In most but not all cases, the symptoms of knee osteoarthritis come and go, becoming worse and more frequent over months or years. It is easy to dismiss early knee arthritis symptoms, but symptoms may worsen if left untreated.

Knee Pain

The most commonly reported symptom of knee osteoarthritis is knee pain. The description of the pain will depend on the person’s condition and situation. For example, the pain may come and go or there may be a chronic low level of pain with intermittent flare-ups of more intense pain. The pain may be experienced as dull and aching or as sharp and intense.

See Knee Pain and Arthritis

Knee arthritis pain usually gets worse with certain activities that place additional strain on the joint, such as when squatting or walking up stairs. Typically, the knee pain can be lessened with rest and an ice compress.

See When and Why to Apply Cold to an Arthritic Joint

Exactly how knee osteoarthritis causes pain is unknown and seems to vary from person to person. 1 Pan F, Jones G. Clinical Perspective on Pain and Pain Phenotypes in Osteoarthritis. Curr Rheumatol Rep. 2018 Oct 31;20(12):79. doi: 10.1007/s11926-018-0796-3. Review. PubMed PMID: 30382417.

Other Symptoms of Knee Osteoarthritis

In addition to knee pain, people with knee arthritis often report one or more of the following symptoms:

Swelling
When knee cartilage wears away, the femur and tibia (and sometimes patella) bones can rub together, resulting in irritation. Sometimes this irritation leads to the production of excess joint fluid, resulting in knee swelling.

See What Causes a Swollen Knee (Water on the Knee)?

Stiffness
Bone-on-bone friction and knee joint swelling makes the knee feel stiff. Some people may only experience knee stiffness for about 30 minutes in the morning or after sitting for a long period. Stiffness may or may not be accompanied by visible swelling or a reduced range of motion.

See How to Care for a Swollen Knee

Redness and warmth
The skin over the knee may become red and warm. These signs could also indicate an infection, which requires immediate medical attention. People who are uncertain of the underlying cause of knee redness and warmth, particularly when accompanied by swelling, are advised to seek immediate medical attention.

See How Infection Can Lead to Severe Knee Pain

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Reduced range of motion
The knee’s range of motion may become limited, making it less flexible. For example, moderate to advanced knee osteoarthritis may make it difficult to completely bend or straighten the knee.

Worsening symptoms with inactivity
Knees can become stiff after sleeping or sitting for a long period of time. People with knee osteoarthritis often find stiffness and pain are most noticeable when they try to get out of bed in the morning or out of a chair after a long period of sitting.

Popping or crunching
Feeling or hearing crunching or popping when bending the knee, such as when bending down into a squat, are signs of knee joint friction. The medical term for this symptom is crepitus. (Crepitus by itself without other symptoms is not a cause for concern.)

See Crepitus in the Knee

Buckling or locking up
Moderate to advanced knee osteoarthritis can cause the sensation of a knee giving way or buckling. This sensation can occur if uneven grooves or flaps in the degenerated cartilage catch or if a piece of cartilage breaks off and becomes lodged in the joint. Knee locking or buckling is also typical in people who have a ligament injury or meniscus tear.

Watch: Knee Meniscus Tear Video

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The symptoms and signs of knee osteoarthritis most often come on gradually. Sudden knee pain is more likely to be caused by trauma or another condition, such as pseudogout. Knee osteoarthritis may be dormant (i.e. a person may be unaware they have it) and only become symptomatic following a traumatic event or excessive physical activity.

Early recognition of knee osteoarthritis symptoms and signs, and appropriate treatment, can dramatically slow or eliminate the progression of osteoarthritis symptoms.

  • 1 Pan F, Jones G. Clinical Perspective on Pain and Pain Phenotypes in Osteoarthritis. Curr Rheumatol Rep. 2018 Oct 31;20(12):79. doi: 10.1007/s11926-018-0796-3. Review. PubMed PMID: 30382417.

Dr. Garrett Hyman is a physiatrist and founder of the sports medicine practice Lake Washington Sports & Spine. He has more than 15 years of experience treating sports, spine, and joint injuries. Dr. Hyman is an educator and leader in the field of sports medicine.

 
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