--- title: "Pain on the Inner Side of the Knee: Causes and Treatment" description: "Inner (medial) knee pain: osteoarthritis, medial meniscus tears, pes anserine bursitis and ligament injury, with treatment options." date: 2026-10-24 lastmod: 2026-11-02 canonical: https://drmotiva.com/en/articles/inner-knee-pain/ lang: en --- # Pain on the Inner Side of the Knee: Causes and Treatment The inner side of the knee carries more load than the outer side when walking, which makes it a common site of pain. ## Common causes - **Medial compartment osteoarthritis:** the most common cause in middle and older age - **Medial meniscus tear:** traumatic in younger people, degenerative in older people - **Pes anserine bursitis/tendinopathy:** pain slightly below the inner joint line - **Medial collateral ligament injury** after a sideways blow or twist Further reading: the [guide “Knee Osteoarthritis”](https://drmotiva.com/en/guides/knee-osteoarthritis/) and the articles [Pain Behind the Knee: Causes and Treatment](https://drmotiva.com/en/articles/pain-behind-the-knee/) and [L4-L5 Disc Herniation: Symptoms and Treatment](https://drmotiva.com/en/articles/l4-l5-disc-herniation/). ## Diagnosis Examination, X-ray for osteoarthritis and, if needed, ultrasound or MRI. ## Treatment - **Osteoarthritis:** exercise, weight management and education are core treatments [3] - **Degenerative meniscus tears:** exercise therapy gave results similar to arthroscopic partial meniscectomy [1], and arthroscopic meniscectomy was not better than sham surgery [2] - Physiotherapy, pain medicines, and injections in selected cases ## Anatomy in brief The inner (medial) side of the knee contains the medial compartment of the joint, the medial meniscus (a C-shaped cartilage cushion between thigh and shin bones), the medial collateral ligament (which stabilises the knee against sideways forces) and, slightly lower, the pes anserinus, where three tendons attach to the shin bone. Pain location, swelling and how the pain started help separate these causes. ## Risk factors - Age and excess body weight, for osteoarthritis and degenerative meniscus tears - Bow-legged alignment, which increases load on the inner compartment - Twisting sports such as football, basketball and skiing - Weakness of the thigh and hip muscles - Previous knee injury ## Assessment in practice The examination checks the joint line, ligament stability, meniscus tests, swelling and walking pattern. A standing X-ray shows osteoarthritis and alignment. Ultrasound can show pes anserine bursitis (inflammation of the small fluid-filled cushion beneath those tendons) and ligament injury. MRI is helpful when a meniscus or ligament injury may change treatment, but degenerative meniscus findings are common in people without pain and must be interpreted with the examination. ## Rehabilitation - Strengthening of the quadriceps (front of the thigh) and hip muscles - Exercises for balance and control of knee alignment - Gradual return to walking, stairs and sport - Advice on load: spreading activity through the day, avoiding prolonged deep squatting during flares The programme is planned by your physical medicine and rehabilitation specialist and the physiotherapist. Whether an injection is suitable is decided after examination. ## Home measures - Ice for 10–15 minutes after activity if the knee is swollen - Supportive, cushioned footwear - A pillow between the knees at night if pes anserine pain disturbs sleep - Weight management when needed ## Red flags Seek prompt assessment for a knee that locks and cannot be fully straightened, rapid swelling after an injury, inability to bear weight, a hot red knee with fever, or calf swelling and pain. ## When to see your physical medicine and rehabilitation specialist Seek assessment if pain is severe, keeps getting worse, wakes you at night or does not start to improve within a few weeks; if numbness, weakness or any warning sign appears; or if you are unsure what your test results mean. Your physical medicine and rehabilitation (PM&R) specialist, a doctor trained to diagnose and treat musculoskeletal and nerve problems without surgery, examines you, explains the findings and plans treatment together with the physiotherapist. Whether injections or other advanced treatments are suitable for you is decided by a PM&R specialist after examination. Prof. Dr. Engin Çakar works in this field and can be consulted online or in person; otherwise, please consult a PM&R specialist near you. To make the most of the consultation, it helps to bring: - A short timeline of your symptoms and what makes them better or worse - A list of your medicines and other health conditions - Previous imaging (the images themselves, not only the reports), test results and treatment summaries - Your questions and goals, such as returning to work, sport or a particular activity ## Frequently asked questions **Is arthroscopic surgery useful for a degenerative meniscus tear?** Usually not as first-line treatment; exercise is preferred. **Can I walk with inner knee pain?** Activity is generally encouraged within comfortable limits. See [Outer knee pain](https://drmotiva.com/en/articles/outer-knee-pain/). **Does a knee brace help?** An unloading brace may help some people with inner-compartment osteoarthritis, but it is an addition to exercise rather than a replacement. **Is inner knee pain in a young athlete usually osteoarthritis?** No. In young people a ligament or meniscus injury, or tendon irritation, is more likely. ## Assessment and contact You can request an appointment or a second-opinion review of existing reports and imaging: [Contact & second opinion (WhatsApp)](https://drmotiva.com/go/wa?l=en&t=&loc=inline_contact&p=%2Fen%2Farticles%2Finner-knee-pain%2F). This page is general health information. Diagnosis and treatment decisions are made individually after examination. ## Sources 1. Kise NJ, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ. 2016. [PMID: 27440192](https://pubmed.ncbi.nlm.nih.gov/27440192/) 2. Sihvonen R, et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013. [PMID: 24369076](https://pubmed.ncbi.nlm.nih.gov/24369076/) 3. Bannuru RR, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019. [PMID: 31278997](https://pubmed.ncbi.nlm.nih.gov/31278997/)