Pain Behind the Knee at Back of Leg

Pain behind the knee at back of leg can be due to many conditions like PCL injuries, Baker’s cysts and osteoarthritis.

In fact, studies show that about 25% of adults experience knee pain at some point in their lives.

That’s why, we’ll go through the causes, diagnosis and treatment for each so you can get relief.

What is Posterior Knee Pain?

A posterior cruciate ligament (PCL) injury can cause a lot of pain behind the knee. This usually happens when the ligament is overstretched or torn due to a forceful impact like hitting your knee in a car accident.

If left untreated a PCL injury can be very painful and unstable. Imaging tests like X-rays and MRIs are usually required to assess the extent of the injury as delaying treatment can lead to long term problems.

Common Causes of Pain Behind the Knee

Pain behind the knee can be caused by many things, each with its own problems. PCL injuries, Baker’s cysts and osteoarthritis are the most common and you need to know what they are to get the right treatment.

A diagram showing common causes of knee pain, specifically focusing on pain behind the knee.

Baker’s Cyst

A Baker’s cyst, also known as a popliteal cyst, is a fluid filled swelling behind the knee. These cysts are usually caused by fluid leaking into the joint space after an injury.

Baker’s cysts can be small or large and can cause tightness or discomfort. If you suspect you have a Baker’s cyst, best to see a doctor for an evaluation which may include an ultrasound.

Osteoarthritis

Osteoarthritis is another common cause of pain behind the knee especially in people over 50. This degenerative disease causes the cartilage in the knee joint to wear away and can cause severe pain, stiffness and difficulty in daily activities.

On a similar note, research indicates that osteoarthritis affects nearly 27 million Americans.

Treatment ranges from over the counter medications to physical therapy and in severe cases total knee replacement.

Vascular Issues

Vascular problems can also cause pain behind the knee. For example a popliteal artery aneurysm which is a dilation of the popliteal artery can cause swelling and pain. This needs immediate medical attention to prevent complications.

Deep vein thrombosis (DVT) which is a blood clot in the deep veins of the leg can also cause swelling and tenderness behind the knee.

Other

Other causes of pain behind the knee are various forms of arthritis like rheumatoid arthritis which can cause a lot of discomfort and stiffness. Infections in the knee joint or surrounding tissues can also cause pain, swelling and redness and needs immediate medical attention.

Pain Behind the Knee Diagnosis

Diagnosing pain behind the knee is a multi step process. This involves taking your medical history, physical examination and possibly ordering imaging tests to determine the cause of the pain and the treatment.

Medical History

Taking your medical history is the first step in diagnosing knee pain. Past injuries, activities and overall health can give you valuable information about the cause of your pain. For example PCL injuries often occur in sports or accidents involving sudden stops or changes of direction.

Physical Examination

Next a physical examination is done to assess your range of motion and check for swelling and tenderness around the knee.

Specific tests like patellar tap test for fluid accumulation and Lachman test for anterior cruciate ligament issues can help identify the problem.

Imaging Tests

Imaging tests will give you a clearer picture of the knee. X-rays are usually the first to rule out fractures or bone related issues, while MRIs are used to diagnose soft tissue injuries including ligament and meniscus injuries.

In some cases CT scan may be used to get a more detailed view of both bone and soft tissue injuries.

Also, you can check knee pain in our knee pain diagnosis chart.

Home Remedies for Knee Pain

You can manage knee pain at home with simple remedies. Applying cold compress for 15-20 minutes can reduce swelling, while warm compress can relax the muscles around the knee and ease the discomfort.

Apple cider vinegar and warm water mixture can also promote circulation and joint health.

POLICE Method

The POLICE method Protect, Optimal Loading, Ice, Compression, Elevation is good for knee injuries. Protect the knee from further injury and gradually load it to promote healing without aggravating the condition.

Ice should be applied for 15-20 minutes to reduce swelling and crutches may be needed if weight-bearing is difficult.

