What causes knee pain at night

Why Do I Have Knee Pain at Night? – Cleveland Clinic

It’s an unpleasant feeling: You’ve been on your feet all day or maybe you’ve had a big workout or a long run. You try to go to bed to rest up, but you can’t fall asleep. The culprit? Knee pain.

Knee pain at night can be incredibly frustrating, especially because you likely didn’t notice any sort of discomfort during the day. It’s only after you lay down for slumber that it feels like it surges forward to keep you awake and cut into your sleep.

To get to the bottom of why this happens and what you can do about it, we talked to orthopedic surgeon Kim Stearns, MD.

What causes the pain?

Knee pain can be caused by a variety of issues, from injury to tendonitis (irritation of tendons) to bursitis (irritation of bursa sacs that cushion your bones and joints). But the primary cause of knee pain, according to Dr. Stearns, is usually a form of arthritis. 

“People with normal, healthy knees usually don’t get pain at night,” he says. “There’s typically a reason, and it’s often because they have arthritis, commonly osteoarthritis.” 

Osteoarthritis is mechanical in nature, caused by wear-and-tear on the joints as well as the cartilage and tendons associated with the joints. This sets the condition apart from rheumatoid arthritis which is inflammation of the joints, typically caused by an overactive immune system. 

While osteoarthritis is typically seen in older patients, it can occur in younger patients, too, particularly those who are prone to overuse of certain joints or suffered significant injuries like ligament tears. 

Why at night?

While activity during the day contributes to the pain you feel in your knees at night, so does the fact that you’ve actually slowed down enough to notice. 

“When you’re moving your joints, they’re also staying lubricated,” Dr. Stearns says. “When you’re not moving, they don’t lubricate as much.” 

Another reason you start noticing the pain? You’re not as distracted by everything else. Dr. Stearns adds, “You don’t have any other distractions around you. It’s quiet and you’re laying still, so you start to notice the discomfort. The lack of movement, the lack of lubrication, it all catches up with you.”

Advertising Policy

How to treat it

Treating this knee pain is all about pain management and what you can do to reduce the stress on those joints. Losing weight is a helpful start. Besides being a key to overall good health, cutting excess pounds lessens the everyday stress on those knee joints and ligaments.

But there are plenty of other ways, too.

Exercise smart

A lot of joint stress is caused by high-impact exercising, especially running on pavement. But there are ways to exercise that can keep you healthy and keep that load off your knee joints. “Low-impact exercises like swimming, bicycling and elliptical are good because they exercise the knee joints but don’t pound them,” says Dr. Stearns.

Knee braces can also be a tool, he adds. “There are special braces that work to keep pressure off of certain parts of the knee — unloader braces — that can sometimes help alleviate arthritis pain.”


If you’re considering over-the-counter (OTC) painkillers to help ease the hurt, Dr. Stearns says it’s best to take naproxen (Aleve) or ibuprofen (Advil) because they have anti-inflammatory properties that can help ease the swelling that’s causing your knee pain. 

“Acetaminophen medications, like Tylenol, don’t work as well because they mask the pain but do nothing about the source of the pain,” he says. 

He also recommends taking the dose after dinner as that allows you to have the maximum dose before you head to bed.

Just be careful: If you’re on any blood-thinner medication, you’ll have to stick to Tylenol or possibly another painkiller prescribed by your doctor because interaction with those anti-inflammatory meds might have dangerous side effects, including internal bleeding. Be sure to check with your healthcare provider to make sure you pick the one that’s best for you.

Cold versus heat

Cold treatment, like ice, can dull pain while heat on injuries can also make a painful joint feel better. The key, though, is to use both. Dr. Stearns says, “Using heat on the sore joint will certainly make it feel better, but it will also increase blood flow to the area. That will eventually leave it more swollen and throbbing.”

Advertising Policy

Instead, he suggests using heat for the initial relief but then switching to cold treatment like ice. “The warmth helps the joint feel better but follow that with cold so the blood doesn’t pool there,” he says. 

Topical gels can also help, he says. “There are prescription gels, OTC gels like IcyHot or Bengay and even anti-inflammatory patches that help bring relief for those painful joints,” he adds.

Again, though, you’ll want to consult with your healthcare provider before going this route to make sure you maximize the treatment and avoid any side effects or additional issues.

