Front Knee Pain
Reviewed By - Sean Byers, MD

Published: Last Updated: Category: Knee Pain

Front knee pain, also referred to as anterior knee pain, is chronic or sudden pain at the front and center point of the knee. Several things can cause front knee pain, including a breakdown of the cartilage tissue, injury, and arthritis. 

According to the American Family Physician, approximately 25 percent of adults struggle with knee pain, which is an increase of 65 percent over the past 20 years.

People who suffer from front knee pain should seek medical attention and have their anterior knee pain diagnosed. Once there is a diagnosis, the orthopedic doctor can start a treatment plan and help alleviate the pain. 

Surgery is one treatment plan option that almost 800,000 people in the United States undergo annually and more than 90 percent of full knee replacement recipients experience a dramatic reduction in knee pain.

Continue reading to learn more about front knee pain and if you still have questions, visit Health Report Live for additional information. Our website can help provide you with additional information about chronic pain and various medical conditions, including front knee pain.

What You Must Know About Front Knee Pain

Front knee pain affects people in all age groups, including adolescents, teenagers, young adults, and senior citizens. 

Front knee pain can dramatically affect a person’s life, resulting in the inability to participate in sports or conduct day-to-day activities, such as walking or climbing stairs. So why is the kneecap so susceptible to injury-causing excruciating pain?

Everything from age to level of activity can cause anterior knee pain, which can cause people to suffer from chronic and sudden pain in the front of their knee. 

In most cases, front knee pain results from an accident or injury and can also result from long-term misuse of the legs and knees. 

Symptoms of front knee pain vary from patient to patient, and most experience mild pain, while others experience severe pain, which impacts their daily lives. 

For example, those suffering from front knee pain may experience a burning sensation in the kneecap or a sharp stabbing pain beneath the kneecap. 

How Do I Know If My Knee Pain Is Serious?

Knee pain can come on slowly, and it might not be evident at first that the front knee pain is severe. On the other hand, the pain may result from an injury, which can cause severe damage to the knee. 

Knee pain is serious when the pain does not go away on its own after self-care or when it significantly impacts your daily routine. 

It is best to schedule an appointment with your doctor if you are experiencing any significant swelling, redness, tenderness, warmth to the touch, considerable pain, or fever associated with your knee pain. 

Also, seek immediate attention if an injury causes the front knee pain, the joint appears deformed, there is a popping noise coming from the knee, or you have intense pain and sudden swelling. 

Understanding The Common Causes Of Front Knee Pain

Both long-term wear and tear and sudden injuries can cause front knee pain. Common causes of front knee pain include torn tendons, torn cartilage, runner’s knee, and arthritis. 

These are just some of the common causes of knee pain, and more details about the different causes of knee pain are listed below. 

Runner’s Knee

It is a common misconception that runner’s knee is only for runners; however, it is a broad term used to describe a specific type of pain felt in the knee. 

Runner’s knee is a significant injury, and some orthopedic surgeons refer to it as a patellofemoral pain syndrome (PFPS). 

Several things can cause a person to suffer from runner’s knee, including: 

  • Overuse and repetitive bending of the knee
  • A direct hit to the knee
  • The bones do not line up from the hip to the ankles
  • Problems with the feet, such as fallen arches or overpronation
  • Weak thigh muscles
  • Chondromalacia patella, a condition where the cartilage in the knee breaks down

Symptoms of runner’s knee include pain in the front of the knee cap, pain that becomes worse when walking downstairs, popping noises, and a grinding feeling in the knee. 

Excessive Pronation

Excessive pronation, also referred to as overpronation, occurs when the foot rolls toward the inside as you walk. Overpronation flattens out the arch, which eventually can lead to your shoes wearing out on the inside of the sole. 

Overpronation is more common than underpronation, and people with this excessive pronation could experience pain in their arch, ankle, heel, shin, knee, hip, and back. 

Common causes of excessive pronation include leg lengths not being even, injury, overuse, walking on hard surfaces, pregnancy, or obesity. 

In addition, injuries such as ankle sprains, plantar fasciitis, metatarsalgia, heel spurs, and tendinitis can also cause overpronation. 

Knee Arthritis

Knee arthritis is an inflammation of the knee joint, often resulting in pain, stiffness, and swelling. Suffering from arthritis in the knee can make it challenging to conduct daily tasks, such as climbing stairs, standing, or walking. 

This condition is one of the causes of people applying for disability and losing time at work. 

Common types of knee arthritis include osteoarthritis and rheumatoid arthritis. Unfortunately, there is no cure for arthritis; however, several treatment options are available to help keep people active and manage pain levels. 

