Last updated: October 2026
Most knee pain comes from a strain, an overuse problem around the kneecap or, after about 45, osteoarthritis, and it usually starts to settle within 6 weeks. The NHS advice is to ease off without stopping moving, use a wrapped ice pack, try pharmacy painkillers and build up gentle strengthening exercises. Get urgent help if you can’t bear weight.
Below: a “where it hurts” table of causes, what to do in the first 48 hours, knee pain when bending and on stairs, a simple exercise routine, what NICE recommends for osteoarthritis, knee pain at night, braces and supplements, and exactly who to call.
Need help now? Call NHS 111 or go to an urgent treatment centre if your knee is very painful, you can’t move it or put any weight on it, it is badly swollen or has changed shape, it swelled straight after a twisting injury, or it is hot and red and you feel hot, cold or shivery. Call 999 if leg pain and swelling come with breathlessness or chest pain. See all the red flags.
What’s causing my knee pain? Where it hurts
Knee pain is very common. A UK review found that in any one year, about 1 in 4 people over 55 has a lasting episode of knee pain, but only about 1 in 6 of them sees a GP about it. Where it hurts, and how it started, are the best clues to the cause. The NHS advises against diagnosing yourself, so treat this table as a guide to what to do next.
| Where or when it hurts | Common cause | What to do |
|---|---|---|
| Front of the knee, around or behind the kneecap; worse on stairs, squatting or sitting with bent knees | Patellofemoral pain (sometimes called runner’s knee) | Ease the load, start the exercises, physio if not better in 6 weeks |
| Between the kneecap and shin, after lots of running or jumping | Tendon irritation (tendonitis) | Cut back jumping and running, then build up gradually |
| Pain and swelling below the kneecap in a teenager or young adult | Osgood Schlatter’s disease | See a GP if you’re worried |
| Outer side of the knee, in runners or cyclists, often worse downhill | Iliotibial band (ITB) syndrome | Reduce mileage, strengthen the hips, see a physio |
| Inner side of the knee | Osteoarthritis, or a sprained inner ligament after a twist or knock | Self-care below; 111 if it swelled straight away |
| Behind the knee, with a soft lump that’s worse after walking | Baker’s cyst | See a GP about any lump; urgent help if your calf swells or reddens |
| Swelled straight after a twist, a pop at the time, gives way or won’t straighten | Torn ligament, tendon or meniscus (cartilage) | Call 111 |
| Overstretched, overused or twisted, without those warning signs | Sprain or strain | PRICE for 2 to 3 days (below) |
| Warm, swollen and worse when kneeling or bending | Bursitis | Rest, ice, padding; GP if not better in 1 to 2 weeks |
| Hot, red knee with sudden, very bad pain | Gout or septic arthritis (a joint infection) | Urgent: 111 or an urgent GP appointment |
| Swelling, warmth or bruising with no injury, especially if you take blood thinners | Bleeding into the joint | Get help promptly: GP or 111 |
| Gradual ache and stiffness in one or both knees, aged 45 or over, worse with use | Osteoarthritis | Exercise and weight first: see NICE advice |
If more than one joint aches, see our wider guide to joint pain.
How long does knee pain last?
It depends on the cause, but most knee pain gets better on its own. NHS inform (Scotland) says new knee pain, or a flare-up of a long-standing problem, should begin to settle within 6 weeks.
- Sprains and strains: most feel better after 2 weeks. The NHS says to avoid strenuous exercise such as running for up to 8 weeks, and severe ones can take months.
- Bursitis: usually goes away in a few weeks.
- Gout: an untreated attack usually lasts 1 to 2 weeks.
- Baker’s cyst: can take a few months to a few years to settle.
- Osteoarthritis: a long-term condition, but the NHS says it doesn’t necessarily get worse over time and can sometimes gradually improve.
If your knee hasn’t started to improve within a few weeks, see a GP or physio.
What to do in the first 48 hours
After an injury (a twist, overstretch or knock): for the first 2 to 3 days the NHS recommends PRICE:
- Protection: protect the knee, for example with a support.