How to sleep comfortably

Finally, you can adjust your position in bed to ensure cutting down on that discomfort and getting more sleep.  

“Sometimes, if you have arthritic knees, we suggest sleeping on your side with a small pillow between your knees,” Dr. Stearns says. The position gives more support and keeps your knees from knocking together. 

If you’re a back-sleeper, he suggests trying to sleep with a pillow under your knees. Besides offering support, this keeps your knees slightly bent which can keep bones from pressing together at the worn-down, painful joint. 

“It’s really about finding the position of comfort and using a pillow for cushioning that feels best for you,” Dr. Stearns says. 

How To Relieve Knee Pain At Night

by arizonapain

When you finally lay yourself down to sleep after a busy day, the last thing you want to experience is pain that keeps you awake. When knee pain at night sends you tossing and turning, though, there are ways to care for yourself during the day (and right before bedtime) to make it better. Here’s your guide to managing and preventing knee pain at night.

What causes knee pain at night?

Our knees are complex joints responsible for bearing the weight of our bodies as it travels to our feet. They literally help us move through the world smoothly, connecting four bones—the femur, the tibia, the fibula, and the patella—and two major muscles groups (the quadriceps in front and the hamstrings in the back).

Connecting and stabilizing these bones and muscles are ligaments and tendons, including:

  • The anterior cruciate ligament (ACL): Located on the front of the knee, the ACL prevents the femur from moving backwards onto the tibia
  • The posterior cruciate ligament (PCL): The PCL keeps the femur nestled back where it belongs
  • Medial ligaments: Stabilize the inside of the knee
  • Lateral ligaments: Stabilizs the outside of the knee

In addition to this, articular cartilage lines the patella to smooth movement, as does the meniscus (lateral and medial) tissue that allows the femur and tibia to glide together. Bursa are fluid-filled sacs inside the joint. They further cushion movement, preventing painful bone against bone rubbing.

Any part of this structure can develop painful conditions or suffer from issues that could cause knee pain at night. In general, the five main causes of knee pain at night are:

  1. Knee replacement pain at night
  2. Arthritis
  3. Gout
  4. Injury
  5. Overuse

Knee replacement pain at night

Knee replacement surgery is often the treatment of last resort when other conservative measures have failed to address painful damage to the knee. A total knee replacement removes the kneecap and removes or repairs damaged bone and other surfaces before inserting an artificial replacement. Partial knee replacement surgery is less invasive and preserves the parts of the joint that are healthy.

The level of your knee replacement pain at night depends on which type of knee replacement surgery you get. The recovery time for total knee replacement can be from one to three months. Partial knee replacement offers a faster recovery time of a week or two. Regardless, during recovery, knee replacement pain at night can be extreme and make daytime activities even more challenging.


The most common form of arthritis, osteoarthritis, is also the most common cause of knee pain at night.

Osteoarthritis is a wear-and-tear condition that affects the joints of the body. As we age, cartilage begins to thin and bursa provides less cushion in the joint. If we exercise less and lose supportive muscles in the quadriceps, hamstrings, and calves, the knee joint begins to press more firmly together, rubbing bone on bone as we move.

This rubbing causes inflammation in the joint. It can also cause pain two ways: when we move and when we are still.


When uric acid builds up in the blood, it is deposited as uric acid crystals in the joints. This can cause painful swelling. Gout most often occurs in the toes but can affect the knees, too. Swelling and uncomfortable warmth from gout can cause knee pain at night.

There is another condition called pseudogout that is less common but found in the knee more often than any other joint. A different type of crystal (calcium pyrophosphate) lodges in the joint, causes similar symptoms to gout (i.e., redness, swelling, warmth, and pain).


Injury to any part of the knee, even what you might consider minor, can cause knee pain at night.

This may not be chronic pain but can cause disrupted sleep, nonetheless.


Whether you are a seasoned athlete or a weekend warrior, overuse of the knees can lead to knee pain at night. This includes going for a long bike ride after some time off, playing pick-up basketball games on Saturday mornings, a leisurely hike through the woods, or anything that taxes your knees.

Even if your knees feel good after the activity, you may experience pain when you lay down to rest. You are not as distracted by the demands of your day, which gives pain a chance to present itself.

What does knee pain feel like?

Knee pain can take many different forms. You might experience burning knee pain at night as an uncomfortable, steady warmth in the joint. You may also have throbbing knee pain at night, no matter what position you lie in.

