Total knee replacement is meant to relieve pain, improve mobility, and help you return to an active life.
But sometimes, even after surgery, a new kind of discomfort shows up—pain behind the knee.
If that’s what you’re dealing with, you’re not alone.
Many people wonder: what causes pain behind the knee after total knee replacement?
Let’s walk through the possible reasons for that knee pain, what to watch out for, and how to get lasting relief—especially with the support of Marin Regenerative Health.
GET RELIEF FROM YOUR KNEE PAIN
Understanding the Back of the Knee
The area behind your knee, called the popliteal region, is packed with muscles, tendons, nerves, and connective tissues.
This includes the hamstring tendons, the gastrocnemius muscle (part of your calf), and major nerves like the tibial and peroneal.
These structures can become irritated during or after surgery, leading to that stubborn pain in the back of the knee.
What Causes Pain Behind the Knee After Total Knee Replacement?
Let’s take a look at some of the causes for pain behind the knee after total knee replacement:
Baker’s Cyst
A Baker’s cyst is a fluid-filled bump that can form behind the knee, often because of swelling inside the joint.
After a knee replacement, the body sometimes produces extra joint fluid, which collects and builds pressure.
This can feel like tightness, swelling, or aching—especially when you bend your leg.
Studies show that these cysts can persist for long periods without treatment.
Arthrofibrosis
Arthrofibrosis happens when too much scar tissue builds up after surgery.
This limits movement and can cause pain, especially when trying to bend or straighten the knee.
The tension it creates often shows up in the back of the knee.
Nerve Irritation or Damage
Pain that burns, tingles, or shoots down your leg might be nerve-related.
The peroneal and tibial nerves run through the back of the knee, and they can become irritated by swelling, scar tissue, or even surgical trauma.
Tendon or Ligament Strain
Sometimes it’s the soft tissues doing extra work.
The hamstrings and calf muscles are responsible for knee stability and movement.
After surgery, poor posture, overuse, or weak surrounding muscles can lead to inflammation or tightness, especially behind the joint.
Implant Positioning Issues
If a knee implant isn’t aligned just right, it can create uneven tension in the knee.
That stress often builds up in the back of the knee and becomes more noticeable with walking, stairs, or standing for long periods.
Referred Pain
Not all knee pain starts in the knee.
Issues in the lower back or hips can send pain signals that feel like they’re coming from behind the knee.
This is called referred pain, and it’s often overlooked.
Infection or Deep Inflammation
Although rare, post-surgical infection is serious.
Pain behind the knee can be a sign, especially if it’s paired with swelling, redness, warmth, or fever.
If you think there’s an infection, don’t wait—get medical help right away.
When to Get Help
Pain is common during recovery, but there are signs that something more serious might be going on.
Contact your provider if you notice:
- Pain that’s getting worse instead of better
- Swelling that won’t go away
- Redness, warmth, or oozing near the incision
- Fever, chills, or fatigue
- Numbness or weakness in your foot or leg
These symptoms could mean there’s an infection, a problem with the implant, or nerve damage.
Early treatment is always better.
How Doctors Figure Out What’s Causing the Pain
A clear diagnosis makes all the difference.
Your doctor might:
- Check your range of motion, strength, and tenderness
- Order imaging like an X-ray, MRI, or ultrasound
- Use aspiration to test joint fluid
- Try a nerve block to see if nerves are involved
Each of these helps narrow down the source so you can get the right treatment.
Treatment for Pain Behind the Knee After Total Knee Replacement
Here are some of the treatment option for pain behind the knee:
Home and Conservative Care
Many people improve with simple steps like:
- Resting and avoiding irritating movements
- Icing and elevating the leg
- Taking anti-inflammatory medications
- Using a compression sleeve
- Working with a physical therapist to stretch and strengthen surrounding muscles
Injections and Minimally Invasive Options
If pain sticks around, other options may help:
- Cortisone shots to calm inflammation
- Hyaluronic acid to lubricate the joint
- Draining a cyst if one is present
- Nerve blocks to reduce shooting or burning pain
These treatments can often reduce symptoms without additional surgery.