Knee Ligament Injuries

Knee ligament injuries cause front knee pain when the elastic bands of tissue connecting the bones are damaged. There are four major ligaments in the knee providing strength and stability to the joint. 

These ligaments can get injured when overstretched or torn from a sudden jarring movement, including twisting when playing sports or exercising. The ligaments can also become damaged from sudden, direct impact to the knee. 

A knee ligament injury symptoms include hearing popping noises when walking, swelling, and instability. This type of injury does not always result in severe pain, but people with a ligament injury may experience discomfort and pain. 

Torn Knee Cartilage (Meniscus)

A torn meniscus, also known as knee cartilage, is most common among people who complain about front knee pain. 

Several things can cause the cartilage to tear, including a forceful knee twist, wear and tear, and obesity. In most cases, torn knee cartilage requires surgery to correct and treat knee pain. 

If you have a torn meniscus, you may experience the following symptoms: 

  • Popping sensation
  • Locking of the knee (especially if the cartilage moves over the knee cap)
  • Front knee pain
  • Trouble straightening the knee
  • Feeling the knee is giving away

Patellar Tendonitis And Tear

Patellar tendonitis is an injury to the tendons connecting the kneecap, also known as the patella, to the shinbone. Injury can be a strain or tear, which is commonly known as jumper’s knee and results from sudden impact from jumping. 

Athletes prone to patellar tendonitis include volleyball and basketball players; however, anyone can experience this condition. Symptoms of patellar tendonitis include front knee pain and swelling. 

Patella Dislocation

Often caused by force, such as a collision or fall, patella dislocation occurs when the kneecap pops sideways out of its groove at the knee joint. A dislocated patella is extremely painful and will prevent you from walking and moving the leg. 

In most cases, the kneecap will sometimes correct itself and return to its groove; however, some situations require medical attention to get the knee repaired. 

Patella dislocation is different from a knee dislocation because a dislocated knee involves the thigh bone (femur) and shinbone and occurs when these bones no longer connect to the knee bone. Patella dislocation is when the kneecap separates from its natural position. 

Common causes of a kneecap dislocation include direct impact, a wrong step, heavy fall, collision, or sudden twisting of the knee joint. In addition, people with an unstable knee, meaning the tendons and ligaments are loose, are more susceptible to patella dislocation. 

Signs and symptoms of a dislocated kneecap include hearing an audible popping sound, the knee-buckling, intense front knee pain, sudden swelling, bruising, locking of the knee joint, inability to walk, and seeing the kneecap visually out of place. 

Patellofemoral Pain Syndrome

The term PFPS describes the pain experienced in the front of the knee surrounding the kneecap. Though often called runner’s knee or jumper’s knee, PFPS can also occur in nonathletes, causing pain when kneeling, walking, climbing stairs, and performing daily activities. 

PFPS occurs when the nerves sense pain in the soft tissues and bone surrounding the patella, including cartilage, ligaments, and tendons. Common causes of PFPS include overuse, improper use, muscular weaknesses, obesity, standing for long periods, and wearing improper footwear. 

Symptoms of PFPS include dull, aching pain and continued discomfort in the area surrounding the front of the knee joint. 

Other Common Causes

The above-listed conditions are common causes of front knee pain, but many other reasons cause anterior knee pain. 

For example, some medical conditions and syndromes can cause the ligaments to weaken, resulting in knee pain. 

Other causes of knee pain include arthrofibrosis, tibial collateral ligament bursitis, isolated ganglions of the anterior cruciate ligament, saphenous nerve palsy, slipped femoral epiphysis, and knee tumors. 

Diagnostic Procedures

If you are suffering from front knee pain that is intensifying or not going away on its own, schedule an appointment with your doctor or orthopedic surgeon. The doctor will use various techniques and diagnostic procedures to determine what is causing the pain during your appointment. 

Medical History

A review of your medical history, including previous knee injuries and surgeries, is vital to help diagnose the cause of the pain. The doctor will ask about all previous attempts to treat the knee pain, including braces, physical therapy, surgery, and medications (both over-the-counter and prescription). 

Additionally, the physician will discuss any history of gout, rheumatoid arthritis, or any degenerative joint disease. 

Knowledge of a patient’s medical history can help the doctor determine if there are any alternative methods to treat front knee pain that has not already been tried. 

Physical Examination

It is common for a doctor to start with a physical exam, to inspect the knee for swelling, tenderness, warmth, discoloration, and signs of bruising. 

They may also see how far the knee joint can bend and stretch while checking the integrity of the joint by pulling on the leg. 

