What causes knee pain at night - What can you do to treat it?

Do you find it hard to fall asleep - or do you wake up in the middle of the night because your knee is hurting? In this article, you can read about the different causes the pain may have and what you can do to relieve it.

With a few easy steps, you can break the vicious circle of sleepless nights.

Injurymap helps you treat your pain Learn more
Sanne-Maria Bjerno Medical Writer
Medically reviewed by 

Knee pain at night can take its toll on your quality of sleep and subsequently your quality of life. Lack of sleep can make the pain seem worse, which in turn makes it even harder to get a good night’s sleep. And that may quickly turn into a vicious circle.

At Injurymap we wish to help relieve pain in the knee during the night by giving you an overview of the different causes and what to do if you experience knee pain.

Knee pain is very common. People of all ages and at all levels of physical activity will be afflicted by it at some point for a shorter or longer period.

However, it is most common for people over the age of 50, since the knee is subject to a considerable amount of wear and tear over the course of a life.

The knee joint is one of the most complex joints in the human body, since it is where the femur (thighbone), patellar (kneecap), fibula and tibia (the two bones in your lover leg). On top of that, the knee consists of four ligaments, two menisci, several tendons, and cartilage.

This makes the knee susceptible to many types of injuries which - just like autoimmune and joint diseases in the knee - can make it difficult to keep up with daily activities.

What causes knee pain at night?

There are several causes to nightly knee pain, many of which can be treated with exercise, pain-relieving habits, and over-the-counter pain medication.

Knowing the cause of the pain makes it easier to determine the best way to treat and relieve the pain. Here are the most common causes. You may also find relevant information in these articles about Osteoarthritis of the knee, Jumper's knee and 10 Common Sources of Knee Pain

Knee Anatomy

1. Arthritis

Osteoarthritis is the most common cause of knee pain at night among people over the age of 50. In fact, when examining the knee with radiography, up to 70 percent of people with chronic knee pain will show evidence of osteoarthritis, according to research published in British Medical Journal.

Osteoarthritis is a degenerative joint disorder, which means that cartilage is worn down. When the cartilage is gone, the bare bones rub against each other, which can be very painful. Osteoarthritis is chronic and cannot be healed completely, though it is possible to slow down the degeneration.

Knee pain

Rheumatoid arthritis is an autoimmune condition where antibodies attack the tissue surrounding your joint. As a result, the thin layer of cells covering your joints becomes sore and inflamed.If rheumatoid arthritis is not treated, the joint may lose its shape and alignment. This can eventually destroy the joint completely.Just like osteoarthritis, this type of arthritis is chronic and cannot be healed completely. With the right treatment, it is often possible to slow down and even stop the progression of the condition.

Post-traumatic arthritis is a condition that afflicts the knee after an injury(trauma), for example, a torn meniscus, a ligament injury, or a knee fracture. In the case of post-traumatic arthritis, the trauma can cause damage to the cartilage of the joint, making it start to break down. Several years may pass from the time of the injury before you experience any symptoms of post-traumatic arthritis.

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2. Gout

Gout is a common cause of knee pain at night. Gout occurs when your body is unable to break down uric acid, which is a waste product of many types of food. Instead of being passed out in your urine, uric acid builds up in your bloodstream, causing crystals to form in joints such as the knee. This leads to inflammation, severe pain and swelling in the knee.

Gout knee symptoms frequently come without warning during the night, as you stop moving and the temperature and blood flow within the joint lowers.

Your knee may periodically become hot, swollen, red and very painful.


3. Patelllar tendonitis

Patelllar tendonitis, also called patellar tendonitis, is an inflammation of the tendon that connects your kneecap to your shinbone. Tendonitis is felt as pain just below your kneecap.

The condition is also called “jumper’s knee” because it often afflicts people who play soccer, basketball, volleyball and other types of sports where jumping and turning are frequent.

You can read more about tendonitis here

4. Bursitis

Bursitis is an inflammation of a bursa, a small fluid-filled sac near your knee joint. There are several bursae in and around your knee joint. The bursae work as a cushion that reduces friction and pressure between your bones and the tendons, muscles, and skin near your joints.

All bursae can become inflamed, but the most common inflammation occurs within the bursa situated on the inner side of the knee, under the joint line.

Want to know more about knee bursitis check out our article

How do I relieve knee pain at night?

There are several ways for you to relieve pain in your knees, even if you do not know what causes it.

However, if the pain does not subside, you should talk to your doctor in order to diagnose the cause of the pain and find the right treatment.

Making simple changes to your daily routines can help prevent your knee from becoming painful during the evening and night.

Preventive measures during the day

  • Rest regularly and give your knees small breaks during the day. Elevating your knees on a chair may reduce swelling.
  • Use compression wraps to reduce swelling and support the knee. Do not wear compression overnight.
  • Choose supportive, cushioned, flat footwear to relieve the pressure going through the knees.
  • Stop smoking. Smoking affects blood circulation and prolongs healing time if your knee has sustained an injury.
  • Lose weight. Any weight loss reduces the amount of strain your body puts on its joints, and especially your knees.

Preventive measures before going to bed

  • Applying warmth or cooling down the knee for 15-20 minutes before bed can ease the pain. Heat improves circulation in the knee and softens rigid tissue. Cold calms inflammation and brings down swelling. Try out what works best for you.
  • Rest on your back with your legs elevated higher than the level of your heart. Do this each night for 20 minutes before actually going to bed. This reduces swelling in the knee.

Is exercise helpful or should I rather rest the knee?

Exercising a knee that causes you pain may seem counterproductive. But research shows that staying active relieves pain, swelling, and stiffness of joints afflicted by arthritis, gout, or other chronic diseases.