HARM

Avoid Heat, Alcohol, Running and Massage (HARM) is important for knee injury management as these can worsen the pain and hinder recovery.

Medical Treatment for Severe Knee Pain

Severe knee pain needs professional attention. Treatment may include physical therapy, medications and possibly surgical procedures depending on the severity of the condition.

Physical Therapy

Physical therapy can help knee pain. Strengthening exercises for quadriceps, hamstrings and calf muscles can stabilize the knee.

Wall squats and lunges can strengthen the muscles around the knee joint and overall function. Low impact exercises like swimming and walking are also good.

Surgical Options

When non surgical treatments fail, surgical options may be necessary. Procedures like total knee replacement or arthroscopy can address structural damage and relieve pain, usually recommended when non surgical treatments are not enough.

How to Prevent Pain Behind the Knee

Preventing pain behind the knee involves several proactive steps. Regular physical activity, maintaining a healthy weight and wearing supportive shoes can reduce the risk of knee injuries.

1. Strengthening Exercises For Knee Pain

Doing exercises regularly can strengthen the muscles around the knee, stabilize the joint and reduce injury risk. Include squats, lunges and leg raises in your daily routine to promote knee health and mobility.

2. Weight Management

Maintaining a healthy weight is key to preventing knee pain. Excess weight adds stress to the knee joints and can cause discomfort and damage.

By the way, did you know that losing 10 pounds can reduce the stress on your knees by 40 pounds? That’s a lot! Right.

3. Proper Footwear

Supportive shoes will prevent knee problems. Shoes with cushioning, arch support and a firm heel counter will align the body and reduce knee joint stress.

Flat feet should wear motion control or stability shoes to prevent overpronation and provide support.

4. Good Posture

Good posture is important especially when lifting heavy objects. Bending at the hips and knees and keeping the load close to your body reduces the strain on the knees and prevents injuries.

5. Warm Up Before Exercise

Warming up before exercise is important to prepare your joints and muscles for activity. A proper warm up increases blood flow and reduces knee injury risk and a safe workout.

6. Low Impact Activities

Choose low impact activities like swimming, cycling or walking instead of high impact activities that stress the knees. These gentle options are good for joint health and minimizes injury risk.

7. Don’t Sit or Stand for Long Hours

Take breaks to move and stretch if you sit or stand for long hours. This will maintain circulation, reduce stiffness and prevent knee pain.

Bottom Line

With all of this in mind, pain behind the knee at the back of the leg can be caused by various factors, such as muscle strain, ligament injury, or issues with the knee joint. Of course, keeping your weight in check, wearing the right shoes, and exercising regularly are all important for having strong and healthy knees.

In fact, a recent survey showed that people who exercise regularly are 40% less likely to suffer from chronic knee pain.

Frequently Asked Questions

What does tendonitis behind the knee feel like?

Tendonitis behind the knee often feels like a sudden aching pain below the kneecap, especially after activities like jumping or going up and down stairs.

What muscle is on the back of your leg behind the knee?

The muscle behind your knee is called the popliteus, and it plays a key role in stabilizing and unlocking your knee joint. It connects the outer thigh bone to the lower leg bone, right at the back of your leg.

What causes pain at the back of the leg behind the knee?

Leg pain behind the knee can be caused by various factors like injury, inflammation, arthritis, or even leg cramps.

How can I tell if I have a PCL injury?

If you’re experiencing severe pain, knee instability, and trouble bearing weight, you might have a PCL injury.

Morris Tucker
Morris Tucker

For over 13 years, Morris Tucker has been a leading orthopedic pain treatment specialist. He diagnoses and treats shoulder, elbow, hip, knee, foot, and ankle pain. Dr. Tucker is a pioneer in non-surgical therapies for chronic pain such spondylosis, back pain, sciatica, arthritis, and fibromyalgia, trained under top US physicians. He has an M.D. and PhD, demonstrating his dedication to pain management research and treatment.