- Rest: stop exercise and try not to put weight on it.
- Ice: an ice pack or a bag of frozen peas wrapped in a tea towel, for up to 20 minutes every 2 to 3 hours. Never put ice straight on your skin.
- Compression: a bandage during the day for support.
- Elevation: keep it raised on a pillow as much as you can.
For the first couple of days, the NHS also suggests avoiding heat (hot baths, heat packs), alcohol and massage, which can add to swelling.
For a flare-up or pain with no clear injury, NHS inform’s advice is a little different:
- Reduce activity, but keep moving as much as your symptoms allow.
- Move your knee gently for 10 to 20 seconds every hour while you’re awake, and avoid long spells on your feet.
- On stairs, lead with your good leg going up and your sore leg going down, using the handrail.
- Ice or heat can both ease pain: up to 20 minutes, with a towel between it and your skin, and a few hours between goes. Skip it if you have poor circulation or reduced feeling. A hot water bottle filled with hot or cold water works too.
- After 48 hours, use your leg more. NHS inform says exercise really helps the knee, and staying at or returning to work is the best way to get better.
Painkillers: the NHS suggests paracetamol or ibuprofen, as a gel or tablets. Ibuprofen isn’t suitable for everyone, so ask a pharmacist which suits you, especially if you take other medicines. If you find you need painkillers regularly for a long time, speak to a pharmacist or GP.
Knee pain when bending, kneeling or on stairs
The likely cause depends on where you feel it.
- At the front, around the kneecap: usually patellofemoral pain. A Cochrane review describes it as pain behind or around the kneecap that mostly comes on when climbing stairs, squatting, running, cycling or sitting with your knees bent. It is common: a 2018 review estimated that about 23% of the general population has it in a given year, and 29% of teenagers.
- At the front, worse kneeling: bursitis, a swollen fluid-filled cushion over the joint. The NHS suggests padding when you kneel and regular breaks.
- Deep in the joint, with stiffness, aged 45 or over: often osteoarthritis. The NHS lists a grating or crackling feeling as a common symptom. Painless clicking on its own is normal.
- Behind the knee: a Baker’s cyst can make the knee tight and hard to bend fully.
- With catching, locking or giving way after a twist: a possible meniscus or ligament tear. See a GP, or call 111 if it’s very painful or swelled straight away.
Stairs tips: use the handrail, take one step at a time (“up with the good, down with the sore”) and build strength gradually with step-ups on the bottom stair, below. For long spells sitting, stretch your legs out or stand up regularly so your knees aren’t bent for hours.
Knee exercises: a simple routine
Strengthening the thigh and hip muscles is the backbone of almost every NHS knee leaflet. These six exercises come from NHS inform and Arthritis UK. Check with a GP or physio first if you’ve just been injured, had surgery, or have any of the red flags.
- Quad squeeze. Sit or lie with your leg straight. Tighten your thigh and press the back of your knee down into the bed or floor. Hold for 10 seconds, then relax.
- Straight-leg raise (sitting). Sit back in a chair. Straighten and raise one leg, hold for a slow count of 10, then lower slowly. Repeat 10 times each leg.
- Heel slides. Sit with your legs out straight. Slide one foot towards you to bend the knee until you feel a stretch, hold for 5 seconds, then straighten and hold for 5 seconds. Repeat 10 times each leg.
- Side-lying leg raise. Lie on your side with a pillow between your knees. Keeping your top leg in line with your body, lift it towards the ceiling, hold for a few seconds and lower. This works the hip muscles that help control the knee.
- Sit to stand. Without using your hands, stand up from a chair and sit back down slowly. Repeat until you can’t do any more, rest for a minute, then do two more rounds. Put a cushion on the seat if it’s too low.
- Step-ups. Step up onto the bottom stair with one foot, bring the other up, then step down. Hold the bannister. As it gets easier, use a higher step.
