Kneecap pain: symptoms, causes and which doctor to see

For kneecap pain you can first see: Orthopedics & Traumatology or Physical Medicine & Rehabilitation. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: dull pain around or behind the kneecap; pain that increases when going downstairs, squatting and kneeling; pain after sitting with bent knees in a cinema or car; a crackling sound from the kneecap; a feeling of the knee giving way. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: weak or unbalanced thigh and hip muscles; repetitive loads such as running, jumping and squatting; alignment problems of the kneecap; flat feet and excess weight. Only a doctor’s examination can determine the exact cause.

Most patients improve markedly with a regular 6–12-week exercise programme. Taping and suitable shoes can help. Surgery is very rarely needed.

It is more common in: teenagers and young adults; women (more common); runners and people who do jumping sports.

The diagnosis is mainly made on examination. An X-ray, and MRI if needed, may be requested to rule out other causes and assess kneecap alignment.

Keeping the front thigh (quadriceps) and hip muscles strong, increasing training gradually and maintaining a healthy weight prevent kneecap pain.

You can see orthopaedics or physical medicine and rehabilitation.

Painless crackling is very common and usually harmless. If pain, swelling or locking come with it, it needs to be assessed.

No. Chondromalacia is softening of the cartilage behind the kneecap and is mostly seen in young people; osteoarthritis is wear of the joint cartilage with age.

If the answer to any of these questions is yes, call 112 without delay: “Is there sudden swelling and redness of the knee with fever?” “After a fall, are you completely unable to use your knee?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: if knee pain has not gone in 4–6 weeks; if there is swelling, locking or giving way of the knee; if it limits sport and daily activities.