How to ease knee pain at night

Knee pain is a common issue in the UK. In fact, the majority of knee patients we support at the Stadium Clinic are suffering from some degree of pain in their knee joint.

One of the worst things about knee pain is it can even affect you at night. Knee pain when lying down can rob you of sleep and rest and leave you feeling exhausted and frustrated. Yet this isn’t something you have to put up with: the earlier you seek treatment, the sooner and more effectively you could be relieved of your pain.

There can be many reasons why your knee aches when sleeping. While we can talk you through some potential causes and treatments, if your knee pain has lasted for several weeks and affects your daily life, you should seek medical advice.

If you think that sleep disturbance is not a big deal, think again. Many are surprised to see how many problems may be related to sleep disturbance:

  • Reduced enjoyment of life

  • Depression and anxiety

  • High blood pressure

  • Confusion

  • Dementia

  • Cancer

  • Diabetes

  • Heart disease

  • Stroke

  • Obesity

  • Loss of sex drive

  • Workplace inefficiency

  • Trauma from road traffic accidents

Why do my knees ache when I sleep?

Patients often ask “why does my knee bother me more at night?”. There are many causes of knee pain and the answer varies accordingly.

In cases of osteoarthritis, joint pain may seem to build through the day and then really flare up during the night or during periods of rest.

In some conditions, the opposite may occur. In rheumatoid arthritis, the pain may be worst in the morning and then improve when the joint warms up and the day goes on.

Some medical issues such as vascular insufficiency may require urgent attention. Vascular insufficiency may also present with rest pain; where blood vessels are already narrowed the reduced blood pressure and blood flow when lying flat can cut off blood supply and cause pain in the calves.

Painful swelling in the knee joint due to a sports injury such as a meniscal tear can make side sleeping difficult.

Knees that are very red and swollen, where even the bedclothes hurt may be suffering from gout or septic arthritis (a medical emergency).

Why do my legs and knees hurt at night?

There are many common causes of knee pain at night, and each has its treatment plan for pain relief.

Knee pain after an injury

This type of knee pain includes pain from accidents such as sprains and strains, torn ligaments and dislocated kneecaps. It also includes conditions such as tendonitis or Osgood-Schlatter’s disease.

If you’ve recently had a fall, slipped or incurred a traumatic event to your knee and believe it’s the cause of your knee pain, then speak to a clinician for pain relief options.

Knee pain without an injury

Knee pain with no apparent injury could be caused by wear and tear or several different conditions, including osteoarthritis, bursitis, bleeding in the joint, or rheumatoid arthritis, gout or septic arthritis.


In a healthy knee, the bones that make up the joint are cushioned by a layer of protective cartilage that allows them to slide over one another freely. However, when you have Osteoarthritis, that cushioning breaks down and wears away to the point where the bones eventually touch and grind against each other.

Osteoarthritis causes symptoms such as joint pain and stiffness or a cracking sound when moving the affected joint. The condition is progressive and cannot be reversed once it starts, which can eventually make it difficult to move or bend your joint.

Fortunately, many different Osteoarthritis pain relief treatments might be able to ease your pain. However, the most critical factor in improving your outcome is to seek an early diagnosis and treatment.

Rheumatoid arthritis

Rheumatoid arthritis is a true inflammatory disease that usually affects a number of joints. The lining of the joint becomes very inflamed and the inflammation can damage the cartilage of the knee leading to a combination of osteoarthritis and rheumatoid arthritis.


Bursitis occurs when the bursa that cushions your joints become inflamed. It can make your joint painful, tender and swollen and might even cause reddening.

Bleeding in the joint

Joint bleeding can cause swelling, warmth and bruising around the joint and is most likely when taking anticoagulant medication.


Gout often affects the knees and feet. They cause sudden, severe joint pain and hot, swollen and red skin all over the affected joint. A gout attack usually lasts between 5-7 days before improving. To avoid lasting joint damage when gout occurs, you should talk to your doctor.

Septic Arthritis

Septic arthritis is a serious joint infection that must be treated by a clinician as soon as possible. Symptoms include severe joint pain, swelling around the joint, a changing skin colour around the joint or feeling generally unwell with a high temperature.

How can I stop my knees from hurting at night?

There are many ways that might help to ease your pain at night:

Find a good sleeping position

Everyone has their own way of finding comfort, but giving your knees extra support is important for pain relief. Those sleeping on their side could try sleeping with a pillow between their knees, and back sleepers could try putting one under their knees.

Take a warm bath

A warm bath 20 minutes before bedtime can aid in reducing swelling and inflammation to make the knee joint more comfortable.

Use a hot or cold pack

Using a heat pack or ice pack wrapped in a towel on your joints could help to reduce swelling and take some of the pain away from the knees.

Weight management

The knee joint takes the full weight of your body for most of the day, so being overweight can put additional stress on the knees. By maintaining a healthy weight by getting regular exercising and sticking to a good diet, you can reduce the strain on your joints.

Knee braces

There are many different types of knee brace out there that can help relieve your pain in daily life which can carry over into the nighttime.

Talk to your doctor for advice on the most suitable aids to help with your night knee pain. The doctor recommended braces are often more helpful than the shop-bought braces.

6. Knee replacement surgery

If you’ve tried many other treatment options but find nothing stops your knee pain, then it might be time for knee replacement surgery. This is a type of surgery that replaces your knee joint either fully or partially with an artificial one. For more information, talk to your doctor.

“In cases of knee arthritis, we want to make sure that we get the timing of replacement right. If we go too early then the satisfaction rate is lower. If we leave it too late then the patient's fitness will be lost and they will have missed out on enjoying all sorts of life experiences. Sleep disturbance is one of the best signs that its time to get on with surgery”.

How do I know if my knee pain is an emergency?

Any persistent knee pain should be examined by a medical professional. In certain instances, knee pain could be something more serious such as septic arthritis and require urgent medical attention.

Symptoms that your knee pain could be due to infection are:

  • Extreme pain

  • Feeling unwell (septic)

  • Having a fever

  • Skin colour changes

  • Large swelling

  • Difficulty bending your knee

  • Being unable to put weight on the affected leg

  • Being unable to straighten your leg

If you have any of these symptoms, you should seek urgent medical treatment.

While knee pain at night can negatively impact your life, there are pain relief options out there that might be able to help. The best thing you can do is to seek medical advice quickly so your doctor can suggest the best course of treatment.

Want to discuss your knee pain with one of our consultants? You can request an appointment at the Stadium Clinic here.