Moderate exercise helps you keep full motion of the knee and strengthens the muscles supporting the joint. These positive effects can be achieved with different types of exercise, such as cardio, strength, and coordination.

If you exercise for at least 30 minutes per day, five days per week, you should experience better mobility and less pain within four to six weeks. You can even break the half-hour down into three 10-minute sessions each day if that works better for you.

If the pain gets worse during or after exercise, you should consider

  • Lowering the intensity
  • Shortening the duration
  • Seeking experts’ help adjusting your methods
  • Talking to your doctor

Are you unsure of how you get started with exercising? The Injurymap app motivates you and adjusts your exercise plan to help you treat your knee pain (at night).

Other tips for exercising when experiencing knee pain at night

  • Warming up before physical activity is important, as is cooling down afterward
  • Taking a break and giving your knee rest on long distances may prevent pain
  • Switching from running on the road or a treadmill to exercising on a bicycle or an elliptical reduces the strain on your knees
  • Exercising in warm water takes the weight off your joint and helps to keep the joint mobile and active

Best exercises for the pain-afflicted knee

You can complete your exercises at home. With these exercises, you do not require any special equipment.

  1. Squat

    Why it works: This exercise strengthens the muscles on the fronts and backs of your thighs, along with the gluteus

    Squat I
    10 reps x 3 sets

    This browser does not support the video element.

    • Stand up in front of a chair without touching it.
    • Stand on both legs with your feet slightly apart.
    • Your toes should point straight ahead.
    • Bend your knees slowly to a point where you almost touch the chair.
    • Then slowly go back up.
    • Perform 3 sets of 10 repetitions.
  2. Heel lift with bent knees

    Why it works: This exercise strengthens the muscles on the fronts and backs of your thighs, as well as your buttocks.

    Heel lift with bent knees I
    5 reps

    This browser does not support the video element.

    • Stand with your feet slightly apart.
    • Your toes should point straight ahead.
    • Slowly move your knee past the toes so that your ankle and knee bends.
    • Move the knees forward as far as possible, so that the ankle is bent to a maximum.
    • You should feel it tightening in the back and front of the ankle, but it should not hurt.
    • Keep your knees bent while slowly raising your heels, so that you're standing on your toes.
    • Hold your balance for a few seconds then slowly lower your heels again.
    • Perform 5 repetitions.
  3. Hamstring stretch

    Why it works: This exercise stretches and strengthens your hamstrings, which are the muscles on the backs of the thighs that attach to the knees.

    Hamstring stretch
    30 sec. x 3 sets

    This browser does not support the video element.

    • Lie on your back.
    • Bend one leg and use both hands to grab your thigh.
    • Pull your thigh up against your chest, so that it's vertically over you.
    • Then, stretch the knee as much as possible.
    • You should feel a stretch in the back of your leg and knee.
    • Hold the position for 30 seconds and repeat 3 times on both legs.

Other treatment options for knee pain at night


NSAID (Non-Steroidal Anti-Inflammatory Drug, e.g. Ibuprofen): Taking an over-the-counter pain medication of the type NSAID, may also help ease pain and calm down inflammation. There is a risk to this type of medication, as it is associated with stomach ulcers, heart or kidney trouble. Therefore, you must talk to your doctor about taking this type of medication

Topical analgesic: Topical analgesics often come in the form of a gel, cream, spray and patches that you apply directly onto your knee. They help reduce pain and inflammation by soaking through the skin directly to the knee joint.

When to see a doctor

If the pain does not subside or it gets worse, you should see your doctor. Knee pain can eventually interfere with your daily activities, making it hard for you to make it through the day without help from others.

Your doctor will be able to assess your pain and prescribe other medications or treatments if needed.

Other treatments include

  • Steroid injections in the joint
  • Injections of hyaluronic acid supplements, which lubricate the knee joints and result in smoother motion
  • biologic response modifiers, which can help prevent your immune system from causing joint inflammation, in autoimmune joint diseases
  • disease-modifying antirheumatic drugs (DMARDs), which can specifically help with rheumatoid arthritis, and other autoimmune causes of arthritis

Surgery of the arthritic knee

For those who have advanced arthritis in the knee, and for whom non-surgical methods have been tried without luck, joint replacement surgery may be the ultimate solution. This is often only considered when the ability to walk is a stake.

Surgical treatments include:+ Restructuring damaged joint: This procedure includes smoothing or reshaping bone surfaces (osteotomy).+ Replacing the joint: With this procedure, the damaged knee joint is removed and replaced with a new plastic or metal joint.

Treat your pain with Injurymap

Download the app to get a customized program that addresses your specific pain with exercises.

About the author

Sanne-Maria Bjerno has 10 years’ experience writing about health, medicine, and treatment. She is a trained journalist originally educated at Medicine Today Denmark and has since worked for the largest Danish public hospital, Rigshospitalet, the doctors’ union and the physiotherapists’ union. Her passion for creating useful, evidence-based information aimed at broad audiences has given her a comprehensive knowledge about most types of health, treatment and medical research related subjects.

References: British Medical Journalhttps://www.bmj.com/content/335/7614/303

Mayo Clinichttps://www.mayoclinic.org/symptoms/knee-pain/basics/causes/sym-20050688?p=1

U.S. News Healthhttps://health.usnews.com/conditions/pain-management/knee-pain/articles/knee-pain-at-night

Medical News Todayhttps://www.medicalnewstoday.com/articles/325786


Bel Marra Healthhttps://www.belmarrahealth.com/knee-pain-at-night-causes-and-home-remedies/

Knee Pain Explainedhttps://www.knee-pain-explained.com/knee-pain-at-night.html