Why Does My Knee Pain at Night?

Introduction:

Knees are the joints that bear the weight of the body while a person carries out his daily activities like standing, lifting, bending, jumping, or running. They contain bones, mainly the tibia, fibula, femur, and patella, along with a large group of muscles like the quadriceps and hamstring that help the knees to support the body weight. The muscles and the bones present in the knees are connected by the tendons (connecting muscle to bone) and the ligaments. The ligaments (connecting bone to bone) and tendons allow the gliding movement of the bones and joints. One of the common reasons for knee pain is when these ligaments or tendons get ruptured or torn due to injuries.

Certain medical conditions like arthritis and gout are also responsible for knee pain. Knee pains are commonly experienced by the elderly and athletes. The reason for knee pain in old

age is wear and tear of the cartilage, which is present between two bones forming the joint

and is responsible for frictionless movements of the joint. The athletes are mainly involved in activities that require quick movements like running and jumping. So, they are vulnerable to ligament injuries and knee pain. The patient must consult the doctor for proper clinical evaluation to know about the exact cause of knee pain and to get a proper line

of treatment.

What Are the Conditions That Cause Knee Pain at Night?

Knee pain causes a lot of discomforts, and the patient experiences trouble while walking, standing, running, and doing activities that require movement. However, it has been noticed that knee pain not only occurs during the day but also during the night (even at rest). Sometimes, the pain is so severe that the person is unable to sleep and remains exhausted throughout the day. There are several causes of knee pain at night. Some of the causes of knee pain are described below:

1. Runner’s Knee - It is the most common cause of knee pain in athletes and people involved in sports activities. The pain is mainly felt in the area behind the knee cap. The person feels a dull and throbbing pain throughout the day. Excessive pressure on the knees while running or jumping and the improper position of the knee cap are some of the causes of the runner’s knee pain. The pain usually subsides when the person stays away from these activities and takes pain-relieving medications.

2. Osteoarthritis - Osteoarthritis, also known as degenerative arthritis, is a condition in which the symptoms are not temporary, and the pain persists for a long time. Normally, the soft tissues (cartilage) support the bones present in the knees. As discussed above, they act as cushions and shock absorbers to support the body weight when the person moves. They do not allow the bones to rub against each other and give frictionless movements when the person bends the knees. However, in osteoarthritis, these soft tissues become damaged due to wear and tear. As a result, the bones collide against each other resulting in inflammation. The person feels stiffness in the knees when he tries to bend them. The person feels better in the morning when he gets up, and the pain is worse at the end of the day. As there is no definite cure for osteoarthritis, the patient needs to either undergo the repair or replacement of the damaged tissues.

3. Gout - It is a type of arthritis that occurs when excess uric acid crystals accumulate in the joints. The most common joint involved in gout is the foot, that is, at the base of the great toe, which is known as the first metatarsophalangeal joint, but knee involvement is also not uncommon. Pain, swelling, and tenderness in the big toe and the knees are commonly seen in patients suffering from gout.

4. Bursitis - The knee contains tiny sacs of fluids that allow the gliding movement of the tendons over the joints. These sacs are known as bursae. The problem arises when these bursae swell up due to inflammation or infection and cause knee pain. This condition is known as bursitis. When a person puts excessive pressure on the knees by activities like squatting and kneeling without wearing knee pads, the risk of bursitis increases.

5. Rheumatoid Arthritis - It is a severe type of arthritis in which the person’s own immune system kills the healthy cells of the body. Rheumatoid arthritis is a type of inflammatory disease that can affect any joint of the body, including the knees. The distinguishing feature of rheumatoid arthritis from osteoarthritis is that the pain is worse in the morning, and it becomes better at the end of the day.

6. Injuries - Knee pain not only occurs because of the medical condition but also due to injuries. Fractures, bursitis (due to chronic microtrauma), tendonitis, and ligament and muscle tear are the most common causes of knee injuries. Knee pain occurs when the structures supporting the knees get damaged due to these injuries.

Why Does the Knee Pain Become Worse at Night?

There are several conditions responsible for knee pain. However, the following factors make the knee pain worse at night:

• Cortisol - Cortisol is a type of steroid hormone that regulates the important processes of the body. It is also an anti-inflammatory hormone because it helps manage the inflammation caused due to knee pain or other conditions. During the day, the cortisol levels are high enough to protect the body from inflammation due to joint pain. Also, the person is busy and preoccupied with thoughts related to work and other activities during the day. So, the person tends to ignore the mild or moderate pain. However, at night, the mind is free of thoughts, and the mind is relaxed. Also, the body produces less cortisol, so the patient tends to experience more pain at night.

