Knee pain is a common condition that can be caused by both short-term and long-term problems.
Many short-term knee problems do not need any help from doctors and people can often help with their own recovery.
Home remedies can also help with many of the long-term problems with knee pain.
The treatment for knee pain will depend, to some extent, on the cause of the problem. However, the following simple remedies can help with many forms of knee pain.
1. Physical activity
Exercise can delay the development of osteoarthritis (OA), one of the most common causes of knee pain.
The American College of Rheumatology (ACR) and the Arthritis Foundation (AF) urge people to exercise to manage OA of the knee. Walking, cycling, swimming, tai chi, and yoga may all be beneficial.
Being physically active boosts the health of cartilage tissue, whether a person has OA or not.
Exercise also strengthens the way the body supports the joints. Strengthening the leg muscles is especially beneficial for the knees.
People with joint pain can benefit from activities such as water aerobics, as this puts little strain on the knees.
2. Strengthening exercises
Individuals can work with a physical therapist to identify the best exercises and programs for their needs.
Strengthening the upper leg muscles—the quadriceps muscles—through exercise can help to protect the knee joint. These muscles are at the sides and front of the thighs.
Here are some ways to strengthen these muscles:
- Straighten and raise a leg while lying or sitting down.
- Place one foot up on a step, then the other, stepping down again, and repeating the step-ups.
- Sit on a chair and then stand and sit repeatedly for a minute. Do this in a slow, controlled way and avoid using the hands to support you.
- Hold a chair and squat until the kneecaps cover the toes. Do this 10 times.
3. Posture and support
Measures that can help to minimize knee strain include:
- avoiding low chairs and couches that you “sink” into
- sitting on a pillow to raise your seating level, if necessary
- checking that you have a good sitting posture, without slouching or leaning
- wearing supportive shoes and avoiding those with broken arches, as they can result in abnormal force and wear on the knee
- avoiding prolonged sitting and long periods without moving, as joints may become stiff and painful without movement
4. Weight loss and diet
People who have excess weight or obesity have a higher risk of knee pain.
Carrying extra weight gives the joints more work to do. Losing it helps to reduce long-term knee pain, including pain caused by arthritis.
Extra weight on your body increases inflammation throughout the body and the knees are affected.
Eating well helps with keeping weight off.
A healthful diet means a balanced one that is:
- high in fruit, vegetables, and fiber
- low in meat, animal fat, and other fat
The Arthritis Foundation recommend a Mediterranean-style diet that is rich in fresh produce.
Experts urge people with OA of the knee to lose weight if they have overweight or obesity. A doctor or dietitian can help decide how much weight a person needs to lose. They can also help plan a suitable diet.
Non-steroidal anti-inflammatory and other medications can help with knee pain caused by arthritis. Some of these need to be given in a doctor’s office, but some can be used at home, either with or without a prescription.
Medications that may help manage pain include:
- oral or topical non-steroidal anti-inflammatory drugs (NSAIDs)
- topical capsaicin
- steroid injections into the joint
Acetaminophen and duloxetine, which is an antidepressant, may help.
Experts do not recommend using opioids, except for tramadol.
Some of these medications are available for purchase over-the-counter or online, including the NSAIDs ibuprofen and naproxen.
Massage, including self-massage, may relieve knee pain.
The American Massage Therapy Association (AMTA) recommend the following.
These should be done in a seated position with the knees pointing forward and the feet flat on the floor.
- Loosely closing the hands into fists, tap the upper, lower, and middle thigh 10 times with both hands. Repeat three times.
- Sitting with the feet flat on the floor, place the heel of the hand on the top of the thigh and glide it as far as the knee, then release. Repeat five times. Do the same for the outer and inner sides of the thigh.
- Press four fingers into the knee tissue and move up and down five times. Repeat all around the knee.
- Place the palm of the hand on top of the thigh, glide it down the thigh, over the knee and back up the outer thigh.
Massaging the thigh muscles will have a beneficial impact on the knee.
