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Physical changes in and around your knee only explain part of your pain. Sensors in your knee, messages in your nerves and spinal cord, and circuits in your brain are all part of the pain system.

Pain and harm

Tissues in the body have an amount of force or load they can take before being harmed. Luckily, pain protects you by warning when your body may be in danger. For example, if you bend your finger backwards far enough, it will start to hurt. If you let it go at this point, the pain will have saved you from harm.

Pain from a long-term condition like OA may be more complex. OA pain can be over-protective. This means you feel pain a long time before reaching the point of danger or harm.

You feel pain before harm. It is safe to feel some pain.

Your pain is changed by more than just what’s going on in your knee.

Pain is also changed by things elsewhere in your body and elsewhere in your life.

The brain makes knee pain when all the information it has says that the knee needs protection. This includes what you're doing, what you're thinking, and how you're feeling. It also includes what's happened in the past, and what you expect to happen. 

When you are angry, worried, feeling down, stressed, tired, or sleeping poorly, the knee problem seems worse. So, you get more pain. This does not mean that your knee is more damaged.

You do not have direct control over your brain making more or less knee pain. If you realise why this happens, you can change how you view and react to these changes in pain. This way, the pain may have less effect on you and your life.

“Keep rising above it. I had to keep my personality the same, and not sit back and wallow in self-pity. It's helped me, even though the pain is quite bad.”
tui, 64 YEARs OLD, knee pain for 11 months
The pain from OA often changes from day to day. This does not mean that your joint problem is changing a lot, or that you’ve done something wrong. Rather, it means the amount your body tries to protect your knee can change.

Sometimes you may have more pain or stiffness than normal for a week or so. It may be a good idea to ease back a little while this settles, but don’t stop altogether.
“I actually did change my mindset about things... I tried to change how I feel, instead of moping around... After that, my knee wasn't as sore. And I was more active too, actually.”
Sela, 36 YEARs OLD, knee pain for 6 months