Knee Pain at Night
Knee pain at night is the symptom usually associated with many knee injuries and joint conditions. But some conditions are characterized mainly by knee pain that intensifies at night (also known as nocturnal knee pain). The latter causes sleep disturbance and reduced hours of sleep, which, in turn, can lead to other health problems. Osteoarthritis is the most common cause of nocturnal knee pain. But knee pain at night can also be triggered by other conditions (e.g., certain types of bone tumors). Nocturnal knee pain is often used as a determinant of the extent of knee joint degeneration, as well as a basis for joint replacement surgery.
The causes of nocturnal knee pain are the following:
- Osteoarthritis – As mentioned earlier, osteoarthritis (also known as degenerative joint disease) is the most common factor behind knee pain at night. It is a condition caused by cartilage loss in a joint.
- Ligament injuries – Sudden twisting movements or immense pressure applied on the outer knee (e.g., from a football tackle) can injure the knee’s ligaments, causing pain and swelling. Knee pain associated with ligament injuries generally worsens at night.
- Fat pad irritation – The infrapatellar fat pad (also known as Hoffa’s fat pad) is a soft tissue that is situated at the base of the patella. Sudden twisting movements or a direct blow to the kneecap can render the fat pad impinged (pinched) between the femoral condyle and the patella. The fat pad then becomes irritated, causing pain.
- Osteoid osteoma – A rare type of benign bone tumor that usually affects the femur. Osteoid osteoma often develops in people between 5 and 25 years old, and is more common among males.
- Patellar tendinopathy – Patellar tendinopathy (also known as Jumper’s Knee) usually strikes athletes that are into sports that involve a lot of jumping. This condition is characterized by inflammation or injury of the patellar tendon, which, in turn, leads to knee pain that intensifies while climbing up the stairs, sitting for long periods of time or resting.
Nocturnal knee pain in itself is already a symptom of a more serious knee injury or joint condition. Consult your doctor immediately as soon as you experience knee pain at night.
Since nocturnal knee pain is a symptom of a more serious knee injury or joint condition, your doctor will check if you have an underlying knee injury or joint problem. Below are the ways of diagnosing knee injuries and joint conditions associated with knee pain at night:
- Physical examination – Your doctor will inspect your knee for deformities, inflammation, swelling and muscle wasting. He will also extend and flex your knee as far as possible to determine your joint range of motion.
- Imaging tests – Your doctor may recommend that you undergo an X-ray, a computerized tomography (CT) scan, an ultrasound and/or a magnetic resonance imaging (MRI). These imaging tests allow your doctor to observe the internal structures of your knee (e.g., bones, ligaments, tendons, muscles and cartilages). By doing so, your doctor will be able to accurately diagnose your knee injury.
- Lab tests – Your doctor may recommend that you undergo a biopsy in order to find out if your knee pain is caused by an osteoid osteoma. A sample of your cells or tissues will be sent to the lab to be checked for cancer cells.
Eliminating nocturnal knee pain involves properly treating the knee injury or joint condition causing it. Knee injuries and joint conditions are treated using the following methods:
- RICE Treatment – RICE is an acronym for rest, ice application, compression and elevation. This treatment protocol helps relieve pain and inflammation, allowing you to sleep longer and more soundly.
- Medication – Your doctor may prescribe drugs that will help relieve pain and inflammation. Examples of these drugs include paracetamol, ibuprofen, mefenamic acid and non-steroidal anti-inflammatory drugs (NSAIDs).
- Physical therapy – Your doctor may advise you to perform certain exercises which will strengthen your knees and make them less prone to injuries.
- Surgery – Surgery can either repair or replace damaged knee joints, as well as extract bone tumors.
- Radiation therapy and/or chemotherapy – These are used to treat bone tumors that cannot be removed surgically.
Prevention is always better than a cure. Below are some tips on how to prevent nocturnal knee pain:
- See to it that your knee injury is treated promptly and effectively.
- Do not bend your knees while sleeping. Sleep with your legs straight.
- Stop doing the activities that make your knees hurt—no matter how important they may be.
- Watch out for these symptoms: leg pain and swelling for no obvious reason, suspicious fractures, leg lumps, fever, weight loss, anemia, limping and fatigue. These are possible symptoms of bone cancer.
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