Gonalgia: meaning, causes of knee pain and treatment

Gonalgia is the medical term for knee pain (from the Greek gonu, knee, and algos, pain). It isn't a diagnosis but a description: it says the knee hurts, not why. If your report says "right gonalgia", "left" or "bilateral", it only tells you which knee hurts, or that both do. The cause is found through examination, and in many cases it's treated without surgery, with exercise.

Causes by where it hurts

At the front, around or behind the kneecap

Patellofemoral pain: the most common in young people and athletes. It hurts going up and down stairs, squatting or after sitting for a long time with your knees bent.
Patellar tendinopathy ("jumper's knee"): just below the kneecap, with jumping.

On the inside

Knee osteoarthritis, especially from 50 onwards.
A medial meniscus injury, sometimes after a twist, with locking or catching.
A medial collateral ligament injury after a blow or twist.

On the outside

Iliotibial band syndrome, typical in runners and cyclists, coming on at the same point in each run or ride.
A lateral meniscus injury.

At the back

A Baker's cyst, which often goes with osteoarthritis or meniscus injuries.
Hamstring or calf overload.

No clear spot

Pain referred from the hip (hip osteoarthritis can hurt at the knee) or the lower back.

Causes by age

Teenagers: Osgood-Schlatter (a painful bump below the kneecap), patellofemoral pain.
Young adults and athletes: patellofemoral pain, iliotibial band, meniscus and ligament injuries.
From 50 onwards: osteoarthritis and degenerative meniscus tears, which often don't need surgery.

What helps

Exercise: the treatment with the strongest support. In knee osteoarthritis it reduces pain and improves function (Fransen et al., Cochrane Database of Systematic Reviews, 2015). For patellofemoral pain, strengthening the hip and knee together is the main recommendation (Collins et al., British Journal of Sports Medicine, 2018).
Adjusting load: temporarily cutting back what triggers it (mileage, jumping, deep squats) without stopping moving.
Losing weight if needed: every kilo less takes a lot of load off the knee when walking.
Comfortable, stable shoes; insoles help some people in the short term.
Ice after activity if there's swelling; heat if stiffness dominates.

Simple exercises to start with, without strong pain:

Sit to stand from a chair slowly, 10 times.
Glute bridge lying on your back.
Side-lying hip abduction (lift the top leg).
Seated knee extension, with a rolled towel under your knee.

How we treat it at the clinic

We examine the knee, but also the hip, ankle and lower back, because the problem isn't always where it hurts. Treatment combines gentle manual techniques and mobilisation of the joints involved with a progressive exercise programme and advice for your sport or daily life. If the examination points to a ligament or meniscus injury that needs imaging, we refer you to a doctor.

When to see a doctor

You can't bear weight or take four steps after a fall or blow.
The knee swells within hours of a twist (there may be blood inside the joint).
The knee locks (you can't straighten it fully) or gives way often.
A hot, red, swollen knee with no injury, or with fever.
Pain and swelling in one calf.
Pain that hasn't improved at all over several weeks.

Frequently asked questions

What does gonalgia mean on a medical report? That you have knee pain. "Right" or "left gonalgia" gives the side; "bilateral gonalgia" means both knees. It doesn't say the cause.

Is gonalgia serious? Usually not. Most knee pain comes from overload or osteoarthritis and improves with exercise and load management.

Can I play sport with knee pain? Yes, in most cases, adjusting what triggers it. A useful guide: pain during exercise shouldn't go above 3 out of 10 and should settle back within 24 hours.

Do I need an MRI? Not always. It's requested if a ligament or meniscus injury is suspected that would change treatment, or if you're not improving.

Are gonalgia and osteoarthritis the same? No. Osteoarthritis is one possible cause of gonalgia, mainly from 50 onwards.