Knee pain going up or down stairs? Causes, quick checks and what actually helps

Quick answer, as of October 2026: Knee pain on stairs can come from the kneecap joint, osteoarthritis, a meniscus problem or a tendon. The direction of the stairs cannot diagnose the cause. A targeted exercise plan is often part of treatment; PRP may be discussed for selected knee osteoarthritis after assessment, but it is not a treatment for every painful knee.

Why do my knees hurt on stairs?

• Pain behind the kneecap, known as patellofemoral pain, affects around 22.7% of the general population in a year, according to a 2018 systematic review in PLOS ONE.
• The same review reported an annual prevalence of 28.9% in adolescents, so stair pain is common at every age.
• Stairs load a bent knee and can provoke pain around the kneecap. Pain on descent is not specific to one diagnosis.
• Strengthening the thigh and hip muscles is the foundation of treatment for most causes of stair pain.
• The London PRP Clinic by The Wellness offers doctor-led knee assessment, with knee PRP from £750, with a free doctor review on WhatsApp.

Why can stairs bring out knee pain?

Knees can hurt on stairs because climbing and descending put far more load through the front of the knee than walking on flat ground. The kneecap presses harder against the thigh bone as the knee bends under body weight. Problems in the joint and surrounding tissues can become more noticeable during this loaded movement.

Stair pain is common. A 2018 systematic review in PLOS ONE reported that patellofemoral pain, a common cause, affects around 22.7% of the general population and 28.9% of adolescents in a given year. The review cautioned that estimates varied between populations and that the evidence was limited. These figures are not a diagnosis or a measure of stair pain itself.

Ask a doctor about your knee pain on WhatsApp and tell us whether it hurts more going up or down.

What are the most common causes of knee pain on stairs?

Possible causes include the following. Patterns overlap, so symptoms alone cannot confirm the diagnosis.

1. Patellofemoral pain. A dull ache behind or around the kneecap, worse going down stairs, squatting or after sitting for a long time.
2. Knee osteoarthritis. Aching and stiffness, often on the inner side of the knee, worse after rest and in people over 45.
3. Meniscus tear. Pain on the inner or outer side, worse with twisting, sometimes with catching or swelling.
4. Patellar tendinopathy. Pain just below the kneecap, worse with jumping, running or climbing stairs two at a time.

Is pain going down stairs different from pain going up?

The pattern is useful to describe, but not specific enough to diagnose a condition. Going down stairs makes the thigh muscles work while lengthening to control the descent, which loads the kneecap joint heavily. Pain on descent can occur with patellofemoral pain or arthritis, among other problems.

Pain on ascent can occur with joint or tendon problems. Twisting pain, swelling or catching can prompt a doctor to assess the meniscus, but are not proof of a tear. These patterns are a guide, not a diagnosis, so a doctor's examination is the reliable next step.

Quick checks you can do at home

A few simple checks help describe stair pain clearly to a doctor. None of them replaces an examination.

• Note whether pain is worse going up, going down or both.
• Point to where it hurts, whether behind the kneecap, below it, or on the inner or outer side.
• Check whether the knee swells after activity or feels stiff after sitting.
• Notice any catching, clicking or the knee giving way.
• Record whether pain wakes you at night.

Book your free suitability review on WhatsApp and share what you notice.

What actually helps knee pain on stairs?

For osteoarthritis and kneecap-related pain, tailored exercise is a core part of care. A clinician or physiotherapist can adapt it to the cause and your capacity. Avoid forcing a painful or unstable knee. A plan may include the following.

1. Strengthen the thigh muscles with exercises such as sit to stand, wall sits and step-ups.
2. Strengthen the hip muscles, which keep the knee aligned on each step.
3. Reduce aggravating load for a few weeks, for example by using the handrail and taking stairs one at a time.
4. Keep active with low-impact exercise such as cycling or swimming.
5. Manage weight where relevant, since every step loads the knee with several times body weight.
6. Add medical treatment where the cause suits it, after a doctor's assessment.

When can PRP help knee pain on stairs?

