Burning Pain Behind or Inside the Knee: Causes and Treatment

Editorially reviewed by: A to Zen Therapies Editorial Team in accordance with our Editorial Policy.

A burning sensation inside or behind the knee can have several possible causes. It may arise from an irritated tendon or bursa, an injured ligament or meniscus, osteoarthritis, a Baker’s cyst, nerve irritation or, less commonly, a vascular problem.

The location of the discomfort provides useful clues, but it cannot confirm the diagnosis. Pain on the inner side of the knee has a different range of likely causes from pain or swelling directly behind it.

Most knee problems are not emergencies. However, sudden calf or leg swelling, warmth, skin discolouration, breathlessness or chest pain requires urgent assessment because a blood clot must be excluded.

This guide explains the common causes, how knee pain is assessed and which treatments may be considered after the underlying problem has been identified.

Burning knee pain can originate from joints, tendons, bursae, nerves or circulation, so its location and accompanying symptoms matter.

Quick Answer

Burning pain on the inner knee may be associated with pes anserine bursitis, an MCL injury, a medial meniscus problem, osteoarthritis or nerve irritation. Pain behind the knee may be related to a Baker’s cyst, muscular or tendon strain, arthritis, a meniscus injury or, more urgently, a blood clot.

Arrange an assessment if the pain is persistent, worsening, affecting walking or accompanied by locking, instability, numbness or swelling. Seek urgent help for sudden one-sided calf swelling or a hot, discoloured leg. Call emergency services if leg pain or swelling occurs with chest pain or breathlessness.

⭐ What is burning knee pain? 

Burning knee pain describes the quality of a symptom. It may occur when a nerve, joint or surrounding soft tissue is irritated, but the burning sensation alone does not identify the cause.

Key Takeaways

• Inner-knee and back-of-knee pain have different possible causes.

• Burning pain does not automatically mean that a nerve is damaged.

• A Baker’s cyst can cause tightness, fullness or pain behind the knee.

• A ruptured Baker’s cyst can resemble a DVT and requires medical assessment.

• Sudden swelling in one calf or leg should not be massaged.

• Exercise should match the diagnosis rather than being selected from symptoms alone.

• Kinesiology tape may provide temporary support for some people, but evidence is mixed.

• NICE does not recommend hyaluronan injections for knee osteoarthritis.

• Evidence for PRP and prolotherapy is uncertain.

• Surgery is considered according to the diagnosis, symptoms and functional limitation—not age alone.

Table of Contents

1. What the Location of Knee Pain May Suggest

2. Common Causes of Burning Inner-Knee Pain

3. Common Causes of Pain Behind the Knee

4. When a Blood Clot Must Be Excluded

5. How Burning Knee Pain Is Assessed

6. Conservative Knee-Pain Treatment

7. Injections and Other Procedures

8. When Surgery May Be Considered

9. How A to Zen Therapies Can Help

10. Frequently Asked Questions

What the Location of Knee Pain May Suggest

The knee contains bones, cartilage, ligaments, tendons, bursae, nerves and blood vessels. Symptoms from these structures can overlap, which is why location is only the beginning of an assessment.

Symptom pattern	Possible explanation
Tenderness just below the inner knee	Pes anserine bursitis or tendon irritation
Pain after the knee was forced inward	Medial collateral ligament injury
Inner-joint pain with catching or locking	Medial meniscus problem
Gradual pain and stiffness with activity	Osteoarthritis
Fullness or lump behind the knee	Baker’s cyst
Pain after running, sprinting or bending the knee	Hamstring, calf or popliteus irritation
Burning with tingling or numbness	Possible nerve irritation
Sudden calf pain and one-sided swelling	DVT or ruptured Baker’s cyst requiring urgent assessment

These patterns can help guide discussion with a clinician, but they should not be used for self-diagnosis.

📊 Evidence Snapshot:The NHS knee-pain guidance emphasises that knee pain can arise from many different conditions. It advises urgent assessment when the knee is extremely painful, cannot bear weight, is badly swollen or deformed, locks or gives way, or becomes hot and red alongside fever or shivering.

Common Causes of Burning Inner-Knee Pain

Pes anserine bursitis

The pes anserine bursa is a small fluid-filled sac located between the shinbone and tendons on the inner side of the knee. Irritation can cause pain and tenderness several centimetres below the joint line.

According to the American Academy of Orthopaedic Surgeons, symptoms may develop gradually and become worse during exercise, stair climbing or after sitting with the knee bent.

