In Singapore, symptomatic knee pain is common and increases with age, especially from age 40 and above. It may also be more common in Indians, followed by Malays and Chinese¹.

This is a knee joint with possible structures that can cause pain around the knee. 

As knee pain is a symptom and not a medical diagnosis, these are other symptoms that you may feel with your knee pain:

• Joint pain or aches around the knee
• Short period of stiffness in the morning
• Mild swelling around the knee
• Painful clicking of the knee joint
• Pain with activities (e.g. squatting, climbing stairs) which relieves with rest
• Reduce knee joint movement 

• Overweight
• Poor sleep, low mood, anxiety
• Overloading with activities 
• Older age (>40 years old)
• Previous knee injury (e.g. ligament injury, fracture)
• Muscle weakness (e.g. hip, knee)

Consult a doctor early if you are experiencing any of the following:

• Hot and swollen knee with or without fever
• Severe fall, trauma or impact to your knee that limits movement to
• Stiff joint in the morning lasting more than 30 minutes
• Rapid worsening of knee pain

• Refer to leaflet on “Self-help tips to manage pain”.
• If you are starting to exercise or get fit, begin with low impact activities like walking or swimming first.
• Do self-directed stretches and exercises regularly.

“Do I need an X-ray to diagnose my knee pain?”

• An X-ray is not necessary to diagnose knee pain. Your doctor may order an X-ray if other causes are to be ruled out or surgery is considered.

 “Does exercising make my knee pain worse?”

• For people with knee pain, there is strong evidence to suggest that certain exercises can help to relieve pain and improve physical function. 
• If one is not used to doing exercises, there may be a slight increase in knee pain, stiffness or swelling initially. But this will improve over time if the exercises are consistently done.
• Appropriate exercises done should not make the pain worse.

“Is it true that once I have knee pain, it will lead to knee osteoarthritis or worsening knee pain?”

• Having knee pain does not necessarily lead to knee osteoarthritis.
• Similarly, having knee osteoarthritis, does not mean your knee condition will deteriorate.

“Is it true that glucosamine can help with my pain and improve my cartilage?”

• Glucosamine and chondroitin are popular supplements used to manage osteoarthritis.
• Although glucosamine and chondroitin for osteoarthritis pain has not been shown to be helpful for all patients, they have also not been shown to be harmful. 

Disclaimer

In most cases, your pain should improve in 6 weeks. See a doctor if your pain worsens or if you have any of the symptoms stated in the “When should you consult a doctor” section above.

Support networks / Useful links:

• https://www.nhs.uk/conditions/knee-pain/
• https://www.healthhub.sg/live-healthy/1060/finding-ease-for-old-knees
• https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849
• https://www.uhcw.nhs.uk/self-care/knee/

Acknowledgements

One-Rehab Musculoskeletal Workgroup (Jan 2023 - Dec 2023)

Musculoskeletal Physiotherapists from Public Healthcare Institutions 

• SGH resources on 'Anterior Knee Pain'; 'Knee Osteoarthritis'
• SHP resources on 'Knee Osteoarthritis'
• TTSH resources on 'Osteoarthritis'; 'Patellofemoral Pain Syndrome (Runner’s Knee)'; 'Exercise pamphlets (Hip and Knee Flexibility, Hip and Knee strengthening, Hip and Knee function'

References

1. Leung, Y. Y., Ma, S., Noviani, M., Wong, S. B. S., Lee, C. M., Soh, I. A. L., & Thumboo, J. (2018). Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore. International Journal of Rheumatic Diseases, 21(3), 629-638.