Current guidelines do not recommend massage as a treatment for OA of the knee, as there is not enough evidence to prove that it helps reduce symptoms. However, massage may offer other benefits, such as managing stress.
7. Aromatherapy preparations
Essential oils may help reduce pain.
8. Protection, rest, ice, compression, and elevation (PRICE)
Rest, ice, compression, and elevation may help treat mild knee pain that results from a soft tissue injury, such as a sprain.
Protection refers to protecting the knee from further injury, for example, by taking a break from the activity that caused it.
Rest can reduce the risk of further injury and give tissues time to heal. However, stopping all movement is not advisable, as this can lead to stiffness and, in time, muscle weakness.
Ice can help reduce swelling and inflammation. It should be wrapped in a cloth and applied for 20 minutes several times on the first day of injury. Never put ice directly the skin, as this can lead to further damage.
Compression with a knee support, for example, can increase comfort levels. The support or bandage should be firm but not tight.
Elevation, or keeping the leg raised, will encourage circulation and reduce swelling. Ideally, the knee should be above the level of the heart.
9. Heat and cold
- Heat relaxes muscles and improves lubrication, leading to a reduction in stiffness. Use a hot water bottle or a warm pad.
- Ice, wrapped in a cloth, can reduce pain, inflammation, and swelling.
Some people may use heat to improve mobility in the morning and reduce swelling later in the day.
Remember to test any hot item before applying it, especially if it is for an older person or someone who cannot communicate easily.
A colder climate is often thought to worsen pain.
Study findings do not support this, although living in a pleasant climate might make pain psychologically easier. It may also provide easier opportunities to achieve a more healthy lifestyle.
In 2014, researchers found that — rather than weather itself — sensitivity to weather in older people with osteoarthritis may affect how they experience joint pain.
People from Southern Europe, women, and those with higher anxiety levels were more likely to report weather sensitivity, and those with higher levels of sensitivity were more likely to report increased pain, especially with damp or rainy and cold weather.
The results of the study did not support the common belief that pain becomes worse in a colder climate.
A 2017 study carried out in the United States supported this view. Findings showed no link between rainfall and increased medical visits for joint pain.
Participants received either 23 true or 23 sham acupuncture sessions over 26 weeks, or 6 acupuncture sessions over 12 weeks.
Those who had true acupuncture scored higher in pain and function scores, compared with the others.
“Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.”
The ACR and AF note that acupuncture may help ease pain.
12. Tai chi
Tai chi is a form of meditative exercise, and the benefits of exercise alone are discussed above.
A year-long study of 204 participants with knee osteoarthritis concluded that tai chi might have similar, if not greater, benefits compared with standard physical therapy. The average age of participants was 60 years.
Improvements in primary outcome scores were recorded in both groups at 12 weeks, and these continued throughout the program.
In addition, those who did tai chi also saw significant improvements in symptoms of depression and the physical aspects of quality of life, compared with those who underwent standard physical therapy.
The ACR and AF strongly recommend tai chi as a form of exercise for people with OA of the knee.
13. Medical marijuana
Recent approval of the use of cannabidiol (CBD), also known as medical marijuana, has provoked interest in it as a solution to a range of health problems.
CBD is not the compound in marijuana that produces psychotropic effects, but it does appear to have a number of pharmacological effects.
Animal studies have suggested that it may improve joint pain, because it:
- inhibits pain pathway signalling
- has anti-inflammatory effects
Clinical trials have not proven its safety or effectiveness for use in rheumatic disease, but researchers suggest it should not be ruled out as an option in the future.
14. Apple cider vinegar and other foods
According to some sources, apple cider vinegar (ACV) has anti-inflammatory properties that can help relieve arthritis and other types of pain.
However, there is a lack of scientific evidence to support this. The Arthritis Foundation refers to ACV as a “food myth.”
Other popular advice for arthritis includes:
- consuming collagen, gelatin, or pectin, and raw foods.
- avoiding dairy, acidic foods, and nightshade vegetables, such as tomatoes, potatoes, and eggplant
There is no evidence to suggest that these are helpful or even advisable.