Possible contributors include:

• repetitive running or cycling

• sudden increases in training

• tight hamstrings

• knee osteoarthritis

• altered lower-limb mechanics

Pes anserine bursitis can resemble an MCL sprain, meniscus injury or stress fracture, so

examination may be required.

Medial collateral ligament injury

The medial collateral ligament, or MCL, helps stabilise the inner side of the knee. It may be sprained when a force pushes the knee inward, particularly during contact sport or a fall.

Symptoms can include:

• pain along the inner knee

• tenderness over the ligament

• swelling

• a feeling of instability

• pain when changing direction

Minor sprains are usually treated without surgery, but an assessment is appropriate when the knee feels unstable or the injury was significant.

Medial meniscus injury

The menisci are cartilage structures that help distribute load within the knee. The medial meniscus can be injured by twisting, pivoting or deep bending. Degenerative tears may also occur gradually.

Possible symptoms include:

• pain along the inner joint line

• swelling

• clicking or catching

• difficulty fully straightening the knee

• locking

• pain during twisting or squatting

Not every meniscus tear requires surgery. Treatment depends on the type of tear, symptoms, age of the injury and whether the knee is genuinely locking.

Knee osteoarthritis

Osteoarthritis can cause pain, stiffness, swelling and reduced movement. Symptoms may initially affect one part of the knee more noticeably than another.

Pain may worsen after activity, while stiffness can be more noticeable after rest. A burning description is possible but is not specific to arthritis.

The central treatments for knee osteoarthritis normally include therapeutic exercise and weight management when appropriate. Medication, injections or surgery may be considered according to symptoms and clinical suitability.

Adductor or medial hamstring irritation

Muscles and tendons from the inner thigh attach around the medial knee. Pain may occasionally be related to a strain, training overload or altered movement elsewhere in the leg.

Targeted adductor stretches may be suitable when muscular tightness has been identified. However, stretching should not be used indiscriminately for suspected ligament, meniscus or bursal injuries.

Nerve-related pain

Burning, tingling, electric pain or altered sensation may indicate nerve irritation. The source may be around the knee, higher in the thigh or in the lower back.

Nerve-related symptoms deserve medical or physiotherapy assessment when they are persistent, spreading or accompanied by numbness, weakness or changes in walking.

Common Causes of Pain Behind the Knee

Baker’s cyst

A Baker’s cyst, also called a popliteal cyst, is a fluid-filled swelling behind the knee. In adults it is often associated with another knee problem, such as osteoarthritis, rheumatoid arthritis, gout, ligament injury or a meniscus tear.

The NHS guide to Baker’s cysts explains that symptoms may include:

• a lump or feeling of fullness behind the knee

• tightness

• aching

• difficulty bending the knee

• symptoms that become worse after activity

Treatment often focuses on the condition producing excess joint fluid rather than simply removing the cyst.

A Baker’s cyst can occasionally rupture, allowing fluid to move into the calf. This may cause

sudden pain, swelling, redness or warmth that resembles a blood clot. DVT must be excluded rather than assuming that the cyst has ruptured.

Hamstring or calf injury

The hamstring tendons and upper calf muscles cross the back of the knee. Running,

sprinting, sudden acceleration or an awkward movement can strain these structures.

Muscular pain is often related to loading or stretching the affected tissue. Bruising, weakness or a sudden tearing sensation may suggest a more significant injury.

Popliteus irritation

The popliteus is a small muscle behind the knee that helps control knee rotation. It may become irritated during downhill running or activities involving repeated rotation.

Pain from this region can be difficult to distinguish from other posterior knee problems, so assessment may be needed before selecting exercises.

Meniscus or arthritic joint pain

Meniscus injuries and arthritis can produce discomfort at the back as well as the side or front of the knee. Swelling inside the joint can create pressure and stiffness throughout the area.

Less common vascular causes

Blood vessels pass through the space behind the knee. Although uncommon, arterial or venous conditions can cause pain, swelling, temperature changes or changes in skin colour.

A pulsating lump, a cold or pale foot, rapidly worsening pain or loss of sensation requires urgent medical assessment.

When a Blood Clot Must Be Excluded

A deep vein thrombosis is a clot within a deep vein, usually in the leg. Symptoms can include:

• throbbing pain in one calf or thigh

• swelling in one leg

• warmth

• red, blue or darkened skin

• enlarged surface veins

The NHS guidance on DVT advises obtaining urgent medical help if DVT is suspected.

Call emergency services if leg pain or swelling occurs with:

• chest pain

• breathlessness

• coughing blood

• collapse

These may indicate a pulmonary embolism.