The physical examination helps the doctor determine if there are any visual causes of the knee pain. 

The doctor will also order additional tests to help get a complete overview of the knee’s condition and help diagnose what is causing the knee pain. 

Imaging

The doctor may order imaging tests to help diagnose the cause of your front knee pain. Some imaging tests may include: 

  • X-ray: Typically, an X-ray is the first test a doctor orders to determine if there are any bone fractures or if the patient has degenerative joint diseases. 
  • Computerized tomography scan (CT): A CT scan allows the doctor to see x-rays of the knee joint from various angles. 
  • Ultrasound: Ultrasounds use soundwaves to create real-time images of soft tissue within the knee, an ultrasound can help the doctor check for specific conditions and problems with the knee. 
  • Magnetic resonance imaging (MRI): An MRI creates a 3D image of the knee’s inside and reveals damage and conditions of soft tissues, including ligaments, tendons, muscles, and cartilage. 

Lab Tests

The doctor may order lab tests, especially if they believe the patient might have an infection or inflammation of the knee. The lab test used is called arthrocentesis, when a small amount of fluid is extracted from the knee joint and sent to the lab for analysis. 

Differential Diagnoses

Differential diagnosis is differentiating between two or more causes of knee pain, which share similar signs and symptoms. 

Since knee pain is a common complaint with many possible reasons, it is vital that doctors use differential diagnoses to do their best to determine the actual cause of the front knee pain. 

For differential diagnosis, doctors will look at all symptoms compared to all test results, and determine which diagnosis most closely fits the symptoms. 

Medical Management (Treatments)

Treatments for front knee pain will vary depending upon the root cause of the pain. Medical management and treatments include everything from self-care strategies to medications and physical therapy to surgery. 

Check with your physician to determine which treatments are best for your front knee pain. If the medical management program your doctor put you on is not working or the pain is getting worse, do not hesitate to let them know. 

More tests may need to be conducted to get a proper diagnosis and find a treatment plan that will work and provide you with pain relief. 

Self-Care Strategies

Some anterior knee pain is mild and typically goes away on its own after using at-home self-remedies. Knee pain caused by muscle weakness or tightness, bending and stretching exercises may help reduce the pain and strengthen the knee muscles. 

Exercises to improve core muscles, gluteal and hip muscles, hamstring muscles, and quadriceps muscles can also help alleviate stress on the knee joint and reduce swelling. 

Other exercises, such as walking, bicycling, and swimming can help strengthen muscles which may provide pain relief to those suffering from knee pain. 

Using heating pads and ice packs can help with pain and reduce swelling of the knee joint. Check with your doctor to see which option is best for your knee condition and what periods of time you should use heat or cold on the knee. 

Physical Therapy

Physical therapy can help strengthen the muscle around the knee in a supervised setting to help monitor your progress and pain levels. 

The physical therapist will evaluate your knee, discuss your front knee pain, and develop an exercise and therapy plan to help build muscles and reduce pain levels. 

Exercises are designed to help strengthen the muscles, including knee bends, but also to help with flexibility and stability of the knee joint. 

Physical therapy may also include stretching exercises with your therapist, massage therapy, the use of a transcutaneous electrical nerve stimulation Unit (TENS Unit) and hot and cold treatments. 

The therapist will also send home a list of exercises you can do at home on days you do not have physical therapy. It may also be recommended for you to use a knee brace or some form of taping to help support your knee.

How often you go to psychical therapy will depend on the doctor’s recommendation based on your pain levels, type of injury, and healthcare insurance coverage.

Medications

Over-the-counter medications, including anti-inflammatory drugs such as naproxen and nsaids, are available to help relieve knee pain and depending upon the severity of the pain, your doctor may prescribe medications to help with pain relief. 

They may also prescribe medications to treat conditions that cause your knee pain, such as gout or rheumatoid arthritis. 

In addition to medications, there are topical ointments (over-the-counter and prescription) available to help ease pain. These ointments can help treat minor aches and pains and are often used in conjunction with medication treatments. 

Injections

Before jumping to needing surgery, your doctor may suggest a series of injections to help heal the injury and reduce front knee pain. Some injections used to treat knee conditions include: 

  • Corticosteroids: These injections are placed in the knee joint to reduce symptoms of arthritis and provide pain relief. Corticosteroids are not effective in all cases and only provide relief for a few months. 
  • Hyaluronic acid: The thick fluid is used to lubricate the joints to improve mobility while easing front knee pain. Relief from a series of hyaluronic shots may last up to six months. 
  • Platelet-rich plasma (PRP): PRP has a concentration of growth factors used to help reduce inflammation and promote the natural healing of the knee joint. 