How much and how hard? NHS inform suggests starting with 2 or 3 repetitions at a time through the day, adding 1 or 2 every few days, up to 2 sets of 15. Rate your pain from 0 (none) to 10 (worst ever) and aim to stay between 0 and 5. Some muscle soreness is normal, but you shouldn’t feel worse the next morning. If you do, do fewer, slow down or rest longer.
Does it work? The 2024 Cochrane review of 139 trials (12,468 people with knee osteoarthritis) found exercise probably improves pain, function and quality of life in the short term, although the average benefit was modest. For kneecap pain, a Cochrane review found low-quality but consistent evidence that exercise can reduce pain and improve function, and that hip plus knee exercises may work better than knee exercises alone. In runners with ITB syndrome, hip strengthening is the most common approach in studies.
Alongside the routine, keep up general activity. The NHS recommends at least 150 minutes of moderate activity a week, such as cycling or fast walking, plus strength exercises on 2 or more days. Swimming and cycling are kind to sore knees, and Japanese walking is an easy interval plan. For rest days and food, see muscle recovery.
Knee osteoarthritis: what NICE recommends
Osteoarthritis is the most common type of arthritis in the UK, and the knees are among the joints it affects most. NICE guideline NG226 says a GP can diagnose it without an X-ray if you are 45 or over, your joint pain is linked to activity, and you have no morning stiffness or stiffness that lasts no longer than 30 minutes. Longer morning stiffness can point to rheumatoid arthritis instead.
NICE calls exercise and weight management (if needed) the “core treatments”. Here’s how other options compare.
| Option | What NICE NG226 says |
|---|---|
| Therapeutic exercise (strength and general fitness) | Offer to everyone. Pain may increase at first, but regular, consistent exercise helps |
| Weight loss, if overweight | Any amount helps; losing 10% of body weight is likely to be better than 5% |
| Anti-inflammatory gel (topical NSAID) | Offer for knee osteoarthritis |
| Anti-inflammatory tablets | Consider if gels don’t work, with a stomach-protecting medicine |
| Paracetamol | Don’t offer routinely: no strong evidence of benefit |
| Walking stick | Consider |
| Manual therapy (such as mobilisation) | Only alongside exercise, not on its own |
| Steroid injection | Consider; relief only lasts 2 to 10 weeks |
| Insoles, braces, tape, supports | Not routinely, unless the knee is unstable and exercise alone isn’t enough |
| Glucosamine | Don’t offer: no strong evidence of benefit |
| Acupuncture, TENS, ultrasound, laser | Don’t offer |
| Hyaluronan injections, keyhole “washout” surgery | Don’t offer |
| Knee replacement | Consider referral if symptoms badly affect quality of life and other treatments haven’t worked |
Why weight matters so much for knees: in a US study of 142 overweight older adults with knee osteoarthritis, every 1kg of weight lost was linked to about 4kg less load through the knee with each step. Over thousands of steps a day, that adds up. Our guide to sleep and weight loss explains one often-missed piece of the puzzle.
Knee pain at night
Knee pain often feels worse at night, when there’s nothing to distract you and you’ve been still for a while. Common reasons include an osteoarthritis flare (NICE notes that flares can affect sleep), bursitis, gout and a Baker’s cyst. Things that may help:
- Find a supported position. On your side, a pillow between your knees stops them pressing together. On your back, a small pillow under your knees takes the stretch off the joint. For bursitis, the NHS suggests extra cushions around the joint. Our guide to the best sleeping position covers more.
- Keep the bedclothes off. With gout, the NHS suggests keeping bedclothes off the joint at night.
- Move a little before bed. A few gentle heel slides or a short walk can ease stiffness, and a warm bath can feel soothing (avoid heat in the first couple of days after an injury).
- Plan your painkillers. Ask a pharmacist how to time them so they cover the night.
- Protect your sleep. A steady wind-down routine helps; see how to stay asleep. If cramp rather than the joint wakes you, read leg cramps at night.
Pain that wakes you every night, doesn’t ease with rest, or comes with a fever, weight loss or a hot, swollen knee needs a GP check.
