Pain above the knee, specifically the area just above the kneecap (patella), is a common complaint. This region contains many muscles, tendons, and other structures prone to injury or irritation. Causes range from acute injuries to chronic conditions, and this discomfort can significantly impact daily activities and movement.
Muscle and Tendon-Related Causes
Pain above the knee often originates from issues within the thigh’s muscles and tendons, especially the quadriceps group. This large muscle group on the front of the thigh connects to the kneecap via the quadriceps tendon.
A common issue is a quadriceps strain, a tear in the quadriceps muscle fibers. This can occur from sudden, forceful movements like sprinting or jumping, or from overuse and insufficient warm-up. Symptoms include localized pain in the front of the thigh, tenderness, and sometimes swelling, making leg movement difficult.
Another source of discomfort is quadriceps tendinopathy, also known as tendonitis. This condition involves inflammation or degeneration of the quadriceps tendon. Repetitive stress from activities like running, jumping, or cycling can lead to its development. Pain worsens with activity, and stiffness and tenderness are felt directly above the kneecap.
The iliotibial band (IT band) can also contribute to pain above the knee, particularly on the outer side. This thick band of fibrous tissue extends from the hip down to the outside of the knee. While pain is felt on the side of the knee, friction or tightness in this band can cause discomfort that radiates higher, especially with certain movements. Repetitive motions, common in runners and cyclists, can lead to this friction and pain.
Bursitis and Joint-Related Conditions
Beyond muscle and tendon issues, pain above the knee can also stem from conditions affecting the fluid-filled sacs (bursae) around the joint or the knee joint itself. These conditions involve inflammation or structural changes that impact the knee’s smooth functioning.
Suprapatellar bursitis is an inflammation of the bursa located just above the kneecap, beneath the quadriceps tendon. This bursa helps reduce friction between the tendon and the thigh bone. Repetitive kneeling, direct trauma, or overuse can irritate and inflame this sac. Symptoms include swelling directly above the kneecap, tenderness, and increased pain with knee movement.
Patellofemoral pain syndrome (PFPS) is characterized by pain around or behind the kneecap, which can be perceived as pain above the knee. This condition arises from issues with how the kneecap tracks within its groove on the thigh bone. Muscle imbalances, overuse, or subtle structural variations can contribute to improper tracking. People with PFPS experience a dull, aching pain, especially during activities like climbing stairs, squatting, or after prolonged sitting with bent knees.
Osteoarthritis of the knee, a degenerative joint condition, involves the wearing away of cartilage within the joint. While commonly associated with pain deep within the knee, the generalized discomfort from these degenerative changes can manifest as pain felt above the kneecap. This pain intensifies with activity or after periods of rest, reflecting the breakdown of the joint’s smooth surfaces.
Nerve Issues and Referred Pain
Sometimes, pain above the knee does not originate directly from the knee structures but from irritated nerves or distant body areas. This phenomenon, known as referred pain, means the sensation is felt in one location while the actual problem lies elsewhere.
Nerve entrapment or compression can lead to pain, numbness, or tingling sensations above the knee. Nerves like the femoral or saphenous nerve, which supply sensation to this region, can become irritated or compressed along their path. Potential causes include direct trauma, pressure from tight clothing, or anatomical variations. The discomfort follows the specific distribution of the affected nerve.
For pain above the knee, common sources of referred pain include issues within the hip or lower back. For example, hip osteoarthritis or a hip flexor strain can refer pain down to the thigh and above the knee. Similarly, a pinched nerve in the lower spine, known as lumbar radiculopathy, can cause sensations that travel down the leg and are perceived above the knee. In these cases, the area above the knee might not show local tenderness or swelling, indicating the pain’s distant origin.
Less Common or Complex Causes
While less frequent, several other conditions can cause pain above the knee. Some of these may be more complex or indicate systemic issues.
Infections, such as cellulitis or septic bursitis, can manifest as pain, redness, swelling, and warmth above the knee. Cellulitis is a bacterial skin infection, while septic bursitis involves an infected bursa. These conditions present with systemic symptoms like fever.
Systemic inflammatory conditions, including certain types of arthritis like gout or pseudogout, can also cause acute and severe pain above the knee. Gout and pseudogout are characterized by the deposition of crystals in the joint, leading to sudden onset of intense pain, swelling, and redness. Though affecting the joint itself, the inflammation can extend to the surrounding area.
Rarely, bone tumors or soft tissue tumors can be the underlying cause of persistent pain above the knee. These can be benign (non-cancerous) or malignant (cancerous). While extremely uncommon, a tumor might present as pain that gradually worsens, especially at night, and may not respond to pain relief measures. For any persistent or unexplained pain, consulting a healthcare professional is important to rule out serious conditions.