Surgical Solutions
If all else fails, and there’s a clear mechanical issue, revision surgery or a cleanup procedure might be needed.
This is more common if the implant is misaligned or if scar tissue is severely limiting movement.
How Marin Regenerative Health Helps with Knee Pain
If you’re still having pain behind your knee after surgery, Marin Regenerative Health offers a different approach—one that focuses on healing, not just masking the symptoms.
We provide non-surgical regenerative treatments that support your body’s ability to recover, including:
- Platelet-Rich Plasma (PRP) therapy, which uses your body’s own platelets to target inflammation and support healing
- Customized physical therapy plans to improve stability, strength, and range of motion without overloading your joint
- Integrated care that looks at the whole picture—joint function, movement patterns, and overall wellness
We work with people who want to avoid additional surgery and get back to doing what they love.
If you’re dealing with long-term knee pain, we’re here to help you move forward.
You can learn more about our approach by contacting us today!
Staying Ahead of Pain: Rehab and Prevention
Even after surgery, your work isn’t done.
Staying active, moving well, and maintaining strength are key to preventing more pain down the line.
Here are some helpful habits:
- Keep up with your physical therapy and follow home exercises
- Focus on building strength in your glutes, hamstrings, and calves
- Avoid staying in one position for too long—get up and move
- Watch your form during everyday activities like sitting, standing, and walking
- Follow up regularly with your provider or specialist if pain returns
Final Thoughts
If you’ve been wondering what causes pain behind the knee after total knee replacement, the answer depends on many factors—scar tissue, nerve issues, fluid buildup, or even referred pain.
But what matters most is this: pain doesn’t mean you’re stuck.
There are ways to treat it, manage it, and prevent it from coming back.
At Marin Regenerative Health, we’re here to help you find long-term relief using treatments that work with your body, not against it.
If you’re ready to feel confident in your knee again, reach out today.
Let’s find a solution that helps you move better and live with less pain.
FAQs
What causes pain behind the knee after total knee replacement?
Pain behind the knee after total knee replacement can be caused by several factors, including a Baker’s cyst, scar tissue buildup (arthrofibrosis), nerve irritation, tendon strain, implant alignment issues, referred pain from the back or hip, or in rare cases, infection. Identifying the root cause is key to effective treatment.
How do you get rid of knee pain behind the knee?
Treatment depends on the cause but often starts with rest, ice, physical therapy, and anti-inflammatory medication. If the pain is due to inflammation or scar tissue, regenerative therapies like PRP or stem cell injections may help. In some cases, aspiration of fluid, nerve blocks, or surgical revision may be necessary.
What does it mean if the area behind your knee hurts?
Pain behind the knee could signal anything from simple muscle strain to more complex issues like a Baker’s cyst, nerve compression, or post-surgical complications. It may also be referred pain from your lower back or hip. A proper evaluation is needed to determine the source.
How long does it take for pain behind the knee to go away?
Mild post-operative pain may improve within a few weeks to months, especially with proper rehab. However, if pain behind the knee persists or worsens after three to six months, further investigation may be needed to rule out complications or secondary issues.
Can you have knee pain after hip surgery?
Yes, it’s possible. Pain in the knee after hip surgery can be referred from the hip joint or related to changes in gait and body mechanics during recovery. If the knee wasn’t previously painful but starts to hurt after hip surgery, it’s important to assess alignment and movement patterns.
What helps with nerve pain after knee replacement?
For nerve-related pain, treatment might include medications for nerve sensitivity, physical therapy to relieve pressure, nerve blocks, or regenerative treatments aimed at reducing inflammation and encouraging nerve healing. Addressing nerve pain early can improve long-term outcomes.