Do not massage, foam-roll, stretch aggressively or apply compression to a suddenly swollen calf before a blood clot has been excluded.

💡 Expert Tip: Before an appointment, record exactly where the pain begins, what movement triggers it, whether swelling is present and whether the knee catches, locks or gives way. Also note any calf swelling, numbness, back pain or recent surgery, immobility or long-distance travel.

How Burning Knee Pain Is Assessed

Assessment normally begins with a history of the symptoms and a physical examination.

A clinician may ask:

• Was there an injury or gradual onset?

• Where is the pain most concentrated?

• Is there a lump or swelling?

• Does the knee lock or give way?

• Can you fully bend and straighten it?

• Is there numbness, tingling or weakness?

• Are symptoms related to walking, stairs, running or rest?

• Have you recently had surgery or been immobile?

• Are there relevant medical conditions or medicines?

The examination may include joint movement, ligament stability, meniscus tests, muscle strength, walking pattern, tenderness, swelling and circulation.

When imaging may be used

Not everyone with knee pain requires a scan. Depending on the suspected condition, a clinician may arrange:

• an X-ray for arthritis or fracture

• ultrasound for a Baker’s cyst or suspected DVT

• MRI for selected ligament, cartilage or meniscus problems

• blood tests when infection or inflammatory disease is possible

Imaging findings should be interpreted alongside symptoms and examination because structural changes do not always explain the degree of pain.

Conservative Knee-Pain Treatment

Treatment should follow the diagnosis. Common non-surgical options include the following.

Temporary activity modification

Reducing an activity that clearly aggravates the knee can allow symptoms to settle. Complete or prolonged inactivity is rarely the long-term goal.

A gradual return to movement may begin once serious injury has been excluded and

symptoms allow. The appropriate pace depends on the condition.

Physiotherapy and therapeutic exercise

A physiotherapist may assess mobility, muscle strength, balance and movement patterns before prescribing exercises.

A programme may include:

• range-of-motion exercises

• quadriceps strengthening

• hip and gluteal strengthening

• hamstring or calf exercises

• balance work

• walking or cycling progression

• gradual return to sport

Exercise should be individualised. A generic stretch could aggravate one condition while helping another.

Low-impact cycling may suit some rehabilitation plans. Our guide to recumbent biking for knee-pain recovery explains practical considerations, but cycling should not be continued through severe pain, acute swelling or mechanical locking.

Cold therapy

A wrapped cold pack may help manage pain or swelling following some acute injuries. Avoid placing ice directly against the skin, particularly when sensation is reduced.

Medication

Paracetamol or a topical anti-inflammatory medicine may be appropriate for some people. Oral non-steroidal anti-inflammatory medicines such as ibuprofen are not suitable for everyone, including some people with stomach, kidney, heart, blood-pressure or anticoagulant concerns.

Ask a pharmacist or doctor about interactions, dosage and suitability rather than assuming that an over-the-counter medicine is risk-free.

Kinesiology tape and braces

Kinesiology tape may provide temporary sensory feedback or a feeling of support, but evidence for meaningful pain and functional improvements is mixed. Claims that it reliably lifts the skin, restores circulation or removes inflammation are not well established.

Braces and walking aids may be useful for selected injuries, instability or osteoarthritis. They should be fitted and used for a clear purpose rather than purchased solely from the location of pain.

Weight management where appropriate

For people living with knee osteoarthritis and overweight or obesity, weight reduction may improve pain and function. This should be approached respectfully and as one part of care—not as an assumption that body weight is the sole cause of knee pain.

Injections and Other Procedures

Injections should follow an appropriate diagnosis and discussion of likely benefits, limitations and risks.

Genicular Artery Embolization

If your knee pain isn’t getting better with rest and therapy, don’t worry; there may still be specialist options to explore before considering major surgery. For example, Genicular Artery Embolization is a minimally invasive procedure being studied for selected people with persistent knee pain caused by osteoarthritis.

The procedure uses a small catheter to deliver particles into selected blood vessels supplying the knee. It aims to reduce abnormal blood flow associated with inflammation while preserving the main circulation around the joint.

However, GAE is not a general treatment for unexplained burning knee pain, meniscus injuries, ligament damage or Baker’s cysts. Current NICE guidance states that short-term safety has not raised major concerns, but evidence about effectiveness and long-term safety remains inadequate in quality and quantity. NICE therefore recommends that the procedure currently be used only in a research context.

Anyone considering GAE should first have osteoarthritis confirmed and discuss established treatments, eligibility, possible risks and the limitations of the evidence with an orthopaedic or interventional-radiology specialist.

