What Causes Knee Pain? The Most Common Reasons Explained

Knee pain is one of the most common musculoskeletal complaints, and it often raises the same question: what is the main cause of knee pain? For some people, it starts suddenly after activity, while for others it develops slowly without a clear injury. The knee absorbs large forces during daily life, work, and sport, which makes it particularly vulnerable to overload and irritation. In this article, we’ll explain the most common knee pain causes, why knee pain can occur without injury, what usually helps, and when it’s important to have it assessed.

WHAT IS KNEE PAIN?

Knee pain isn’t a diagnosis on its own, it’s a symptom that can come from several different processes. Clinically, knee pain can be divided into three broad categories.

The first is arthritic conditions, such as osteoarthritis, rheumatoid arthritis, or gout. These involve changes within the joint itself and often develop gradually over time.

The second category is inflammatory conditions, including bursitis, tendinitis, and iliotibial band syndrome. These are commonly linked to overuse and repetitive strain.

The third category is structural injury, such as meniscus tears, ligament injuries (ACL, PCL, MCL, or LCL), or a Baker’s cyst. These can occur with trauma or develop gradually under repeated stress.

COMMON KNEE PAIN CAUSES

The most common reason for knee pain seen in practice is overuse. This doesn’t only affect athletes, it commonly occurs in people who sit for long periods, repeat the same movements daily, or suddenly increase activity levels.

Common knee pain causes include:

• Repetitive movements without enough recovery

• Prolonged sitting, particularly behind a desk

• Sudden increases in running or gym training

• High forces through the knee causing ligament or meniscal strain

In many cases, knee pain is not caused by one incident, but by cumulative stress over time.

KNEE PAIN WITHOUT INJURY

Knee pain without injury is extremely common. Rather than a single event, it’s best understood as a build-up.

Low-level irritation and inflammation often sit in the background and gradually accumulate. Eventually, the body reaches a tipping point — often described as the straw that broke the camel’s back — and pain appears. Even though it feels sudden, the process has usually been developing for weeks or months.

COMMON TRIGGERS OR ACTIVITIES

Certain activities commonly aggravate knee pain, especially when combined with limited recovery:

• Sitting for long periods at work

• Frequent stair use

• Beginning running without preparation

• Squatting or kneeling repeatedly

These triggers are typical of overuse-related knee pain rather than acute injury.

WHAT USUALLY HELPS

Early management focuses on restoring healthy movement rather than complete rest.

Helpful strategies often include:

• Gentle, pain-free movement

• Modifying aggravating activities rather than stopping all activity

• Using heat, which improves blood flow and helps relax surrounding muscles

• Professional assessment to identify contributing factors beyond the knee

Ice is not always the most effective solution, particularly for ongoing or non-traumatic knee pain.

WHAT OFTEN MAKES IT WORSE

Some common habits can slow recovery:

• Ignoring symptoms and pushing through pain

• Keeping the knee still or locked for long periods

• Avoiding movement entirely

• Continuing exercises that repeatedly cause pain

Most knees respond better to guided movement than prolonged rest.

WHEN SHOULD YOU BE CONCERNED?

Although many cases of knee pain are mechanical, certain symptoms should be assessed:

• Instability or giving way

• Locking or catching sensations

• Pain that worsens at night

• Sudden swelling, redness, or warmth

• Progressive weakness

These signs may indicate a more serious condition requiring further investigation.

HOW KNEE PAIN IS ASSESSED AND TREATED

Assessment should look beyond the knee itself. A thorough evaluation considers the lower back, pelvis, hips, ankles, and feet, along with work habits and activity levels.

Treatment is individualised and may include:

• Hands-on care such as soft tissue work, dry needling, or joint mobilisation

• Rehabilitation exercises that can be performed without pain

• Education around movement habits and load management

With appropriate care, many patients improve within six weeks, although recovery timelines vary.

CAN A CHIROPRACTOR HELP WITH KNEE PAIN?

An evidence-based chiropractic approach can be helpful for many knee pain presentations, particularly those related to overuse and biomechanics. Care focuses on restoring movement, improving load tolerance, and empowering patients through education.

If you live or work in Bryanston, Sandton, Morningside, or Rivonia, early assessment of knee pain can help prevent long-term issues and unnecessary flare-ups.

If this sounds like what you’re dealing with, you’re welcome to book an assessment to determine the cause of your knee pain and see if we can help.