How to diagnose and
treat knee pain

How do clinicians diagnose knee pain?

Clinicians usually start by listening to your story. They will ask where your knee hurts, when the pain began, whether it came on after an injury or over time, and what makes it better or worse.^{1 3 4} They may ask about your job, hobbies, sports, past injuries, body weight, and medical conditions like gout or inflammatory arthritis. ^{1 2 11 15}

Next comes a physical exam. Your clinician will look at how you stand and walk, check for swelling, and feel around the knee for tender spots along the joint line, kneecap, ligaments, and tendons.^{1 3 4} They will usually test how far your knee can bend and straighten, how strong your thigh and hip muscles are, and how your knee feels when you squat, step down, or go up and down a small step. ^{1 3 4 12}

Specific tests help point to certain problems. Gentle pulling and twisting can check the ligaments, such as the anterior cruciate ligament and collateral ligaments.⁴ Pressing along the inner or outer joint line and moving the knee can suggest a meniscal (flexible cushion cartilage) tear.^{5 6 7} Squat or step-down tests, taping trials, and pressing around the kneecap help assess patellofemoral pain.^{3 12}

After a recent injury, many clinicians use the Ottawa Knee Rule. This is a simple checklist that looks at age, where the bone is tender, and whether you can take a few steps.⁸ It’s very sensitive in picking up fractures, which means that if you do not meet the rule, a broken bone is very unlikely and you often do not need an X-ray.^{8 10}

Imaging is used when it will change care. X-rays are usually the first test if a fracture is suspected after trauma, or if osteoarthritis is likely based on age, stiffness, and activity-related pain.^{1 2 9 10} For ongoing pain that does not settle, or when there are signs of internal damage, your clinician may order an MRI to look at cartilage, menisci, and ligaments more closely.^{5 6 9 10} Ultrasound can be helpful for some tendon and bursal problems or to guide fluid removal.^{9 10}

Blood tests and joint fluid sampling are used in special cases. If the knee is very hot, swollen, and painful, especially with fever or if you feel unwell, clinicians may draw fluid from the joint to check for infection or crystals like gout.^{1 11} Septic arthritis is an emergency because delay can damage the joint and affect overall health.¹¹

Throughout the visit, the focus is not just on what the scan shows, but on how your knee feels and what you can and cannot do in daily life. This helps ensure that the diagnosis and treatment plan match your goals, not just the images.^{1 3 9 13}

Clinical insight

For many adults with knee pain from wear and tear, a structured plan that combines education, strengthening, and weight management often works as well as surgery for pain and function over several years. ^{1 2 5 6 7 15}

What are the treatment options for knee pain?

Most people with knee pain improve with a plan that focuses on education, progressive exercise, and load management, along with weight management when needed. ^{1 2 3 5} Surgery and injections are usually reserved for clear reasons after a good trial of non-surgical care. ^{1 2 5 6 7}

• Education and activity changes:
• Exercise-based rehabilitation
• Supports and orthoses
• Medications
• Injections
• Surgery
• Recovery expectations

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
• Simple, non-invasive, evidence-based programs
• Proven results for pain relief, movement, and satisfaction

How can I find pain relief for knee pain?

There are several low-risk steps that many people can try to help calm knee pain and stay active. For everyday activities, it can help to break tasks into shorter bouts, take the elevator when pain is high, and use handrails on stairs while you work on strength and confidence.^{1 2 3} Short rest periods are reasonable during a flare, but long-term rest usually leads to more stiffness and weakness.^{1 2 3}

Gentle, regular movement is often better than complete rest. Low-impact activities like walking on flat ground, cycling, or swimming can keep the joint moving and support heart health without overloading the knee. ^{1 2} Simple strengthening exercises, such as sit-to-stands from a chair, mini-squats in a pain-tolerable range, and side-leg raises, help your muscles share the load. ^{1 3 12}

It is common to feel some discomfort when starting or progressing exercises. Pain up to a mild or moderate level that eases within a day is usually acceptable, but sharp or worsening pain that lingers may mean the exercise or volume needs adjusting. ^{3 12} A physical therapist or similar professional can help you find the right starting level and pace your progress. ^{1 3 4 12}

Using ice packs for short periods, simple pain medicines when safe, and, in some cases, topical anti-inflammatory gels can help you move more comfortably. ^{1 2} Supportive shoes and, when advised, braces or taping can also reduce strain on sensitive areas. ^{2 3 12}

You should contact a clinician promptly if your knee is very hot and swollen, if you cannot bear weight after an injury, if the knee seems out of place, or if there are signs of infection or blood clot, such as fever or sudden calf swelling.^{8 10 11} If pain has lasted more than 4 to 6 weeks or keeps you from important activities, it is also a good time to seek professional guidance. ^{1 2 4}