Knee pain is a widespread issue among older adults, significantly impacting mobility, daily functioning, and overall quality of life.

As the body ages, joints endure years of wear and tear, making them more susceptible to damage and inflammation.

Understanding the root causes of knee pain is essential for prevention and effective management, as different factors can contribute to knee problems.

This blog by Mykare Health outlines some of the most common reasons for knee pain in older adults and provides practical advice on managing and preventing these conditions.

Causes of Knee Pain

Osteoarthritis

Osteoarthritis (OA) is the leading cause of knee pain in older adults. This degenerative joint disease develops when the protective cartilage that cushions the ends of the bones gradually deteriorates, causing the bones to rub against each other.

This friction results in pain, stiffness, and swelling, making it difficult to move the knee joint. Osteoarthritis typically develops over time, often due to a combination of ageing, genetics, and previous injuries. Risk factors like obesity and a sedentary lifestyle can exacerbate the condition, leading to a faster progression.

Symptoms

• Pain during movement or after activity

• Joint stiffness, especially in the morning or after periods of inactivity

• Decreased range of motion

• Grating sensation or popping sounds in the knee

Management Tips

Regular low-impact exercises like swimming or cycling, maintaining a healthy weight, and using assistive devices such as knee braces can help manage symptoms and improve joint function.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is another common cause of knee pain in older adults, though it differs significantly from osteoarthritis. RA is an autoimmune disease in which the body’s immune system mistakenly attacks the joint lining, leading to inflammation, swelling, and damage to the cartilage and bones.

Unlike osteoarthritis, which usually affects one joint, RA typically involves multiple joints and can cause systemic symptoms like fatigue and fever.

Symptoms

• Symmetrical joint pain (affects both knees)

• Morning stiffness lasting more than 30 minutes

• Warmth and redness around the joints

• Fatigue and general feeling of being unwell

Management Tips

Early diagnosis and treatment are crucial for RA. Medications such as disease-modifying antirheumatic drugs (DMARDs) and biologics, along with physical therapy, can slow the progression of the disease and reduce symptoms.

Bursitis

Bursae are small, fluid-filled sacs that act as cushions between bones and soft tissues. When the bursae in the knee become inflamed, a condition called bursitis occurs, causing localised pain and swelling.

This condition is often caused by repetitive stress or direct trauma to the knee. Older adults, particularly those who kneel frequently or have a history of joint problems, are at a higher risk.

Symptoms

• Swelling and warmth at the front of the knee

• Sharp pain that worsens with movement or pressure

• Limited range of motion in the knee

Management Tips

Rest, ice, compression, and elevation (RICE) can help manage bursitis symptoms. Avoiding activities that put excessive pressure on the knee and using knee pads during kneeling tasks can prevent flare-ups.

Tendonitis

Tendonitis is the inflammation or irritation of the tendons, the thick cords that attach muscles to bones. In the knee, it most commonly affects the patellar tendon, which connects the kneecap to the shinbone.

Overuse, repetitive movements, and sudden increases in physical activity can lead to tendonitis, making it a frequent issue among older adults who remain physically active or have recently taken up new activities.

Symptoms

• Pain around the kneecap, especially during or after activity

• Swelling and tenderness along the tendon

• Pain when bending, jumping, or climbing stairs

Management Tips

Resting the knee, applying ice, and engaging in physical therapy exercises to strengthen the tendons can alleviate pain. In severe cases, a healthcare provider may recommend anti-inflammatory medications or corticosteroid injections.

Meniscal Tears: Age-Related Degeneration

The meniscus is a C-shaped piece of cartilage that acts as a shock absorber between the thigh bone and shinbone. Over time, the meniscus can become more prone to tears due to wear and tear or sudden twisting movements.

Meniscal tears are common in older adults because of the natural weakening of the cartilage that occurs with age. Even minor movements, like squatting or stepping awkwardly, can result in a tear.

Symptoms

• Sharp pain along the knee joint line

• Locking or catching sensation in the knee

• Swelling and stiffness

• Difficulty straightening the knee fully

Management Tips

Rest, ice, and physical therapy are often recommended for minor tears. Severe cases may require arthroscopic surgery to repair the damaged meniscus.

Gout

Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints, leading to sudden, severe pain and swelling. Although it typically affects the big toe, gout can also involve the knee.

Older adults are more susceptible to gout due to decreased kidney function and higher uric acid levels. Certain foods, medications, and alcohol consumption can trigger gout attacks, making lifestyle management an important aspect of treatment.

Symptoms

• Sudden onset of intense pain, often at night

• Redness and warmth in the affected knee

• Extreme tenderness to touch

• Limited movement due to pain

Management Tips

Managing gout involves dietary changes to reduce uric acid levels, such as avoiding red meats, shellfish, and alcohol. Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can provide relief during acute attacks.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome, also known as “runner’s knee,” is a common cause of knee pain, particularly in older adults who remain active.

It occurs when the cartilage under the kneecap is damaged due to overuse, misalignment, or injury. While it is commonly associated with younger, active individuals, older adults who engage in activities like running or squatting may also develop this condition.

Symptoms

• Pain around the kneecap, especially when sitting for long periods, climbing stairs, or squatting

• Popping or grinding sensation in the knee

• Swelling around the kneecap

Management Tips

Rest, avoiding activities that aggravate the condition, and performing specific exercises to strengthen the quadriceps and improve knee alignment can help alleviate symptoms.