Experiencing pain on the inside of the knee while walking, often called medial knee pain, is a common complaint that can significantly impact daily activities. Various factors, from acute injuries to degenerative conditions, can contribute to this discomfort. Understanding the potential causes and management approaches can help individuals navigate this issue. This article explores conditions that cause inner knee pain when walking, along with diagnostic and treatment considerations.
Common Causes of Inner Knee Pain When Walking
Pain on the inner side of the knee during walking can stem from several distinct issues, each involving specific anatomical structures. Identifying the precise cause is important for effective management.
Medial Meniscus Tears
The medial meniscus is a C-shaped cartilage on the inner knee joint, acting as a shock absorber and stabilizer between the thigh and shin bones. Tears can occur from sudden twisting motions with the foot planted, or gradually through wear and tear. A torn medial meniscus causes pain on the inside of the knee when walking, which may worsen with twisting or squatting. Individuals may also experience clicking, catching, or a sensation of the knee locking, making walking difficult.
Medial Compartment Osteoarthritis
Osteoarthritis is a degenerative joint condition where cartilage cushioning bone ends breaks down. In the knee’s medial compartment, this involves inner cartilage, leading to bone-on-bone friction as the protective layer erodes. This friction causes pain, stiffness, and sometimes swelling, often worsened by weight-bearing activities like walking. Pain may increase at the end of the day or after activity, with morning stiffness lasting less than 30 minutes.
Medial Collateral Ligament (MCL) Injury
The medial collateral ligament (MCL) is a strong tissue band along the inner knee, connecting the thigh and shin bones. Its function is to resist inward knee forces, stabilizing the joint. An MCL injury, a sprain or tear, often results from a direct blow to the outside of the knee or a twisting motion. Inner knee pain is a common symptom, often with tenderness and instability, making walking or bearing weight challenging.
Pes Anserine Bursitis/Tendinitis
Pes anserine bursitis is inflammation of the bursa, a fluid-filled sac located 2-3 inches below the inner knee joint, where three muscle tendons (sartorius, gracilis, semitendinosus) attach. Tendinitis is inflammation of these tendons. Both cause pain and tenderness in this area, especially when walking, climbing stairs, or bending the knee. Pain may worsen with repetitive knee flexion and extension.
Medial Plica Syndrome
Plicae are folds in the synovial membrane, remnants from knee development. While often asymptomatic, the medial plica, on the inner side of the kneecap, can become irritated or inflamed from overuse, repetitive motion, or trauma. An inflamed medial plica causes inner knee pain, often an aching sensation, especially with activity. Individuals might also report clicking, popping, snapping, or a feeling of instability or catching when walking.
Diagnosing Inner Knee Pain
A healthcare professional employs a systematic approach to determine the specific cause of inner knee pain. This process begins with a thorough evaluation of the patient’s history and a physical examination.
The doctor inquires about pain onset, worsening or alleviating activities, and associated symptoms like swelling, clicking, or instability. During examination, the knee is inspected for swelling, redness, or tenderness, and its range of motion assessed. Specific tests, such as palpation and stress tests, help pinpoint affected structures and evaluate ligament stability.
Imaging studies confirm diagnosis or rule out other conditions. X-rays reveal bony abnormalities or osteoarthritis signs like narrowed joint spaces. Magnetic Resonance Imaging (MRI) provides detailed soft tissue images, effective for identifying meniscus tears, ligament injuries, or bursae inflammation. Patient history, physical findings, and imaging combine to help clinicians arrive at an accurate diagnosis.
Treatment and Management Strategies
Managing inner knee pain often involves a combination of conservative approaches, with medical interventions considered for persistent or severe cases. The initial focus is on reducing pain and inflammation while promoting healing.
Conservative management begins with the RICE method: Rest, Ice, Compression, and Elevation. Resting the knee avoids aggravating injury; ice minimizes swelling and pain. Compression with a bandage reduces fluid buildup, and elevating the leg aids drainage. Over-the-counter pain relievers, such as NSAIDs, also help manage discomfort.
Physical therapy strengthens knee-supporting muscles like quadriceps, hamstrings, and glutes, aiding recovery. Exercises improve flexibility, range of motion, and gait mechanics to reduce knee stress during walking. Activity modification, adjusting movements or reducing intensity, is also advised to prevent further irritation.
When conservative measures are insufficient, medical interventions may be considered. Corticosteroid injections reduce inflammation and provide pain relief, especially for bursitis or severe arthritis flares. Hyaluronic acid injections (viscosupplementation) lubricate the joint and cushion cartilage, primarily for osteoarthritis. For conditions like meniscus tears or advanced osteoarthritis unresponsive to other treatments, surgical options may be discussed.
When to Seek Professional Medical Advice
While some inner knee pain may resolve with rest and home care, certain symptoms warrant professional medical evaluation. Prompt assessment can prevent complications and ensure appropriate treatment.
Seek medical attention if pain persists and does not improve with rest or home remedies. Swelling, redness, or warmth around the knee also indicates a need for professional consultation. Inability to bear weight, or if the knee feels unstable, locks, catches, or gives way, are concerning signs. Pain developing suddenly, especially after direct injury or trauma, should also be evaluated promptly.