• Inflammation - When the person sleeps at night, his body is at rest, and there is no activity. As a result, the joints become stiff, making it difficult for the person to walk after he wakes up. Moderate activities like walking, swimming, and yoga help to keep the joints healthy and flexible. So, one of the reasons for knee pain becoming worse at night is the lack of activities. As the patient is simply lying down and not doing any activity, the blood circulation becomes restricted. When the tendons and ligaments present in the knees receive less blood, knee pain occurs frequently.

• Muscles Relaxation- At night, when the person is at rest, the muscles around the knee joint also get relaxed. When the muscles are contracted or in an active state during the day, they brace the knee joint and prevent any loose or sudden movement. But at night, these muscles get relaxed, and there are some loose and higher magnitude of movements which is responsible for more pain.

What Symptoms Are Seen Along With Knee Pain?

Knee pain is not a condition; rather, it is a symptom of various diseases that affect the knees. The other symptoms that the patient experiences, along with knee pain, are listed below:

1. Stiffness and swelling of the joints.

2. The area becomes red and warm due to inflammation.

3. Fever.

4. Weakness.

5. Changes in the appearance of the joint.

6. Popping or crunching sound due to the injury.

7. The patient is unable to straighten his knees.

How to Get Rid of the Knee Pain at Night?

It becomes frustrating when the knees start paining at night because the entire sleep cycle gets disturbed. The following methods help to get rid of the knee pain:

• Warm Bath - Taking a warm bath before going to bed helps to relax the body and relieves joint pain. The warm bath has the following benefits:

  • It improves blood circulation.

  • It helps to reduce the inflammation and swelling that happens due to knee pain.

  • The pressure on the knees is relieved.

  • It supports the knees and the legs.

• Sleeping Position - It is important to sleep in a proper position because a poor sleeping position increases the risk of joint pain. Make sure the knees are supported by a cushion during sleep. The cushions can be placed below or between the knees depending upon the sleeping position. When the knees are supported with the help of a cushion, the chances of pain become less.

• Heat and Cold Pack - Applying heat or a cold pack before going to sleep provides great relief. The patient needs to apply an ice pack or a heating pad for 15 to 20 minutes. This helps to reduce swelling and inflammation. Do not apply ice directly on the knees; instead, wrap it in a cloth or a towel and then apply.

• Bodyweight - Obesity or excessive weight puts unwanted pressure on the knees and increases the risk of pain. It is important to maintain healthy body weight and remain fit. Dietary changes and regular exercise help maintain body weight.

• Changes in the Routine - Certain activities increase pressure upon the knees, and the patient experiences knee pain. The following changes in the routine help to deal with knee pain:

  • Do not lift heavy objects or carry excess weights.

  • Do stretching exercises regularly to prevent knee pain.

  • Wear knee pads or knee braces while squatting down.

  • Always do the correct form of exercise.

  • Patients having walking difficulties due to knee pain can use crutches.

  • Exercise within the limits of the body. Do not strain the body during exercise.

• Knee Massage - Massaging the knee before going to bed improves blood circulation. As a result, the area becomes warm, and the patient is relieved of the pain.

Conclusion:

Knee pain is a common symptom experienced by patients suffering from joint diseases like arthritis, gout, and bursitis. Knee pain can also occur due to injuries like fractures, ligaments, and meniscus tears. The knees are important joints of the body. They contain muscles and bones attached by ligaments and tendons. The knee bears the weight of the body when the person walks, stands, bends, or lifts something heavy. Sometimes, the knee pain resolves when the underlying cause is treated. However, the knee pain persists when it is due to a medical condition like gout or osteoarthritis. The pain becomes worse at night because the patient is relaxed and the cortisol levels are low. As a result, the inflammatory response of the body becomes high resulting in pain and swelling of the knees. If the knees hurt at night, it becomes annoying and frustrating for the patient because he remains exhausted throughout the day. The sleep cycle also gets disturbed, and the patient is unable to focus on his daily activities. If the pain is mild, a warm bath, massage, applying an ice pack, and a good sleep position help a lot. However, consult the doctor if the pain is severe and persists for a prolonged period.