Lateral knee pain refers to pain you feel outside or around your knee joint. Depending on the cause of the injury, the pain may be a general ache or a specific sharp pain associated with a certain type of movement. You may experience outer knee pain that worsens with time or feel acute pain immediately after an injury. If the injury is associated with neural damage or impaction, you may also feel pins and needles, tingling, and/or numbness.
What are the Causes of Lateral Knee Pain?
Localized lateral knee pain is usually caused by injury to one of the tissues (nerve, tendon, muscle, or bone) on the outside of your knee. This could be the result of a sporting injury, overuse, or age-related degeneration.
Osteoarthritis, (wear and tear arthritis) is the degeneration of the protective layer of cartilage within a joint. With the cartilage wearing away, the ends of the bones begin rubbing together. This causes severe discomfort and leads to bone damage and inflammation within the joint.
Osteoarthritis (OA) is more common in people over the age of 50.1 Knee OA occurs more frequently in people who play intense sports and have had previous knee injuries. There is a genetic correlation with the prevalence of OA. The risk of developing OA is higher if there is a family history of OA.
Iliotibial Band Syndrome
Iliotibial band syndrome (ITBS) is the most common cause of lateral knee pain. The iliotibial band is a thick tendon that runs along the outside of your thigh from the iliac crest down to the knee. ITBS, inflammation of the iliotibial band, is usually a non-traumatic injury caused by overuse. The outer knee pain associated with ITBS usually worsens with exercise such as running, hiking, cycling, climbing stairs, or squatting.
Differences Between Inner and Outer Knee Pain
Depending on where in the knee the injury occurs, there are slight differences between inner and outer knee pain.
The meniscus is a C-shaped piece of cartilage that acts as a shock absorber between the femur (thigh bone) and tibia (shin bone). There are two menisci in each knee joint. One on the outside of the knee (lateral) and one on the inside (medial). A medial meniscus or lateral meniscus tear can occur because of a single acute injury such as a quick turn during sports. It can also be a result of degeneration due to overuse or age.
MCL vs. LCL tears
There are two collateral ligaments on the sides of your knee. On the inside of your knee, the medial collateral ligament (MCL) connects the femur to the tibia while the lateral collateral ligament (outside) attaches the outer side of the femur to the fibula. These ligaments control the side-to-side movements of your knees and brace them against unnatural motion. Collateral ligaments may tear during sporting activities when you change direction quickly, stop suddenly, or are tackled.
Injury to the MCL will cause pain on the inside of your knee, while an LCL tear will result in pain on the outside of your knee. The pain often worsens with bending your knee, walking, or climbing stairs. Swelling may occur around the injury site, and you could feel as if your knee is giving away when you stand up or try to walk.
How Do You Relieve Lateral Knee Pain?
The best treatment for lateral knee pain depends on the underlying cause of the pain. A treatment plan will usually combine physical therapy, specific exercises to strengthen adjacent muscles, and rest from strenuous or aggravating exercises. Depending on the origin and severity of the lateral knee pain, your treatment protocol may even include injections and/or surgery.
At-Home Treatment for Knee Pain
For pain resulting from soft tissue injuries such as a sprain, the following treatment may help:
- Ice wrapped in a cloth can lessen pain and inflammation.
- The application of a hot water bottle or heating pad can relax muscles and improve lubrication within the joint.
- Resting with your leg raised just above heart height will encourage circulation and decrease swelling.
- Support of the knee joint with compression or bandages can improve your comfort levels.
Professional Treatment for Knee Pain
There are several treatment options for knee pain. The protocol you and your doctor choose will depend on the extent of your pain and what is causing it. You may consider some of the following options:
- Lateral knee pain caused by osteoarthritis is usually treated with medication and physical therapy.
- Orthopedic surgeons can repair tendon and ligament tears with minimally invasive surgery.
- Injecting corticosteroids, lubricants (hyaluronic acid), or platelet-rich plasma (PRP) directly into the knee can help reduce inflammation and improve mobility.
- Severe damage to bones in the knee joint may require knee replacement surgery.
- Acupuncture may help with lateral knee pain.
What are the Top Risk Factors that Lead to Lateral Knee Pain?
Systemic Inflammatory Disease
An overactive immune system can cause joint inflammation or inflammatory arthritis (IA). IA conditions such as gout and rheumatoid arthritis can be painful and incapacitating.
People who have previously had a knee injury are more likely to re-injure their knee.
Lack of Muscle Flexibility
Strong, flexible muscles help to prevent injury by providing good joint support and range of motion.
Bursae are small synovial-secreting sacs that cushion joints and reduce friction during movement. There are 11 bursae in each knee. Bursitis, inflammation of one or more of these sacs, may cause knee pain and limited mobility.
Biceps femoris tendinitis is the degeneration or inflammation of the hamstring tendon (biceps femoris) that connects at the back of the knee. Tendinitis may cause stiffness in the knee joint first thing in the morning or after sitting for a time. It could also result in pain and swelling at the back of the knee.
How to Prevent Lateral Knee Pain
Individuals who are overweight or obese are at higher risk of lateral knee pain. Maintaining healthy body weight is vital for reducing inflammation and limiting stress on joints like the hips and knees. Regular low-impact exercise can boost the health of cartilage tissues in the joints and strengthen muscles that support the joints.
Regular sessions with a physical therapist can help to strengthen muscles and other tissues adjacent to the knee joint. This will result in better support of the joint, quicker rehabilitation, and a decreased likelihood of injury.
Find the Right Treatment Protocol for Your Lateral Knee Pain
Knee pain affects almost one in four Americans.2 Whether your lateral knee pain stems from chronic inflammation or degeneration, there are several treatment options available. Our pain specialists can help to address your knee pain. If you need assistance finding the right treatment protocol, schedule an appointment today to discuss your knee pain and the treatment options available.
Frequently Asked Questions
Is it better to keep a sore knee straight or bent?
It is advisable to keep your leg straight as much as possible. If you have to sit with crossed legs, try to minimize it to 20 minutes at a time. The best sleep position for knee pain is to lie on your back with your knee slightly elevated.
What exercises should be avoided with lateral knee pain?
Avoid any exercise and movement that places excessive strain on the knee joint such as deep lunges and deep squats. Also, steer clear of activities that jar your joints such as running, jumping, and kicking.
How do you stretch the lateral part of the knee?
The knee joint attaches to several muscles, so it is essential to stretch all these muscles. Stretches such as knee straighteners, straight leg raises, side leg raises, calf stretch, and seated hamstring stretch.
- Lawrence et al, 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266664/
- Nguyen et al, 2011. https://acl.gov/news-and-events/news/one-four-adults-suffers-chronic-knee-pain / https://www.acpjournals.org/doi/10.7326/0003-4819-155-11-201112060-00004?doi=10.7326%2F0003-4819-155-11-201112060-00004