Manage Knee Pain at Night: Causes and Effective Treatment

SLEEPLESS NIGHTS DUE TO KNEE PAIN

Knee pain at night is an unpleasant feeling as you’ve been on your feet all day or maybe you’ve had a big workout or a long run. Knee pain does not let you fall asleep. Generally, your nocturnal knee pain makes it hard to drop off, wakes you up, or leaves you feeling restless. This can have a big impact on your quality of sleep along with general health and quality of life.

The stresses and strains on our knees build up over the day and once you finally relax and unwind, knee pain can strike with a vengeance.

WHAT CAUSES KNEE PAIN AT NIGHT?

Knee pain results from numerous issues, from injury to tendonitis (irritation of tendons) to bursitis (irritation of bursa sacs that cushion your bones and joints). But primarily knee pain is usually a form of arthritis. Some of the reasons for knee pain include:

Gout: This is a common cause of knee pain, particularly, at night while sleeping. Uric acid build-up causes crystals to form in joints that result in inflammation, excruciating pain, and swelling. Knee pain due to gout frequently flare-up very suddenly at night as the crystals form in the joints at lower body temperature. This often results in debilitating nocturnal knee pain, redness, heat, and swelling in the knee. Gout can be easily treated with a combination of rest, medications, and ice and usually settles in a week or two. But, there might be a high risk of recurrence unless proper preventative strategies are applied.
Knee Arthritis: This is a common cause of knee pain at night especially at the age of ‘60s. Arthritis leads to thinning of the knee cartilage and bone spur formation that causes narrowing of the joint space. The fluid that is surrounding the knee joint in form of a capsule helps in nourishing, lubricating, and cushioning the joint. The fluid can dry up overnight, and the knee bones start to rub against each other. This would result in knee pain at night and stiffness in the joint when you wake up. The pain would eventually ease once you get going for the day but often return in the evening.
Inflammation & Activity: Tendonitis, knee sprains and strains, trauma, bursitis, and rheumatoid arthritis can cause swelling or inflmation in the knee joint, especially at night. There is less space in and around the knee joint, so any injury that causes swelling or excess fluid in the joint. A cartilage tear can increase the pressure resulting in a dull, achy pain in the knee. Physical activity can increase the blood flow to joints causing swelling. Inflammation can increase due more you use the knee joint that tends to peak in the evening. Physical exertion can also cause a build-up of lactic acid in muscles leading to delayed onset muscle soreness.
Growing Pains: Children may suffer from knee pain at night during their growth spurts. The leg bones grow faster than lengthening the leg muscles, exerting a lot of pressure or tension through the muscles and tendons. This can start to pull on the bone, causing knee pain to worsen at night.
Osteonecrosis (Avascular Necrosis): This is a condition resulting from the death of bone tissue due to a lack of adequate blood supply. You may experience severe pain on the inside of the knee with tenderness and joint swelling. You may experience pain when bending or straightening the knee along with a limp when walking.
Knee Tumor: A knee tumor at the knee joint is rare. Typically, a tumor will develop slowly, causing intermittent and eventually constant pain accompanied by joint swelling. Pain may be more notable at nighttime, causing awakening from sleep.

WHY DOES KNEE PAIN WORSEN DURING NIGHT?

There are numerous reasons for knee pain during the night, but commonly the pain could worsen at night time:

Lack of Distractions: During the day people are distracted by various things. When we climb into bed, due to less stimulation and diversions to distract us, the pain becomes evident.
Sleep Deprivation: Knee pain at night can quickly become a vicious cycle. Sleep deprivation increases pain sensitivity, decreases pain thresholds, impair healing, reduces tolerance levels, and increases fatigue. The pain levels increase and the cycle continues and knee pain at night gets progressively worsen.
Carbon Dioxide and Blood Vessels: Decrease in carbon dioxide during sleep due to a decrease in the number of times we breathe in and out per minute. A decrease in the level of carbon dioxide in our blood increases causes blood vessels to dilate putting pressure on surrounding nerves causing knee pain at night.

HOW TO TREAT NIGHT KNEE PAIN?

Various treatment options help relieve knee pain at night such as gentle exercises, over-the-counter medication, and home remedies such as ice or heat packs, relaxation, and deep breathing.

Ice or Heat Packs: Knee ice wraps typically work better in the short term following an injury, heat pads tend to be better with long-term conditions.
Elevate Your Legs: Resting your knee by elevating up on cushions or pillows helps reduce any swelling in the knee.
Comfortable Sleep Position: A comfortable sleep position and support in a bed can help in relieving and preventing knee pain. Some extra support to the knee while sleeping helps relieve pain and sleep better. Placing a knee support pillow between your knees while you sleep on your sides provides comfortable support and helps take some of the pressure off the knees. While sleeping place the knee in a comfortable position, like placing a pillow between your knees to relieve pain and sleep better.
Relaxation Techniques: Listening to relaxing music, visualization techniques, deep breathing, or meditation app helps in relaxing and sleeping better.
Take Medication: Your doctor may advise pain relief and anti-inflammatories for knee pain to get better sleep.
Topical Analgesic: If you don’t want to, or can’t, take oral medication, your doctor may advise topical analgesics available as gels, creams, sprays, and patches. These can be applied directly to your knee and help reduce pain and inflammation.
Walking Aids: If you are getting knee pain during the day, try using a stick or crutches to reduce the pressure and stress on your knees so the pain doesn’t build-up
Supplements: Natural supplements, such as omega-3, SAM-e, and feverfew, might help to reduce your knee pain at night, particularly if you have arthritis.

OUTLOOK

Knee pain that worsens during sleep may be treatable with some prevention techniques and strategies. Home therapies focus on temporarily relieving or preventing symptoms from occurring. But, you should still consult your healthcare provider if your symptoms do not improve.