It commonly affects teenagers, especially young female athletes. It is the most common overuse syndrome in sportspeople.
Most cases of front knee pain are injuries from overuse, or from poor preparation for exercise. The problems usually go away on their own, and sporting activities can resume after the pain subsides.
The pain varies but tends to:
- be a dull ache that starts gradually, and is linked to activities
- produce clicking or other sounds
- come on when going upstairs, or when getting up after a long time sitting, squatting down, or kneeling
- produce a weakness in the legs
Recommended treatments for front knee pain include:
- stopping the activities that trigger it until it is resolved
- applying ice when the knee is painful
- taking over-the-counter pain relievers such as ibuprofen or naproxen
- using strengthening exercises
Osteoarthritis is one of the most common causes of long-term knee pain.
One common reason for long-term knee pain is a type of arthritis known as osteoarthritis. It is thought to be caused by wear and tear in the joint. It affects mostly older people over 65 years.
The knee bends and straightens smoothly because of the cartilage that covers the ends of the bones in the healthy joint.
Long-term damage to this cartilage leads to osteoarthritis. Movement becomes restricted and pain gradually increases.
The pain worsens on weight-bearing and is relieved with rest.
Pain also comes on after waking up or following periods without moving.
Movement reduces stiffness.
Another kind of arthritis, rheumatoid arthritis (RA), can cause knee pain, too.
Rheumatoid arthritis tends to involve swelling of the knee. Sore joints will tend to be red, tender, warm, and swollen.
The pain involves more general stiffness that is typically worse in the early morning. There can be afternoon fatigue. Knee pain with these symptoms needs the attention of a doctor for correct diagnosis and treatment. Rheumatoid arthritis benefits from early treatment.
Sprains, strains, and injuries
Sprains and strains happen when tissues in the knee become stretched by unusual or increased activity, or an awkward twist or trip.
PRICE, described above, should lead to a reduction in pain and improved movement within days, and a gradual improvement over the weeks to follow.
A sprain often resolves itself, but some problems can require more treatment. For example, an injury to the pad of tissue in the knee joint known as the meniscus may require surgery.
Gout is another type of arthritis. It produces sudden episodes of severe knee pain with redness and swelling, and can affect other joints. The condition can be treated under medical care with medication and changes to diet and exercise.
An obvious knee injury caused by sudden trauma, such as from a road accident or a fall, may need immediate medical attention.
A knee should be checked by a doctor if there is considerable pain, deep cuts, swelling, or the person is unable to use their leg.
For other cases of knee pain, a doctor will need to examine the problem if it:
- persists for a long time
- gets progressively worse
- disrupts daily activities
It is important to get a diagnosis and treatment from a doctor if knee pain involves red, tender, warm, and swollen joints.
If the symptoms are persistent, involve other joints, and there are other symptoms such as morning stiffness, it could be rheumatoid arthritis. Doctors can give drugs for both the disease itself and the pain it causes.
If a swollen knee is very hot and painful, and if there are other general symptoms of feeling unwell, this is a time to get urgent medical help. The knee could be infected, and serious infection can be dangerous. This needs urgent hospital treatment.
Anyone whose knee pain is receiving medical help should see contact their doctor again if problems get worse or if there are issues with treatment, such as a drug side effect.
Should I take glucosamine supplements for knee pain?
Glucosamine sulfate has been shown to provide reduction in pain for people with osteoporosis. This may be a good choice for people who are unable to take over the counter nonsteroidal anti-inflammatory drugs (NSAIDs).
There may be some digestive side effects. It is possible to be allergic to glucosamine, especially for people who are allergic to shell fish. Stop using if you develop skin rash or other symptoms of allergy.
Herbs can interfere with medications. Glucosamine should not be taken if you are on blood clotting medications and can interfere with effectiveness of over the counter pain killers.
I think glucosamine sulphate is worth trying for those with chronic knee pain, but tell your doctor so you are sure that it is safe to take.
Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.