Some people have pain that is sharp when they switch positions after being still. Other forms are not pain at all but can consist of tenderness or swelling inside the joint.

When should I see a doctor for knee pain at night?

In the days after knee replacement surgery or another type of injury, it is normal to expect a little pain at night. A few nights of lost sleep are not anything to worry about.

However, there are times when you should see a doctor for knee pain at night. Schedule a regular appointment if you experience the following symptoms:

  • Unusual or significant swelling
  • Excessive redness (redness that does not go away after the injury)
  • Fever
  • Increased or excessive pain
  • Warmth in the joint
  • Tenderness to the touch

There are also symptoms that warrant emergency treatment for knee pain. These include:

  • Deformed appearance of the joint
  • Pain that makes weight-bearing impossible
  • Injury that causes your knee to make a popping sound
  • Swelling that occurs suddenly

If your knee pain at night consistently interferes with sleep it could make pain during the day worse, too. When it comes to knee replacement surgery, poor sleep can also slow healing times. If pain is steady for three or four days, or intermittent for a week or two, best to schedule a follow-up with your doctor.

How to relieve knee pain at night

Relieving knee pain at night may be simply a matter of practicing a few comfort measures before you settle in for some shut-eye. Other nights, you might need something else.

Here are ten options for knee pain treatments that can help you get some rest.

1. Check your mattress

Is your mattress firm enough to provide the support you (and your knees) need? Sometimes a sagging or too-soft mattress is not a great choice.

As a general rule, replace your mattress every eight to ten years. For knee pain at night, foam mattresses can provide great support, as can a mattress that has independently wrapped coils. Ask your doctor for recommendations, then go give them a try.

Look for mattress companies that offer a money-back guarantee or free exchange, too.

2. Use pillows

Place pillows between your knees for extra support. This relieves pressure on the IT band and also prevents bones from pressing into each other during the night.

3. Establish a nightly routine

Sometimes dreading a poor night of sleep is a self-fulfilling prophecy.

Establish a nightly routine that includes gentle stretches and relaxing routines (e.g., a good book and a hot cup of tea) to set yourself up for sleepy success.

4. Stretch before bed

Knee pain stretches may be as simple as working out tight muscles in your quadriceps, forward folds to release hamstrings, or calf stretches to lengthen and strengthen those muscles, too. Keep your exercises low-key and relaxed. Consider the following:

  • Restorative yoga before bed: A quick 20-minute routine can prepare you for bed and keep all of your joints healthy (see the video below)
  • Stretches for knee pain: These knee pain stretches work the muscles in the lower leg to relieve tightness that applies pressure to the knee joint
  • Strengthening for knee pain: Again, these exercises target the muscles surrounding the knee to provide better support in the joint

As always, check with your doctor before starting any exercise program. If you experience an increase in pain, stop and check in with your doctor again.

5. Time medications

If you are regularly taking medications for chronic knee pain or are on prescribed medicine after surgery, time your medications so that they relieve pain overnight.

6. Use hot or cold packs (or both!)

Hot and cold packs can help alleviate pain and swelling. It may be challenging to sleep with a chilly cold pack on your knee, though.

Alternate this treatment so that you can go to bed with warmth.

7. Treat the underlying condition

If your knee pain is caused by an underlying condition like gout, it’s crucial to get a proper diagnosis and begin treatment. If the condition is unresolved, then further damage can occur.

8. Try TENS

TENS, or transcutaneous electrical nerve stimulation, replaces pain signals with a mild electrical buzzing. Patches are placed on the skin and connected to a patient-controlled device that is about the size of a cellphone. When deployed, a mild electrical current confuses pain signals being sent to the brain.

Some people may find the buzzing sensation distracting, but others are able to get used to it quickly and drift off to sleep. This non-invasive solution is a good conservative treatment option.

9. Consider knee joint injections

There are several types of knee joint injections that can provide long-term relief from knee pain when more conservative measures have failed. Corticosteroid injections can provide relief from pain and swelling. Hyaluronic injections rejuvenate the cushioning and lubrication in the knee.

Knee joint injections are generally recognized as safe, but there are risks and side effects. It’s important to talk to your doctor about all of your options.

10. Look into nerve blocks

A nerve block is a specific type of knee joint injection that prevents nerves from delivering pain signals to the brain.

