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Knee Pain When Going Up or Down Stairs: Common Causes
Updated: Oct 14
Quick answer: Pain around or behind the kneecap is often related to patellofemoral pain or arthritis.
Stairs place greater load across the knee than level walking. Going down stairs increases demand on the quadriceps and patellofemoral joint, while going up requires more force from the quadriceps and patellar tendon. Pain does not automatically mean the knee is damaged beyond repair, but the location, timing and associated symptoms can help narrow the cause.
Common causes
Pain around or behind the kneecap is often related to patellofemoral pain or arthritis. A meniscus tear can cause joint-line pain, swelling or catching. Patellar or quadriceps tendon problems are more likely to hurt with jumping, running or forceful stair climbing.
Evaluation
X-rays are useful when arthritis is suspected, while musculoskeletal ultrasound can evaluate tendons, effusions and soft-tissue problems. MRI is usually reserved for persistent uncertainty, significant injury or when surgery is being considered.
Treatment
Treatment depends on the diagnosis and may include physical therapy, activity modification, weight management when appropriate, bracing, medications and selected image-guided injections. PRP or other procedures may be considered for selected conditions.
When to seek care
Persistent pain, progressive weakness, recurrent swelling, locking, inability to bear weight after an injury, or symptoms that limit sleep and daily activity deserve medical evaluation. Treatment is most effective when it is based on a clear diagnosis rather than simply the location of pain.
Related care: nonsurgical knee pain treatment
Carolina Nonsurgical Orthopedics provides physician-led evaluation and nonsurgical treatment for musculoskeletal conditions in Raleigh and Cary, North Carolina. This article is for general education and is not a substitute for an individual medical evaluation.
Related orthopedic resources
About Your Physicians
Dr. Matthew Kanaan
Nonsurgical Orthopedic Specialist
Founder of Carolina Nonsurgical Orthopedics. Fellowship trained in sports medicine at Duke; residency in family medicine at Duke, where he served as Chief Resident.
Dr. Pierce Knox
Nonsurgical Orthopedic Specialist
Fellowship trained in nonsurgical sports medicine at Penn Medicine; residency in primary care at Christiana Care.
