Knee Pain at Night

knee pain at nightKnee pain at night is 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).

Nocturnal knee pain 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.

What causes knee pain at night?

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.

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Comprehensive list of symptoms in our Knee Pain Diagnosis can help you determine the exact cause of knee pain.


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.

How to treat knee pain at night?

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 TreatmentRICE 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 knee strengthening exercises which will improve your knee condition 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.

How to prevent knee pain at night?

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.

Have You Had Knee Pain At Night? Please Comment Below.

Article last updated on January 8th, 2019, first published on September 23, 2013.

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2 thoughts on “Knee Pain at Night

  1. I have persistent joint pain in my left knee only after going to bed at night. The pain will usually begin after I have been in bed for about 20 minutes. I have taken AlevePM which helps. Occasionally I will have nights with absolutely no pain issues at all. For many years I have always slept on my side with a pillow between my knees and sleep equally well on either the right or left side. I find it difficult to sleep on my back with straight legs unfortunately.

    Swimming, walking 20-30 minutes daily, or golf present no pain issues. My guess is that I somehow strained or pulled a ligament which in time will heal, but this night pain has been a problem for about two or three months. Any comments would be appreciated.

  2. I have also right knee pain at night that just started a few days ago. I am unable to lift that knee in to a high march stance. It is stiff and painful when trying the high leg march. The pain is in the lower left hand side below the knee cap…seems like it is in the tendon area. No pain during the day or when I walk 2 to 3 miles per day. I workout a couple days a week at planet fitness and do not use heavy weights.

    I sleep also with a pillow between my knees and found that laying on my good side with a pillow between my knees and another one between my ankles seems to relieve the pain significantly.

    I will wait another week or so and if the pain continues will make an appointment with an excellent orthopedic surgeon we have in Myrtle Beach. I am 74 years and Old Age Sucks…both hips have been replaced thus far.

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