Knee braces, supports and insoles: do they help?
The evidence is weaker than the shop shelves suggest.
- Braces: a 2015 Cochrane review of 13 studies (1,356 people with knee osteoarthritis) found the evidence on braces inconclusive.
- Wedged insoles: the same review found moderate-quality evidence that lateral wedge insoles worked no better than flat insoles. A 2013 analysis of 12 trials (885 people) reached the same conclusion when the best-matched comparison was used.
- NICE says not to offer insoles, braces, tape or supports routinely, unless the knee is unstable and exercise alone isn’t enough.
What is worth doing: the NHS suggests footwear with shock-absorbing soles, and, if your knee affects how you walk, a walking stick held on the opposite side to the sore knee. A simple sleeve may help you feel more confident while you build strength, but it is no substitute for the exercises. If your knee gives way, ask a physio whether a brace makes sense for you.
Glucosamine, turmeric, CBD and creams
- Glucosamine: NICE tells doctors not to offer it for osteoarthritis because there is no strong evidence of benefit, and the NHS no longer prescribes it. See our full glucosamine guide.
- Collagen: the evidence is mixed and the products vary a lot; see collagen supplements.
- Turmeric (curcumin) and ginger: some small trials have been done in knee osteoarthritis, with caveats. See turmeric benefits for what they found and who should avoid it.
- CBD: two placebo-controlled trials in knee osteoarthritis, using 600mg and 45mg of CBD a day, found it worked no better than a placebo. CBD isn’t a treatment for knee pain or arthritis. More in CBD for arthritis and CBD for pain.
- Creams and rubs: anti-inflammatory gels are the cream with real evidence for knees. The NHS says warming rubs (rubefacients) have little effect on osteoarthritis symptoms. A massage balm can be a pleasant part of a routine, but it isn’t a treatment.
Red flags: when to call 999 or 111
Call 999 or go to A&E if you have pain and swelling in your leg and:
- you feel breathless
- you have chest pain
These can be signs of a blood clot that has travelled to your lungs. Don’t drive yourself: ask someone to take you or call 999.
Call NHS 111, use 111 online or go to an urgent treatment centre if:
- your knee is very painful
- you can’t move your knee or put any weight on it
- it is badly swollen or has changed shape, or it swelled straight after a twisting injury
- it locks, gives way or clicks painfully (painless clicking is normal)
- you’ve had a significant injury in the last 7 days, such as a fall from height or a direct blow
- you have a high temperature or feel hot, cold or shivery, with redness or heat around the knee, which could be an infection
Ask for an urgent GP appointment or call 111 if pain or swelling in your calf suddenly gets worse, or the skin is warm, red or darkened. That can mean a burst Baker’s cyst or a blood clot (DVT).
When to see a GP or physio
See a GP if:
- your knee pain hasn’t improved within a few weeks, or is getting worse
- your knee is hot, swollen or tender and you can’t remember injuring it
- you have a lump behind your knee and don’t know what it is
- you think you have gout for the first time
- bursitis hasn’t improved after 1 to 2 weeks of self-care
Physiotherapy without a GP: in many areas you can refer yourself to NHS community musculoskeletal (MSK) services, which include physiotherapy. Check your local NHS website, or ask your GP surgery for a first contact physiotherapist.
What a GP may offer: prescribed medicine, physiotherapy, or a referral for a scan or to a specialist. For osteoarthritis, scans usually aren’t needed.
Where our products fit (honestly)
No supplement or balm is a treatment for knee pain, and nothing replaces strengthening exercise and proper medical advice. Here’s how our products can sit alongside a healthy routine.
Our CBD Balm, Muscle and Joint Support is a massage balm made with broad spectrum CBD, peppermint, eucalyptus and juniper. It feels cooling and non-greasy, and some people like to massage it in before or after their exercises. Read more in our CBD balm guide.
Our Magnesium Glycinate Sleep Complex is a caffeine-free evening drink with magnesium bisglycinate and citrate, glycine and L-theanine. Magnesium contributes to normal muscle function. For more, see magnesium for muscle pain.
