Chronic nighttime knee discomfort is a typical complaint. Your quality of sleep and, by extension, your health and quality of life can be significantly impacted by knee pain, whether it makes it difficult to fall asleep, wakes you up, or makes you feel agitated.

When we sit down to decompress at the end of a long day, the knee discomfort that has been building up all day might hit us like a ton of bricks. But why is this happening, and what can we do about the nighttime knee pain?

Causes of Throbbing Knee Pain at night

Knee pain at night can be caused by several different musculoskeletal disorders or injuries and is not always worse at night. Therefore, your doctor may investigate a variety of possible causes.

• Gout Knee

When you sleep on your knees, you may get pain from gout . Uric acid crystals cause inflammation, severe pain, and swelling when they accumulate in joints.

Knee pain from gout tends to come on unexpectedly at night when crystals accumulate in the joints due to the cooler temperature. Consequences include severe nighttime knee discomfort, inflammation, and edema.

Medications, ice, and rest are the standard treatments for gout, and the pain typically subsides after a week or two. But, unless adequate measures are taken to prevent such occurrences, the problem will likely persist.

• Inflammation and Activity

Knee pain in the evening can be caused by several conditions, including tendonitis, knee injuries, trauma, uveitis, and rheumatoid arthritis.

Because the space in and around the knee joint is limited, an injury that leads to inflammation or extra fluid in the knee, such as a ligament tear, can elevate the pressure and cause a dull, aching ache.

Joint swelling is a common side effect of physical activity because it increases blood flow to the area. Knee inflammation worsens throughout the day and reaches a climax in the evening because of how hard we work our bodies. A delay in relieving muscular discomfort after physical activity is attributed to the accumulation of lactic acid in the muscles. You may not realize that you exert too much effort during workouts until the following day, when you get severe nighttime knee discomfort.

• Runner’s Knee

Athletes frequently suffer from knee pain, and the runner’s knee is a primary culprit. You can feel pain in the area behind your kneecap if you have a runner’s knee. Some of the most common complaints from those suffering from this ailment include a grinding sensation near the kneecap or a dull, aching discomfort near the knee.

This generalized knee discomfort is commonly known as a runner’s knee. Several potential factors may contribute to this. As an illustration, you could have aggravated your knee by jumping when you should have been running. Runner’s knee is more common in some persons because their kneecap is not in the ideal position to provide adequate protection for the joint. After a few weeks of rest from vigorous activity and over-the-counter pain medications, the runner’s knee symptoms typically disappear.

• Osteoarthritis

Osteoarthritis symptoms, in contrast to moderate cases of the runner’s knee, persist over the long term. Since osteoarthritis is a long-term condition, patients should work with their doctors to devise a treatment strategy that will last for years. Cartilage tears in the knee are more common in OA  patients, according to the research.

Cartilage and other soft tissues in a healthy knee act as shock absorbers for the thigh, shin, and knee. These tissues serve as shock absorbers, protecting you from injury when you tumble or walk. If you have damaged cartilage in your knee, bending it could cause the bone to rub against the bone.

These soft tissues have deteriorated in an osteoarthritic knee. Because of this, discomfort and inflammation of the knees can develop from bone scrapes. It’s possible that bending or standing will cause your knee to feel stiff.

As the joint tissue is irreparably damaged and cannot be replaced, there is currently no treatment for osteoarthritis. Fortunately, there are several treatments available to help ease the discomfort of osteoarthritis and keep the knees from getting any weaker.

Feelings of stiffness, soreness, swelling, or throbbing are all common with osteoarthritis. Because osteoarthritis pains often worsen at night, these signs may appear more severe.

• Iliotibial Band Syndrome

Iliotibial band syndrome is the medical term for the searing sensation felt on the side of the knee. Two common types of knee overuse problems are PFPS and ITBS . The iliotibial band tendon can enlarge and irritate from trauma or overuse, leading to nerve compression. Both knees are equally at risk.

Pain that feels like fire when bending or straightening the knee is a classic sign of this illness. As a result, this is one of the most common causes of painful knees. This syndrome is characterized by knee pain localized to the lateral femoral epicondyle and a burning sensation in the affected area. A study conducted in 2020 suggests that non-invasive therapy methods can help with this localized knee pain.

Why Knee Pain Is Worse at Night

Rest for a few weeks can help many knee ailments, such as the runner’s knee and bursitis. But, you may experience nighttime flare-ups of your knee discomfort. Let’s see why that happens:

• You’re relaxing

The aches and pains that you usually ignore while your mind is busy at work may become more apparent while your body is at rest.

Since inflammation contributes to or is the direct cause of most joint ailments, maintaining a healthy cortisol level can be beneficial. However, your body produces less cortisol to reduce swelling and irritation in your knees while at rest, such as when attempting to get to sleep.

• Inflammation During the Night

It is natural for the body to relax and rejuvenate during sleep. You may wake up feeling stiff and less mobile from lying still for so long. Knee pain is often the result of overdoing it, but regular moderate exercise is good for the knees. Walking, swimming, and yoga are all low-impact activities that can help you maintain joint mobility and flexibility.

These movements stimulate the circulation of fluid that can lubricate and safeguard the knee joints, and the tendons are kept limber. Regular exercise, under the supervision of a healthcare expert, can help people with chronic illnesses like arthritis live healthier lives with less pain.

• Sleep Deprivation

Intractable knee discomfort at night can ruin your sleep and cause a snowball effect of problems. Lack of sleep has been linked to various adverse health outcomes, including heightened sensitivity to pain, lower pain thresholds, slowed healing, lower tolerance levels, and increased exhaustion. Knee pain worsens throughout the night as these factors reinforce and cause a vicious cycle of growing discomfort.