Knee pain is one of the most common reasons people seek orthopaedic advice. But what many patients don’t realise is that the knee isn’t always the true source of the problem.
In some cases, the pain you feel in your knee could be a symptom of something happening elsewhere in the body – particularly the hip or lower back. This is known as referred pain, and it’s more common than you might think.
As a consultant orthopaedic surgeon with a special interest in both hip and knee conditions, Mr Nirav Shah often sees patients who’ve been told they have ‘knee problems’, only for the real issue to lie somewhere else entirely. That’s why taking a holistic, whole-body approach to diagnosis is so important.
What is referred pain?
Referred pain occurs when discomfort is felt in a different location from where the problem originates. It’s due to the way our nerves communicate signals to the brain. Because the hip and knee share overlapping nerve pathways, pain caused by a hip condition can sometimes be felt in the knee instead.
It can be confusing – especially if your knee feels sore, stiff or even swollen. But if there’s no obvious damage within the joint itself, it’s worth investigating other possible sources.
Could it be your hip?
It’s not unusual for hip conditions like arthritis or impingement to masquerade as knee pain. Patients will often say their knee aches when walking or getting out of a chair – and they may not feel any obvious discomfort in the hip at all.
Other signs that the hip might be involved include:
- Groin pain that comes and goes
- Difficulty bending or rotating the leg
- Pain that worsens with prolonged standing or climbing stairs
- A sensation of stiffness in the upper thigh or buttock
Hip problems can be particularly deceptive, especially in younger or more active individuals. That’s why it’s essential to assess the whole kinetic chain – how your hip, knee and surrounding muscles all work together.
What else could be causing knee-like pain?
Other potential sources of referred pain to the knee include:
- Lumbar spine issues, such as a slipped disc or sciatica
- Tightness or weakness in the glutes or hamstrings
- Pelvic imbalance or poor posture
- Nerve entrapment in the lower back or groin area
In each case, the pain may localise to the knee, but treating the knee directly won’t address the root cause.
Mr Shah’s approach to diagnosis
When patients come to see Mr Shah with knee pain – particularly when previous treatments haven’t helped – he takes a step back and assesses the broader picture.
This includes:
- A detailed discussion about your symptoms, lifestyle and goals
- A full physical examination, including hip, spine and posture
- Diagnostic imaging if needed (MRI, X-ray or ultrasound)
- Reviewing previous diagnoses with a fresh perspective
It’s important to get to the bottom of what’s really going on, rather than simply treating symptoms. Sometimes, the answer lies in a small detail that’s been overlooked. Other times, a second opinion can reveal a misdiagnosis that’s delaying proper treatment.
The importance of accurate diagnosis
Treating the wrong joint can lead to frustration, unnecessary procedures and ongoing pain. That’s why a thorough and thoughtful approach to diagnosis is key – especially for patients who’ve tried physiotherapy, pain relief or even surgery without lasting improvement.
If you’re experiencing knee pain that isn’t improving, or you suspect something deeper might be going on, don’t hesitate to get it checked. The right diagnosis is the first step towards the right treatment – and a better quality of life.
If you’d like to discuss your joint pain or get a second opinion, Mr Shah offers in-depth assessments and tailored treatment plans at Goring Hall Hospital in West Sussex. With over 10,000 orthopaedic procedures performed, he brings extensive experience and a personalised approach to every patient.