Corticosteroid injections

A clinician may consider an intra-articular corticosteroid injection for short-term relief from osteoarthritis when other suitable treatments have not provided enough benefit or when temporary relief may support participation in exercise.

NICE advises explaining that the benefit is generally short term—approximately two to ten weeks. Repeated injections are not a cure and require an individual risk assessment.

Hyaluronic acid injections

Hyaluronic acid, or hyaluronan, injections are marketed as improving lubrication inside an

osteoarthritic knee. However, NICE advises not offering intra-articular hyaluronan injections for osteoarthritis because available evidence has not demonstrated sufficient benefit.

Availability and recommendations may differ in other healthcare systems, so patients should ask what evidence and guidance their provider follows.

Platelet-rich plasma

PRP is prepared from the patient’s blood and injected into the affected area. It is offered privately for osteoarthritis and some tendon conditions.

Some providers describe PRP therapy when discussing non-surgical treatment options. However, the evidence varies according to the condition and the way PRP is prepared.

NICE guidance on PRP for knee osteoarthritis states that there are no major safety concerns, but evidence of efficacy is limited in quality. It recommends using the procedure only with special arrangements for clinical governance, consent and audit or research.

Readers comparing private PRP knee treatment should ask:

• What precise diagnosis is being treated?

• What evidence supports PRP for that diagnosis?

• Who performs the procedure?

• Is ultrasound guidance used where appropriate?

• What risks and alternatives have been explained?

• How will outcomes and adverse events be monitored?

• What happens if the treatment does not help?

Inclusion of an external provider does not constitute a clinical endorsement or guarantee an outcome.

Prolotherapy

Prolotherapy involves injecting an irritant solution, often containing dextrose. Research

remains limited and inconsistent. It should not be described as proven to strengthen ligaments or heal chronic knee instability.

Anyone considering prolotherapy should discuss the evidence, regulatory status, risks, costs and established alternatives with a suitably qualified medical professional.

How to Choose the Right Treatment for Burning Knee Pain

With so many knee pain treatment options, how do you know which one is right for you? The best treatment depends on several factors, including the underlying diagnosis, the severity of your inner-knee pain, your lifestyle, general health and long-term goals.

Important considerations include:

• The underlying cause: A ligament injury, Baker’s cyst, osteoarthritis, nerve problem and suspected blood clot require very different approaches.

• Symptom severity: Mild, recently developed symptoms may improve with appropriate activity modification and rehabilitation. Severe or worsening symptoms require assessment before treatment.

• Function: Difficulty walking, climbing stairs, working or sleeping may influence how quickly specialist care is required.

• Mechanical symptoms: Locking, giving way or loss of movement may require further examination or imaging.

• Previous treatment: A clinician should review which exercises, medicines or other treatments have been tried, for how long and with what result.

• Medical history: Diabetes, cardiovascular disease, bleeding disorders, anticoagulant medicines and previous surgery may affect treatment suitability.

• Personal goals: Returning to sport may require a different rehabilitation plan from improving comfort during everyday walking.

• Quality of evidence: Newer procedures are not automatically better. Ask what evidence supports the treatment for your specific diagnosis.

Treatment should not be selected solely because it is described as conservative, regenerative or minimally invasive. A clinician should explain the expected benefit, risks, alternatives, recovery requirements and what happens if the treatment does not help.

When Surgery May Be Considered

Surgery is not selected simply because pain is severe or because a person has reached a particular age. The decision depends on the diagnosis, functional limitation, clinical findings and response to suitable non-surgical care.

Arthroscopy

Knee arthroscopy uses a small camera and instruments inserted through small incisions. It may be appropriate for selected injuries, such as certain repairable meniscus tears or mechanical problems.

Arthroscopy is not routinely recommended as a general treatment for osteoarthritis. Pain alone does not establish that “cleaning out” the joint will help.

Meniscus or ligament surgery

Surgery may be considered for selected traumatic tears, persistent instability or mechanical locking. Many meniscus and ligament problems can initially be managed through rehabilitation, depending on the injury and the person’s goals.

Partial or total knee replacement

Joint replacement may be considered when osteoarthritis substantially affects quality of life and suitable non-surgical treatments no longer provide adequate support.

A partial replacement addresses damage confined to one compartment. A total replacement resurfaces the whole knee joint. Eligibility depends on the pattern of joint damage, symptoms, general health and personal preferences.

Cartilage procedures

Cartilage repair techniques may be considered for carefully selected localised injuries. They are not appropriate for every person with arthritis or burning knee pain.

