What causes pain behind the knees after intra-articular injection to the knees?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

Pain behind the knees after knee injections is a common side effect that typically resolves within a few days, and the most effective management strategy is to apply ice to the area, take over-the-counter pain relievers, and rest the knee while keeping it elevated, as recommended by the most recent and highest quality study 1.

Management of Pain Behind the Knees

To manage pain behind the knees after knee injections, consider the following:

  • Apply ice to the area for 15-20 minutes every 2-3 hours
  • Take over-the-counter pain relievers like acetaminophen (Tylenol) at 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours as needed
  • Rest the knee while keeping it elevated
  • Avoid strenuous activities for 24-48 hours after the injection The pain occurs because the medication can temporarily irritate surrounding tissues or because fluid from the injection may leak into the back of the knee joint (popliteal area) 1.

Monitoring for Complications

If the pain is severe, worsens after 2-3 days, is accompanied by significant swelling, redness, warmth, fever, or inability to bear weight, contact your healthcare provider as these could indicate infection or other complications 1.

Expected Outcome

Most patients experience relief from their original knee pain within a few days after the temporary post-injection discomfort subsides, and intra-articular corticosteroid injections have been found to reduce joint pain and improve function in OA-related knee pain, although the effects are time-limited without long-term improvement at 2-year follow-up 1.

From the Research

Pain Behind the Knees After Injection

  • The available studies do not directly address the issue of pain behind the knees after injection to the knees 2, 3, 4, 5, 6.
  • However, some studies discuss the management of musculoskeletal pain and the effectiveness of different pain medications, which may be relevant to understanding pain behind the knees after an injection 2, 5, 6.
  • A study on the prediction and management of chronic postsurgical pain after total knee replacement found that a botulinum toxin A injection provided meaningful pain relief for about 40 days in patients with chronic postsurgical pain after knee replacement 3.
  • Another study compared the efficacy of oxycodone/acetaminophen to that of acetaminophen alone as second-line treatment for patients with acute musculoskeletal pain who were administered prescription-strength ibuprofen and reported insufficient relief 1 hour later, and found that oxycodone/acetaminophen resulted in slightly greater pain relief than acetaminophen, but was associated with more medication-related adverse events 2.
  • A review of systematic reviews and meta-analyses found that ibuprofen was consistently superior to paracetamol at conventional doses in a range of painful conditions, including acute post-operative pain, dysmenorrhoea, tension-type headache, migraine, osteoarthritis, and rheumatoid arthritis 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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