Inner knee pain, also called medial knee pain, is common in walkers, runners, and sportspeople. It can come on gradually or suddenly, with or without injury. So what causes pain on the inner side of the knee, and how do we reach the right diagnosis?
This is the hub for pain on the inside of the knee. For pain in the back of the knee, see pain behind the knee.
Symptoms of inner knee pain
People usually point to the inner side of the knee, across from the kneecap. Medial knee pain typically occurs during or after running or sports. Depending on the cause, you may also notice swelling, difficulty bending the knee, a feeling of instability or giving way, or the knee locking in one position.
Common causes of inner knee pain
Medial meniscal tear
The menisci are the shock absorbers of the knee. You can tear the medial meniscus during a twisting injury, or it can wear with age. A tear causes pain at the inner joint line, often with swelling and restricted movement — and sometimes locking or giving way.
Osteoarthritis
Osteoarthritis wears away the cartilage lining the joint, producing inflammation and swelling. The medial compartment is often affected, causing generalised inner knee pain with puffiness and sometimes restricted movement and difficulty walking long distances. Treatment includes exercise therapy, weight loss, medication, and injections.
Patellofemoral pain syndrome
Patellofemoral pain arises from the joint between the kneecap and thigh bone, usually from kneecap mal-tracking and overuse. The pain is often at the front of the knee, but commonly sits one or two fingers from the kneecap on the inner side. It usually settles with physiotherapy that modifies lower-leg and pelvic biomechanics.
Pes anserine bursitis
The inner-thigh tendons attach to the top of the shin, where a bursa can swell from overuse — pes anserine bursitis. People feel pain just below the inner joint line, with tenderness and pain on hamstring activation. It often occurs alongside arthritis or a meniscal tear. See our full pes anserine bursitis guide for treatment.
Medial collateral ligament (MCL) sprain
The MCL stabilises the inner knee and is usually injured in a twisting injury, most often at its top attachment to the femur. People feel pain above the inner joint line, with restricted movement and localised swelling. Other structures (ACL, PCL) are sometimes injured too, so see a doctor for a definitive diagnosis. MCL injury can occasionally calcify, causing pain and stiffness — a condition known as Pellegrini-Stieda syndrome.
Osteochondritis dissecans
Osteochondritis dissecans affects the cartilage and bone in teenagers and young adults, disrupting the cartilage’s blood supply and leading to the formation of a loose body. It causes pain, clicking, locking, and giving way. Early diagnosis improves outcomes.
Less common causes of inner knee pain
Medial plica syndrome, fat pad impingement, and referred pain from the hip or spine. Lower hamstring tendonitis (the semimembranosus tendon) can also cause pain at the inner back of the knee.
How do we diagnose inner knee pain?
An accurate diagnosis can be challenging because inner knee pain often has multiple causes. A specialist examines the knee — tender areas, movement, ligament stability, and the areas above and below it, including foot biomechanics, gait, and pelvic control. We then investigate based on that assessment: weight-bearing X-rays show arthritis and alignment, MRI shows cartilage, meniscal, and tendon problems, and we sometimes add ultrasound or CT.
When to see a doctor
Not all medial knee pain is serious, but see a doctor if you’ve had trauma, the pain limits your movement, the knee locks or gives way, or inner knee pain lasts more than a few weeks.
Frequently asked questions about inner knee pain
What’s the most common cause of pain on the inner side of the knee?
In older adults, a degenerative medial meniscal tear or medial-compartment arthritis. In younger, active people, pes anserine bursitis, an MCL sprain, or patellofemoral pain are more likely. The pattern and any injury help point to the cause.
Are there simple treatments for inner knee pain and swelling?
Yes. Ice for 10–15 minutes three to four times daily, plus topical or oral NSAIDs such as ibuprofen, settles pain and swelling. A knee brace adds support and reduces swelling.
Are injections effective for inner knee pain?
It depends on the cause. Cortisone can reduce swelling from a meniscal tear or pes bursitis; hyaluronic acid or PRP can help with knee arthritis. We perform these under ultrasound guidance.
How do I know if my inner knee pain is a meniscus or pes anserine bursitis?
Pes anserine pain sits lower, just below the joint line, and builds gradually from overuse. A meniscal tear sits higher at the joint line and often follows a twist, sometimes with locking or swelling. An experienced doctor — and, if needed, an MRI — can tell them apart.
Final word from Sport Doctor London about inner knee pain
Inner knee pain is complex and often has several underlying causes. See a specialist physician early for an accurate diagnosis and the right management plan.
To book a knee assessment with Dr Masci in London, contact the team here or call +44 (0) 203 488 0350.
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