Because the knee one of the most actively used joints in the human body, pain in this joint isn’t an uncommon complaint. Although knee pain can take many forms, burning pain in the knee can be an indicator of a variety of problems.
You can have a burning sensation that seems to encompass the full knee, but often it’s felt in a specific area — most commonly behind the knee and in front of the knee (kneecap). For some, the burning sensation is focused along the sides of the knee.
There are several causes for burning in the knee. Where you feel the burning sensation has a lot to do with what’s causing the problem.
Burning behind the knee is often caused by:
Burning in the front of the knee is often caused by an overuse injury known as runner’s knee – also referred to as chondromalacia or patellofemoral pain syndrome (PFS). As well, it could be tendonitis caused by the inflammation of the patellar tendon.
Burning on the outside of the knee is often caused by iliotibial band syndrome (ITBS).
Some people experience increased knee pain at night. This could be caused by a number of reasons:
- Blood vessels increase in diameter during sleep, putting pressure on nerves.
- Thinking about your physical pain without the distractions of the day results in an increase that’s psychologically driven.
- Hormone signals are reduced while you sleep, allowing more pain signals to get through to the brain.
Treatment for a burning knee depends on the cause.
Knee ligament tear
If a knee ligament tear is diagnosed as partial, treatment might include:
- muscle-strengthening exercises
- protective knee brace, to be used when exercising
- limits to activity that might cause further damage
A complete knee ligament tear might have to be surgically repaired.
Knee cartilage tear (damage to the joint surface)
The first stage of cartilage tear treatment is nonsurgical and could include:
- muscle-strengthening exercises like monitored physical therapy or a program of home exercise
- pain relief, typically nonsteroidal anti-inflammatory drugs (NSAIDs)
- steroid injections in the knee
For those whose situation doesn’t improve with more conservative treatment, the next stage is surgery. There are a number of surgical options including:
- Knee chondroplasty. The damaged cartilage is smoothed to reduce joint friction.
- Knee debridement. Loose pieces of cartilage are removed, and the joint is flushed with a saline solution (lavage).
- Osteochondral autograft transplantation (OATS). Undamaged cartilage is taken from a non-weight-bearing area and moved to the damaged area.
- Autologous chondrocyte implantation. A piece of cartilage is removed, cultivated in a lab, and put back into the knee, where it grows into healthy replacement cartilage.
Osteoarthritis in the knee
Osteoarthritis can’t be reversed, so the best that can be done is symptom management, which can include:
- pain management with over-the-counter (OTC) medication such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve)
- physical and occupational therapy
- cortisone injections
Eventually, joint replacement surgery (arthroplasty) might be necessary.
Also known as runner’s knee, chondromalacia is the deterioration of the cartilage under the patella (kneecap). The initial treatment for chondromalacia includes:
- ice to reduce swelling following exercise
- pain relief with OTC medication
- rest for the knee joint, which includes avoiding squatting and kneeling
- alignment of the patella with a brace, tape, or a patellar-tracking sleeve
If the initial nonsurgical treatments fail, your doctor could suggest arthroscopic surgery to smooth unstable cartilage flaps and the trochlear groove (a groove on top of the femur).
Patellofemoral pain syndrome (PFS)
For mild cases, PFS is treated with:
- rest for the knee, which includes avoiding climbing stairs and kneeling
- OTC pain medications
- rehabilitation exercises, including those for quadriceps, hamstrings, and hip abductors
- supportive braces
For more severe cases, your doctor might recommend arthroscopy, a surgical procedure to remove fragments of damaged cartilage.
Patellar tendinitis is a common overuse injury to the tendon that connects your kneecap (patella) to your shinbone. It’s usually treated with:
- rest, especially avoiding running and jumping
- ice to reduce swelling
- pain management via OTC pain relievers
- exercise focused on the leg and thigh muscles
- stretching to lengthen the knee muscle-tendon unit
- patellar tendon strap to distribute force from the tendon to the strap
If conservative, noninvasive treatments aren’t effective, your doctor might recommend:
- platelet-rich plasma injection
- oscillating needle procedure
ITBS is a repetitive knee strain injury experienced primarily by runners. Although at this time there is no definitive treatment for it, runners are usually advised to adhere to the following four-step program:
- Stop running.
- Cross-train with no-impact exercise like cycling and pool running.
- Massage the quads, glutes, hamstrings, and iliotibial band.
- Strengthen your core, the glutes, and the hip area.
Burning knee pain can indicate a problem with the joint or the soft tissues around the knee such as ligaments and tendons. If a burning pain in your knee seems to be associated with a specific area of the knee — front, back, or sides — you may be able to narrow down the potential causes of the pain.
If the pain persists or interferes with your daily activities or sleep, you should consult with your doctor.