If you also take CBD by mouth, keep the FSA’s advice in mind. The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
Our products are for adults (18+) only. We don’t recommend our products during pregnancy or breastfeeding. If you take prescribed medicines, check with your pharmacist before adding a supplement.
Related guides
- Heel hurting too, especially first thing in the morning? See our guide to plantar fasciitis, with stretches and an honest look at insoles.
- Shoulder playing up too? See shoulder pain: causes, exercises and when to worry.
- If the ache is higher up, around the hip or groin, see our guide to hip pain, including outer hip pain and how to sleep with it.
FAQs
Why does my knee hurt when I bend it?
Pain at the front of the knee when bending, squatting or on stairs is most often patellofemoral (kneecap) pain. Other causes include bursitis, osteoarthritis, a Baker’s cyst or a torn meniscus.
How long does knee pain take to go away?
Most new knee pain begins to settle within 6 weeks, and most sprains feel better after 2 weeks. See a GP or physio if it isn’t improving within a few weeks.
Should I rest or exercise with knee pain?
Rest for the first 2 to 3 days after an injury, then start moving. For other knee pain, keep gently active and build up strengthening exercises, keeping pain at 5 out of 10 or less.
Should I use ice or heat on a painful knee?
Use a wrapped ice pack for up to 20 minutes after an injury and avoid heat for the first couple of days. For stiffness or osteoarthritis, either ice or heat can help.
Why is my knee pain worse at night?
Stillness, stiffness and fewer distractions make pain more noticeable, and osteoarthritis flares, bursitis and gout can all affect sleep. A pillow between or under your knees can help.
Do knee supports help knee pain?
The evidence is weak. NICE doesn’t recommend braces, insoles or supports routinely unless the knee is unstable. Strengthening exercise does more.
When should I worry about knee pain?
Call 111 if you can’t put weight on it, it is badly swollen or misshapen, it locks or gives way, or it is hot and red with a fever. Call 999 if leg swelling comes with chest pain or breathlessness.
Sources
- NHS. Knee pain.
- NHS inform. Knee problems and Exercises to help with patellofemoral knee pain.
- Arthritis UK. Exercises for the knees.
- NICE. Osteoarthritis in over 16s: diagnosis and management (NG226). 2022.
- NHS. Osteoarthritis and Osteoarthritis: treatment.
- NHS. Sprains and strains.
- NHS. Baker’s cyst.
- NHS. Bursitis.
- NHS. Gout.
- NHS. Septic arthritis.
- NHS. DVT (deep vein thrombosis).
- NHS. Physiotherapy.
- Peat G, et al. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis, 2001. PMID 11156538.
- Smith BE, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS One, 2018. PMID 29324820.
- van der Heijden RA, et al. Exercise for treating patellofemoral pain syndrome. Cochrane, 2015. PMID 25603546.
- Lawford BJ, et al. Exercise for osteoarthritis of the knee. Cochrane, 2024. PMID 39625083.
- Sanchez-Alvarado A, et al. Effects of conservative treatment strategies for iliotibial band syndrome on pain and function in runners: a systematic review. Front Sports Act Living, 2024. PMID 39247485.
- Messier SP, et al. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum, 2005. PMID 15986358.
- Duivenvoorden T, et al. Braces and orthoses for treating osteoarthritis of the knee. Cochrane, 2015. PMID 25773267.
- Parkes MJ, et al. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis: a meta-analysis. JAMA, 2013. PMID 23989797.
- Pramhas S, et al. Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee. Lancet Reg Health Eur, 2023. PMID 38033459.
- Mojoli A, et al. Effects and safety of a CBD-rich Cannabis sativa oil in knee osteoarthritis (CANOA). Front Pharmacol, 2025. PMID 41487518.
This guide is general information, not medical advice. If you’re worried about knee pain, speak to a GP, pharmacist or physiotherapist. Evopure makes the CBD Balm, Muscle and Joint Support and the Magnesium Glycinate Sleep Complex.