After a knee replacement, the most common kind of nerve block for knee pain is a saphenous nerve block. For patients who cannot have knee replacement surgery or who are experiencing chronic knee pain at night from other causes, genicular nerve blocks are another option.

Schedule your appointment

At Arizona Pain, we know how challenging it is to be up all night in pain. If you’re in Arizona and knee pain at night is disrupting your sleep and impacting your life, get in touch today. We can help you get back to your life and reduce your nighttime aches.

Knee pain | orthopedic clinic.com

Knee pain © Fotolia.com

Knee pain is a signal of danger and it is a "folk" disease: between five and ten million people in Germany suffer from this disease. There are different types of knee pain. Similarly, its possible causes are varied. A thorough medical examination is necessary in order to determine the exact causes in each individual case.

Both the flashing red light of the oil level indicator in the engine and knee pain should be assessed not as an enemy, but as a necessary warning. It indicates that something is wrong in the knee. And if you respond to this warning in time and eliminate the causes, then many problems can be solved. More dangerous are painless defects, such as small meniscal fissures or incipient cartilage destruction, which can lead to osteoarthritis of the knee without being noticed.

There are two main causes that cause the vast majority of knee complaints: trauma and arthrosis of the knee.

List of treatments (the appropriate method is determined according to individual indications):

medical inquiry

Various types of knee pain

How does it hurt?

Depending on the cause, knee pain manifests itself in different ways. Outwardly, for example, bruising, redness, swelling, fever, and limited mobility are often observed. Pain in the knees can be pulling, stabbing, pressing, as well as continuous dull or convulsive.

Where does it hurt?

It is also very important where exactly in the knee the main source of pain is located: inside or outside, on the front or back of the knee, or in the entire knee region.

When does it hurt?

Many knee pains start when running or climbing stairs. Sometimes symptoms appear only after heavy or prolonged exertion. Some diseases of the knee are characterized by pain even at rest or when sitting: knee pain when sitting for a long time can be a sign of damage to the cartilage under the patella, which the sooner it is detected, the more effectively it can be treated.

Frequent cracking of the knee can also be a sign of joint damage - although it is usually not painful. In the same way, by the way, as the feeling of instability in the knee with cruciate ligament injuries.

Causes and consequences

Pain in the knee after external damage (trauma). Although the knee can withstand up to 1.5 tons of stress for a short time, it is very prone to injury because it is not surrounded by a protective layer of muscle. Bruises, blows during sports or as a result of traffic accidents fall directly on the joint.

In an acute injury or accident, knee pain usually occurs immediately after the accident. Often at rest, the pain after injuries decreases, but returns with exertion. As a rule, after an injury in the joint, an inflammatory process begins and, consequently, night pains at rest.

In an injury to the cruciate ligament of the knee, a feeling of lack of stability in the joint is typical.

Pain in the knee due to joint wear (arthrosis)

As we age, more and more people suffer from joint wear. The reason is the wear of the cartilage layer, which provides easy sliding of the joint and subsequent damage to the cartilage. In diseases associated with wear and tear, there is usually a gradually increasing pain, aggravated by exertion. Initial pains are also characteristic during the first movements after a period of rest. Since there is usually no inflammatory process in arthrosis, as a rule, pain is not observed at night or at rest, unless they were preceded by heavy overloads.

Osteoarthritis sometimes progresses from continuous (chronic) irritation to inflammatory arthritis, which can result in swelling and effusion.

Knee pain may also occur after overexertion with harmless short-term irritation. In addition, knee pain can be caused by radiating pain from another diseased joint. Typical of these "shifted pains" is that in addition to pain in the knee, there is also pain in other joints.

Pain in the knee due to inflammation in the joint (arthritis)

Characteristic features are stiffness of the joints in the morning, severe pain at rest and less pain on exertion. The pain usually gets worse at night.

Knee pain due to cartilage injury A painful change in the cartilage of the patella (chondromalacia patella) manifests itself in severe pain during prolonged sitting or climbing stairs. It is often seen in teenagers. Damage to the cartilage on the surface of the sliding part of the joint often makes itself felt in the later stages of the development of the disease.

What to do about knee pain?

