You would be forgiven for thinking the pain in your knee is caused by a problem in your knee.
It’s the obvious assumption.
What if we told you that your knee pain may not be caused by your knee at all. In fact, at The Brisbane Spine Clinic, we often see people complaining of knee pain that is actually referred pain from their back.
The Australian Institute of Health and Welfare reports that 1 in 6 Australians had back problems in 2017-18.
Are you wondering if your knee pain is actually caused by a back problem? Then you’re in the right place.
Here we discuss referred knee pain from back nerves and what symptoms you should be on the lookout for. We will also explore some treatment and management options.
What is referred pain?
Referred pain occurs when a problem in one part of the body causes pain in another. This happens because the pain travels down a nerve.
For example, a pinched nerve in your back can cause pain and other problems in your legs.
Referred pain needs to be correctly diagnosed to make sure it’s treated effectively. If you can learn to understand and recognise the links between your knee and back pain, you’ll be better able to identify the real source of your knee pain.
The link between back and knee pain
You’re asking, how could a problem in my spine be causing pain in my knee?
Well, our knees and spines are connected by nerves. The muscles that surround your knees are attached to the nerves in your lower back. Occasionally, after injury or as we age, the discs between the vertebrae can bulge out and press on these nerves. The pressure on the nerve causes irritation. Where you feel pain depends on which disc is protruding.
The nerves that send fibres to the knee are located at the second, third, and fourth lumbar vertebral levels in the lower back area. When one of the nerves in this area becomes irritated or damaged, referred pain will often be felt in the knee.
How to tell if your knee pain is coming from your back nerves
Unless you’ve injured your knee, your pain may in fact be coming from your back.
Here are four signs that may indicate your knee pain is caused by a spinal condition:
1. You have knee pain and back pain
If you’re experiencing knee pain – either as a one-off occurrence or an ongoing problem, take the time to think about whether you’re experiencing pain anywhere else in your body. Even if the two seem unrelated, it’s worth noting the pain and discussing it with your spinal specialist.
Back nerves causing knee pain is more common in people who sit a lot, so if you work a desk job or spend a lot of time in your car or on planes, it’s worth investigating. Remember, the back pain may not seem as severe as the knee pain – it may even just feel like tight muscles.
2. You’re getting bunions
It may sound like a strange connection, but bunions can actually be a sign of underlying back problems. This is because the spinal issue that causes your knee pain could also be affecting the way you stand, walk, and run.
Bunions are caused by the big toe tilting to an unnatural angle. This leaves space for ‘bone spurs’ (or bunions) to form. This angle of the toe is often caused by a weakening of muscles.
There are nerves running from our backs to both the inside and outside of our feet. When one becomes irritated, it can affect the operation of the muscles in our feet and cause them to loosen leading to a tilting of the toe joint.
This means that if you have both knee pain and bunions it is worth investigating if the nerves in your back could be the cause.
3. You have tightness in your hamstrings
If you’re stretching your hamstrings trying to relieve pain or tightness- but it’s not working –there may be a nerve issue in your back causing trouble.
The hamstrings are a group of muscles that run down the back of your thigh.
The L5 nerve travels from the lumbar spine down the outer hamstring muscle. Issues with this nerve can affect the knee in two ways – directly, as irritation of this nerve causes pain in the hamstring, and indirectly as your knees will compensate for the pain by changing the way they move, which may cause damage.
4. You have hip or quadricep weakness
The quadriceps are a group of muscles that run down the front of your thigh. They help you to move your knees and hips. If the quadriceps have a problem your hips and knees could be affected.
The nerves that control the quadriceps also come from the spine. If you find you’re experiencing a weakening hip or quadricep, it may be a sign of nerve issues.
When problems in the spine cause your hip muscles to weaken, your knees may have to work harder to compensate – causing pain.
Treatment and management options
If you’re experiencing knee pain, it’s important to get to the true cause– particularly before considering invasive procedures like surgery.
All too often, knee pain is not the issue but a symptom of a problem elsewhere.
Talking to a physiotherapist or spinal consultant is a good way to get an assessment of how issues in your back may be causing knee pain. Once the cause has been diagnosed a plan for treating and managing your pain can be formulated. Some of the options you may be given include:
Hands on physical therapy which may include putting pressure on muscle tissue or joint manipulation.
Your physiotherapist can also teach you exercises, stretches, and strategies for strengthening your back muscles, managing pain, and helping your body to move more comfortably.
- Correction of Posture
Having good posture means your hips, knees, back, and feet are aligned. This can keep the pressure off the nerves in your lower back and stabilise your lower body.
Looking after your body by keeping within a healthy weight range, being physically active, and regularly completing your exercises and stretches is essential.
Letting your body have enough rest to avoid fatigue or strain is also important.
How The Brisbane Spine team can assist
If you are experiencing knee pain, the team at The Brisbane Spine Clinic are here to help you.
We are highly trained in non-surgical techniques that aim to restore health and well-being. Our goal is to help you overcome injuries and conditions and get you back to normal activity.
In summary, your knee pain may be caused by an issue in your knee joint. However, your knee pain could also be caused by your back nerves, in which case treating your knee alone will not solve the problem.
The Brisbane Spine Clinic works with you to pinpoint the cause of your pain. We’ll tailor an individualised plan, aiming to improve pain levels and get you back to your active life.
Book an appointment with one of our team today. We have locations in Eight Mile Plains, North Lakes and Daisy Hill (opening early 2023).
Australian Institute of Health and Welfare. (2020). Back Problems.
Healthdirect. (2022). Back Pain. https://www.healthdirect.gov.au/back-pain
Inverarity, L. (2022). Back Disorders and Knee Pain; Can Knee Pain Come from your Spine?
Physiopedia. (2022). Referred Pain. https://www.physio-pedia.com/Referred_Pain
Sports Medicine Australia. (2022). Hamstring Strain.