Our guide to the stages of joint rehabilitation explains how movement, strength and function are gradually rebuilt after joint injury or surgery.

When to Seek Professional Help

Arrange an assessment if:

• pain persists or repeatedly returns

• the knee is limiting walking or everyday activities

• there is a new lump behind the knee

• the joint locks or gives way

• swelling is persistent

• movement is becoming more restricted

• there is numbness, tingling or weakness

• symptoms began after a significant injury

• the current treatment plan is not helping

Obtain urgent advice if:

• the knee is extremely painful

• you cannot move it or bear weight

• it is badly swollen or has changed shape

• the knee is hot and red and you have a fever or feel unwell

• pain or swelling in the calf suddenly worsens

• the lower leg becomes warm or discoloured

Call emergency services for chest pain or breathlessness accompanying leg pain or swelling.

How A to Zen Therapies Can Help

A to Zen Therapies does not diagnose ligament tears, meniscus injuries, Baker’s cysts, blood clots, infection or arthritis. Unexplained, persistent or worsening knee pain should be assessed appropriately before complementary treatment.

Once serious and structural causes have been considered, sports massage in London may support temporary relief from muscular tension around the thigh, hip or calf when clinically suitable. Read more about the potential benefits and limitations of sports and deep-tissue massage.

Massage should not be performed directly over acute swelling, a suspected Baker’s cyst, an inflamed joint or a leg in which DVT is possible. Deep pressure should not be applied indiscriminately to the space behind the knee because important blood vessels and nerves pass through this area.

Acupuncture in London may also be considered for selected musculoskeletal pain conditions after appropriate assessment. It cannot repair a torn ligament, dissolve a blood clot or replace medical or physiotherapy care.

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Continue Exploring Knee Pain and Rehabilitation

Managing knee pain may involve diagnosis, activity adjustment, progressive exercise and appropriate clinical care. Explore our Pain Management Hub, Exercise and Rehabilitation Hub, Massage Therapy Hub and Acupuncture Hub for further evidence-informed guidance.

Frequently Asked Questions

What causes a burning sensation on the inner knee?

Possible causes include pes anserine bursitis, MCL injury, medial meniscus irritation, osteoarthritis, tendon problems or nerve irritation. The burning sensation alone cannot identify which condition is present.

What causes burning pain behind the knee?

Possible causes include a Baker’s cyst, hamstring or calf injury, popliteus irritation, arthritis, a meniscus injury or nerve-related pain. Sudden calf swelling requires urgent assessment for DVT.

Can a Baker’s cyst feel like burning?

A Baker’s cyst may cause aching, tightness, stiffness or pain behind the knee. If it ruptures, it can cause sudden calf irritation and swelling that may resemble a blood clot.

How can I tell the difference between a Baker’s cyst and DVT?

It may be impossible to distinguish them safely from symptoms alone. Both can cause calf pain and swelling, so urgent clinical assessment and sometimes ultrasound are required.

Should I massage pain behind my knee?

Not until unexplained swelling, DVT, a ruptured cyst and vascular problems have been

excluded. The area behind the knee also contains important nerves and blood vessels, so forceful direct pressure is inappropriate.

Can knee arthritis cause burning pain?

Yes, some people describe osteoarthritis pain as burning, although aching and stiffness are more typical. Burning can also occur with nerve or soft-tissue irritation.

Does kinesiology tape treat the cause?

Tape may provide temporary support or sensory feedback for some people, but it does not repair a torn ligament, remove a cyst or reverse osteoarthritis.

Are knee injections a permanent solution?

Usually not. Corticosteroid injections may provide short-term relief for selected patients. Hyaluronic acid is not recommended by NICE for osteoarthritis, and evidence for PRP remains uncertain.

When is an MRI needed?

MRI may be considered when examination suggests a significant ligament, meniscus or other soft-tissue problem and the result would change management. It is not automatically required for every episode of knee pain.

Can I exercise with burning knee pain?

It depends on the cause. Gentle movement may be useful for many conditions, but acute injury, severe swelling, locking, instability or an undiagnosed lump requires assessment before starting a new programme.

References

• NHS — Knee Pain

• NHS — Baker’s Cyst

• NHS — Deep Vein Thrombosis

• NICE — Osteoarthritis: Assessment and Management

• NICE — PRP Injections for Knee Osteoarthritis

• AAOS — Pes Anserine Bursitis

• AAOS — Meniscus Tears

• AAOS — Baker’s Cyst

• AAOS — Knee Conditioning Programme