In any case, with constant pain in the knee, you need to consult a specialist. With the help of the necessary diagnostic measures, he can determine the source of the pain, as it may be radiating pain from another diseased joint. It can also detect diseases such as osteoporosis, bone infarction or tumors, which in rare cases can also cause knee pain.

Often knee pain is the result of a short-term overload of the joint and disappears without a trace after a period of rest. Often the pain goes away as quickly as it came. Local cooling and taking light anti-inflammatory and painkillers can speed up the process.

However, in any case, you should not hesitate to go to a specialist: prolonged treatment of a knee injury can lead to irreparable damage. It is better to have a short diagnostic evaluation than the prospect of chronic knee pain due to non-treatment or improper treatment.

medical inquiry

causes, symptoms, diagnosis and treatment

General practitioner


Natalia Vladimirovna

Experience 19 years

First category local general practitioner

Make an appointment

Pain under the knee, sharp and cutting or, on the contrary, aching and intrusive, significantly worsens the quality of life and in most cases requires an appointment with a specialist. Inability to walk or run fast, lameness, increased swelling - these are just some of the side effects of the symptom, and in order to get rid of them, you should figure out what caused it.

Causes of knee pain

There are many reasons for knee pain. The most common are:

Physical injuries:

  • fracture of the knee joint, may be accompanied by displacement of the knee disc. With a fracture, the patient experiences unbearable pain, which increases with pressure on the affected area; the knee cannot be bent, as the joint swells and fills with blood;
  • dislocation - displacement of the position of the bones. In terms of symptoms, it is similar to a fracture: the knee also swells and hurts;
  • torn or sprained ligaments and tendons. Often at the same time, the knees hurt and crunch; while walking, the victim may hear uncharacteristic clicks, observe swelling and excessive joint mobility. The pain is most often cutting or shooting;
  • bursitis - inflammatory processes in the knee area. Puffiness appears, especially knees hurt at night and with excessive physical exertion;
  • meniscal tear - occurs as a result of abnormal cartilage development or injury (impact, displacement, etc.). The victim has severe pain in the joints of the knees, increased swelling is observed, and activity decreases.

Diseases of the joints:

  • rheumatism - a disease characterized by alternating unpleasant sensations, i.e. first the right knee hurts, and then the left, and vice versa. Teenagers are most susceptible to it, as well as people who have recently had streptococcal diseases;
  • reactive arthritis - inflammation of the joint, which appears mainly in people aged 25-35 years. With it, the knee may hurt from the inside, front, back, side or bottom, swelling appears, redness of the affected area, may be accompanied by conjunctivitis;
  • Reiter's syndrome - the symptoms are completely similar to reactive arthritis, however, in addition to them, urethritis and intestinal failure are noted;
  • Osteoarthritis is a disease that affects the elderly. Characterized by aching pain in the knee, aggravated during bad weather, the knee also hurts at night and when walking;
  • Osgood-Schlatter disease - knee hurts when bending, walking up stairs, squats;
  • Rheumatoid arthritis is a completely unexplored autoimmune disease. Manifested in the form of increased swelling. The patient has unbearable pain in the front of the knee, especially at night;
  • gout - appears due to an unbalanced diet, excessive consumption of junk food and alcohol. The patient experiences an obsessive aching pain in the patella.

What to do?

Patients with knee pain should be treated by a physician. Nevertheless, everyone should be able to competently respond and provide first aid in case of injury to the designated area, because the salvation of the patella itself may depend on this.

So, it is necessary to completely immobilize the injured limb together with the joint and apply a cold compress to it, and then seek qualified medical help by calling an ambulance.

The specialist will first of all conduct an examination and prescribe drugs that relieve pain behind the knee or in front, after which treatment will be carried out depending on the cause of discomfort.

Arthritis is treated with drugs that reduce inflammation and kill germs. They are prescribed exclusively by a doctor. Arthrosis requires heat, so experts prescribe warming herbal compresses and ointments to patients, which increase the protective properties of cartilage.

JSC "Medicina" (clinic of Academician Rothyberg) has the most advanced equipment, which allows for a quick and accurate examination of the knee joints. The specialists of the medical center will make the necessary diagnostics, after which they will prescribe the required treatment.

To receive the highest level of care, it is enough to make an appointment with a therapist who will determine the exact cause of pain. Also, in our clinic in the center of Moscow, the best traumatologists, rheumatologists, surgeons and neurologists are waiting for you.

Learn more