Why Do I Experience Knee Pain While Going Down Stairs?

Some individuals experience knee pain when going down stairs. It can be mild and occur periodically, or the pain can be excruciating and frequent. There are a number of conditions that can cause this type of knee pain, particularly ones that affect the kneecap. Issues with other parts of the knee joint can also trigger pain.

This article discusses the common causes of knee pain when doing down stairs and ways you can help manage this type of pain.

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is also known as jumper’s knee or runner’s knee. This condition is known to cause pain around or under the kneecap, which can make it difficult to walk down stairs. This condition can happen in one or both of the knees. Both children and adults can experience PFPS.

Symptoms

Some of the most common symptoms of PFPS include:

• Tenderness to the touch of the knee
• Cracking or grinding sounds when the knee is bent or straightened
• Pain around the kneecap
• Dull or aching pain in the front of the knee
• Pain after sitting for a period of time with the knees bent
• Worsening pain while going down stairs

These symptoms begin gradually and may get worse over time.

Causes and Risk Factors

Some of the causes of PFPS include:

• Weak thigh muscles
• Tight hamstrings
• Poor foot support
• An injury
• Overuse during exercise and movement
• A kneecap that is too high in the knee joint

Chondromalacia Patella

Chondromalacia patella is the breakdown and softening of the cartilage on the patella—or underside of the kneecap. Pain occurs when the thigh bone and knee rub together. This pain can worsen when you go up or down stairs.

Symptoms

Some of the symptoms of chondromalacia patella include:

• Dull pain behind, below, and on the sides of the kneecap
• Feeling of grinding when going down the stairs, running downhill, or doing squats or knee bends
• Pain standing up after sitting for a period of time

Causes and Risk Factors

Chondromalacia patella occurs when there is:

• Abnormal kneecap positioning
• Muscle weakness or tightness around the knee
• Flat feet
• Too much movement that involves the knee

Individuals who are at risk of getting chondromalacia patella include people who:

• Had an injury, dislocation, or fracture that is related to the kneecap
• Are overweight
• Exercise often such as bicyclists and runners

Osteoarthritis of the Knee

Osteoarthritis (OA) is the most common form of arthritis that affects the knee joint. More common in older people, osteoarthritis happens when tissues in the joints start to break down over time. Knee pain during weight-bearing activities, such as using stairs, can be an early symptom of the condition.

Depending on the severity of OA, some individuals have a lot of pain, while it doesn’t affect the day-to-day activities of others. When OA in the knee occurs, the cartilage in the knee joint wears away gradually, and the protective space between the bone decreases. Because the cartilage and protective space have decreased, this can result in the bones rubbing together, which creates pain and damage. Although OA develops slowly, it can worsen over time.

Symptoms

The symptoms of OA include:

• Swelling around the joints
• Giving out of the knee
• Muscle weakness around the joints
• Limited range of motion
• Aches and pains during an extended amount of activity
• Cracking sounds of the knees

Causes and Risk Factors

OA was long believed to be caused by the wearing down of joints over time. Scientists now see OA as a disease of the joint. Some of the causes of OA include:

• Advancement of age
• Joint injury
• Overuse of the same joint
• Weak muscles
• Obesity due to the stress on the joints
• Inflammation
• Genetics

Women are more likely to develop OA than men.

Pes Anserine Bursitis

Pes anserine bursitis occurs when the pes anserine bursa (a fluid-filled sac on the inside of the knee joint) becomes inflamed and swollen. This happens when the bursa becomes irritated and makes too much fluid. This can cause knee pain when going up or down stairs.

Symptoms

Symptoms of pes anserine bursitis include:

• Pain on the inside of the knee or in the center of the shinbone, around 2 to 3 inches below the knee joint
• Knee pain that worsens with exercise or climbing stairs
• Swelling or tenderness in the affected area

Causes and Risk Factors

Pes anserine bursitis usually develops when the bursa becomes irritated, often as a result of overuse or constant friction. The following can increase your risk of developing this condition:

• Incorrect training techniques
• Tight hamstring muscles
• Obesity (due to the stress on the joints)
• Being duckfooted or having knock knees
• Osteoarthritis in the knee
  

Diagnosis

To determine the diagnosis and best treatment for knee pain, the healthcare provider will administer several different tests. Some include a blood test, X-ray, MRI, and/or physically touch the knee to determine the tenderness or mild swelling.

How to Make Walking Down the Stairs Not Hurt Your Knees

One of the most common at-home treatments for knee pain caused by an injury is RICE:

• Rest: Stop or reduce any activity that's causing your knee pain.
• Ice: If you've injured your knee, apply ice or a cold pack to the area for 10 to 20 minutes, three times a day. This can help prevent or minimize any swelling.
• Compression: Gently wrap or bandage your knee to help reduce swelling.
• Elevate: Keep your foot above heart level.

Medications may include nonsteroidal anti-inflammatory drugs such as aspirin, naproxen, or ibuprofen. Weight loss may also help reduce stress on the knee.

Contact your healthcare professional to discuss the proper treatment based on your specific condition. They may recommend other treatment options such as physical therapy. In some cases, surgery may be required to treat certain knee conditions.

Coping

If you saw a healthcare provider and are still experiencing knee pain walking down stairs, these techniques may help:

• Step onto the stairs with the whole foot: Stepping on toes can cause anterior knee pain due to increased pressure on kneecap and compression of the knee. 
• Activate the gluteus muscles: Do this by pushing off from the outer heel. This puts less strain on the knee.

Understanding the cause of knee pain will ultimately help you cope. It is important to speak with your healthcare provider to get the best advice and treatment regarding knee pain.