Complementary And Alternative Therapies

The above-listed medical management options are not the only treatments available for knee pain. 

Several complementary and alternative therapies can be used to help alleviate knee pain and promote natural healing abilities of the knee joint. 

Some complementary and alternative therapies for front knee pain include acupuncture, acupressure, tai chi, yoga, massage therapy, taking supplements, and drinking green tea. 

Integrative medicine combines conventional medicine with complementary and alternative therapies to help provide patients with every pain management option available. These practices have shown to be effective and safe through scientific research and have become common practices in sports medicine.

Cannabidiol (CBD) may help reduce inflammation in the knee, relieving pain. CBD may also help reduce any anxiety you may have associated with arthritis and other chronic medical and pain conditions. 

Several products containing CBD are available, including topical creams, gels, oils, tinctures, and edibles made for consumption. 

Additionally, CBD does not produce the high effects caused by marijuana. Contact your physician or pharmacists to ensure the CBD does not cause any problems with any existing medication or health conditions. 

Before seeking alternative treatment, check with your physician to ensure it is a safe option based on the diagnosis of your knee pain and condition. 

Seeking guidance from your doctor first can help identify risks and benefits to complementary and alternative treatments. 

Surgery

Depending upon the cause of the anterior knee pain and how long you have been experiencing pain, the only option is to have surgery. 

Though it is not typically necessary to have an operation immediately, when all other treatment methods fail, it may be the only option. 

Before agreeing to undergo surgery, speak with your doctor, consider the pros and cons of surgery and other non-surgical options. Determine if surgery is the best option for you. 

If you have chosen to have surgery, the type you have depends greatly upon what is wrong with your knee. There are several different surgical options available, including: 

  • Arthroscopic surgery: Used to examine and repair minor joint damage using a fiber-optic camera, and long narrow tools inserted through a few small incisions at the knee. This surgical option can also be used to remove loose bodies around the knee joint, reconstruct torn ligaments, and remove torn and damaged cartilage. 
  • Partial knee replacement surgery: This procedure is used only when a portion of the knee is damaged and can be replaced using metal and plastic parts. The healing time for a partial knee replacement surgery is far less than a total knee replacement. 
  • Total knee replacement surgery: During this surgery, the orthopedic surgeon cuts away the damaged parts of the knee including bone and cartilage, separating it from the tibia, kneecap, and thighbone. They then replace the bone with an artificial joint made from high-grade plastics, polymers, and metal alloys. 
  • Osteotomy: This surgery is done in the hopes of delaying or avoiding total knee replacement and removes the bone from the shinbone or thighbone to relieve arthritis and create a better alignment of the knee joint. 

Prevention Of Front Knee Pain

Once front knee pain begins, for most, it is a long-term medical condition they must live with and undergo regular treatments. 

Though not always avoidable, especially among those who play sports or suffer an injury, there are lifestyle activities and things you can do to prevent anterior knee pain. 

Some things you can do to help prevent front knee pain or reduce your chances of developing a chronic knee condition, include: 

  • Stay active: Living an active lifestyle and participating in physical activity can help keep you healthy, which can reduce the chances of suffering from a sports injury. 
  • Maintain strength: Having strong quadriceps and muscles surrounding the knee help keep it balanced when moving.
  • Improve flexibility: Work on stretching exercises and activities which will help keep your knee flexible. 
  • Alignment: Focus on keeping the knees in perfect alignment with the rest of the body when working out, lifting, playing sports, and other activities involving squatting or bending the knee. 
  • Eat healthy: Eating healthy and having a well-balanced diet can help keep the body strong and healthy on the inside, reducing the chance of experiencing muscle or bone degeneration from poor eating habits. 
  • Lose excess weight: Maintaining a healthy weight helps alleviate the stress put on our knees. If you are overweight, losing weight can help prevent knee pain from arthritis, wear and tear, or injury. 
  • Wear good shoes: Wearing comfortable shoes that fit properly and offer plenty of support and shock absorption can help prevent knee pain. Running shoes help prevent runner’s knee and other running-related injuries. If needed, use shoe inserts or arch supports to help offset flat feet. 
  • Protect the knees: When kneeling or gardening, use knee pads or other padded options to protect the kneecaps. Wearing a knee brace can also help prevent injury to the knee.

Speak with your physician immediately if you have concerns about knee pain. Together, your doctor will help develop a treatment plan based on the final diagnosis of the root cause of the pain. 

Before starting any form of treatment, it is always best to seek medical advice to ensure you do not cause additional pain or more damage to your knee.

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