with Biceps Femoris Tendonitis, one should also consult a physician or health care professional to ascertain which activities should be avoided so that reoccurrence doesn’t happen again.

Jumper’s Knee

Jumper’s knee, also known as patellar tendonitis, is a common knee problem that affects athletes such as runners, basketball players, and other people who consistently jump or land hard on their knees. It is an overuse injury caused by tiny tears in the tendon that connects the kneecap (patella) to the shinbone (tibia).

When too much stress is placed on the patellar tendon, it causes inflammation and swelling. As your body tries to repair itself, more of these tiny tears occur, further increasing inflammation and resulting in pain in your knee.

Apart from pain in the back of your knee, there are other symptoms associated with a jumper’s knee. These can include stiffness and pain when bending or straightening your leg; difficulty jumping; swelling or tenderness around or at the base of your kneecap; weak quadriceps muscles; painful squatting motions; and difficulty fully extending your leg after a jump so that you need to stop then re-start running immediately afterward.

Jumper’s knee can affect any athlete who performs regular jumping activities but it is most prominent in those with over-active quadriceps, weak hamstrings, flat feet, and poor balance or posture. To prevent Jumper’s Knee from developing it is important to ensure you warm up properly before starting any strenuous activities – this includes stretching exercises for both your hips and legs – as well as strengthening exercises for your gluteal muscles and hamstrings which help support your knee joint.

Prehabilitation exercises as well – such as plyometric drills which help increase speed while minimizing the impact on joints – are also beneficial in reducing the overall risk of developing a jumper’s knee. Additionally, it is recommended to rest between periods of activity whenever needed to let the tendon recover – this could be anywhere from 48 hours up to two weeks depending on the severity of the injury – so that tissue damage does not continue to increase leading to long-term chronic damage or complete rupture of the patellar tendon which will likely require surgery.

Leg Cramps

Leg cramps are a common, temporary problem that can often cause pain in the back of the knee. They can affect anyone but are more likely in people with specific medical conditions or those taking certain medications. Leg cramps usually come and go quickly, lasting only a few seconds or a few hours, and are most likely caused by muscle contractions due to fatigue or dehydration.

There are many possible causes of leg cramps, some of which include nerve problems, such as pinched nerves; circulatory problems like poor blood flow to the legs; mineral imbalances due to excessive sweating; liver disease; hormonal imbalances; and certain medications. Additionally, leg cramps may be caused by physical activity, prolonged sitting or standing, and simple overuse of the leg muscles.

If you experience leg cramps that last more than 24 hours or occur frequently, you should talk to your doctor about it as these symptoms could indicate other underlying conditions such as peripheral artery disease. Preventing future leg cramps can be done by drinking plenty of fluids and stretching your calf muscles before exercising or after periods of inactivity.

If you have chronic or severe cramping episodes, then it’s important to speak with your doctor so they can determine any underlying medical condition that may be causing them.

Frequently Asked Questions

The back of your knee may hurt due to a variety of factors, including bursitis, a Baker's cyst, a muscle strain, a ligament sprain, or even arthritis. If the pain persists, it is best to see a doctor to determine the exact cause of the pain and the best course of treatment.

Acute pain at the back of the knee is typically caused by a sudden injury, such as a strain or tear of the hamstring or calf muscles, or a tear of the posterior cruciate ligament (PCL). It can also be caused by a direct blow to the knee or a sudden twist of the joint. Other causes of acute knee pain include joint inflammation, bursitis, tendinitis, and a Baker's cyst.

Posterior knee pain is the pain located at the back of the knee. It is often caused by overuse injuries, such as tendinitis, bursitis, or a strain of the muscles and tendons surrounding the knee. Other causes of posterior knee pain include injury to the ligaments, cartilage damage, and arthritis.

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To conclude, pain in the back of the knee can be caused by a number of different conditions and medical interventions may be required to treat the issue. As we have discussed, the knee joint is particularly prone to injury due to its weight-bearing nature and is often subject to sudden twists or bends when engaging in sports activities or physical exercise. It is important that any underlying medical conditions are ruled out before attempting any sort of treatment program.

In most cases of knee pain, rest and anti-inflammatory medications are sufficient for alleviating short-term symptoms but great care should also be taken in managing an injury as a chronic condition if it fails to resolve itself quickly. Strengthening, stretching and other exercises should ideally form part of any rehabilitation program recommended by your physiotherapist or doctor.

While muscles may often be the overshadowing factor responsible for back-of-the-knee pain, they are not always entirely responsible and attention needs to be directed to other likely sources such as tight tendons or ligaments along with preparing your body adequately with ice packs, warm-ups, and stretching routines before enrolling in strenuous physical activity.

Through proper diagnosis, consultation with a physiotherapist, and possibly surgical intervention if needed, full recovery can be achieved for even the most serious injuries sustained at the biggest joint in our body – The Knee!

Spine Institute NY