PRP may be discussed for selected people with mild to moderate knee osteoarthritis after exercise and other care have been considered. A 2025 meta-analysis by Bensa and colleagues included 18 randomised trials and 1,995 people. It found clinically relevant WOMAC function improvement over placebo at 1, 3, 6 and 12 months and pain relief at 3 and 6 months. Results varied with platelet concentration.

That is not a guarantee of benefit. The RESTORE trial found no significant advantage over saline for pain or cartilage volume at 12 months in 288 people. NICE HTG497 says efficacy evidence is limited in quality and requires special governance, consent and audit or research arrangements. PRP is not a proven cartilage-regrowth treatment.

Evidence for other causes cannot be assumed from knee-arthritis trials. Patellofemoral pain is usually managed with education and exercise; tendon or meniscus problems need their own assessment and treatment plan.

When should I see a doctor about knee pain on stairs?

NHS knee-pain advice recommends urgent advice from 111 if the knee is very painful, badly swollen or misshapen, cannot move or bear weight, locks, gives way or painfully clicks. A hot or red knee with fever or feeling shivery can indicate infection and needs urgent assessment. Do not wait for a routine PRP review for these symptoms.

Arrange a non-urgent review if pain is not improving within a few weeks, is disrupting sleep or is limiting normal activities.

What happens at The London PRP Clinic?

A knee assessment at The London PRP Clinic by The Wellness starts with a free doctor review on WhatsApp. Approved patients see a doctor at the clinic, who examines the knee and confirms the cause. The doctor decides whether imaging is needed and which test would answer the question. Any separate costs are confirmed first.

Where PRP suits the cause, the number and spacing of injections are agreed individually, alongside a strengthening programme.

Request your knee plan on WhatsApp and a doctor will outline the next steps.

How much does knee PRP cost in London?

As of October 2026, The London PRP Clinic by The Wellness offers doctor-led knee PRP from £750. The doctor confirms the full plan and cost before treatment begins. Read our full guide to PRP joint injection costs in London.

How does the free suitability review work?

The free suitability review is a doctor's honest opinion before any appointment. Send a short description of your knee pain, when it hurts most, what you have tried and any scan reports through WhatsApp. A GMC-registered doctor reviews the case and either approves you for a consultation or recommends a more suitable route.

Start your free knee review now, call +44 20 3951 3429, or email team@thewellnesslondon.com.

Frequently asked questions

Why does my knee hurt going down stairs but not up?

Descending loads a bent knee as your muscles control the movement. Kneecap-related pain and arthritis are possible causes, but this pattern alone does not establish the diagnosis.

Is knee pain on stairs a sign of arthritis?

Knee pain on stairs can be a sign of arthritis, especially with stiffness after rest in people over 45. It can also come from the kneecap joint, a meniscus tear or a tendon problem, so a doctor's examination confirms the cause.

What exercises help knee pain on stairs?

A physiotherapist may use sit-to-stand, step-ups and hip or thigh exercises, tailored to the cause. Start gently and stop if there is sharp pain, instability or new swelling. Do not exercise through urgent symptoms.

Can PRP help knee pain when climbing stairs?

PRP may help some people with mild to moderate knee arthritis, but results vary and some trials show no benefit over placebo. It is not a treatment for every cause of stair pain.

Where can I have my knee assessed in London?

The London PRP Clinic by The Wellness offers doctor-led knee assessment, with knee PRP from £750 in London.

About The London PRP Clinic

The London PRP Clinic by The Wellness is a doctor-led regenerative medicine clinic in London. The clinic offers PRP for joints, tendons, hair and skin, with every treatment planned and performed by GMC-registered doctors. Any imaging needs and separate costs are discussed before booking.

References

1. Smith BE and colleagues. Incidence and prevalence of patellofemoral pain, a systematic review and meta-analysis. PLOS ONE, 2018.
2. Bensa A and colleagues. Platelet-rich plasma versus placebo for knee osteoarthritis, meta-analysis. American Journal of Sports Medicine, 2025.

Smith et al: patellofemoral pain prevalence, 2018. NICE osteoarthritis exercise and weight-management guidance.

Reviewed by The Wellness Clinical Team. Updated 22 October 2026.

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