Shooting pain in the knee at night: causes and treatment.


Knee pain is a common annoyance, and many people struggle with pain-related insomnia. Knee pain in nighttime worries. A throbbing or pain in your knee can prevent you from getting enough sleep, which can lead to exhaustion. Not knowing the reason is an additional frustration.

No medical condition alone causes knee pain at night, so your healthcare provider may consider several possible causes. Some of the more common sources of nighttime knee pain include runner's knee, osteoarthritis, bursitis, or injury. Once your healthcare provider can determine the cause of your pain, they can help you find the treatment you need to make your rest easier.

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Causes of stabbing knee pain

Pulsating pain can be the result of various diseases or injuries of the musculoskeletal system. Some of these conditions, such as a runner's knee, may go away after resting the knee. Others, like osteoarthritis, are chronic.

Runner's knee

Runner's knee is one of the most common causes of knee pain in athletes. If you have a runner's knee, you may feel pain behind your kneecap. Many people report similar symptoms, such as a dull or radiating pain in the knee area or a grinding sensation in the kneecap area.

However, runner's knee is a general term for this knee pain; therefore, there may be several reasons for this. You may have overextended your knee while running or jumping. Some people are more likely to develop a runner's knee joint because their kneecap may not be positioned correctly to properly cover and protect the joint.

In most runners, knee symptoms resolve after a few weeks of rest after strenuous activity and taking over-the-counter pain relievers as needed.


Unlike most mild cases of runner's knee, the symptoms of osteoarthritis are not temporary. Osteoarthritis is a chronic disease and patients should consult with their healthcare professional to develop a long-term treatment plan.

In a healthy knee, soft tissues, including cartilage, cover three bones. These fabrics are shock absorbers that support the weight of your body when you walk or fall. The cartilage in the knee helps the knee bend without scratching the bones together.

In the knee with osteoarthritis, these soft tissues have been degraded due to wear and tear. This can cause the bones in the knee to rub against each other, causing irritation and inflammation. The knee may feel stiff when you try to bend it or stand up.

Unfortunately, there is no cure for osteoarthritis because there is no way to completely repair or replace damaged or eroded joint tissue. However, osteoarthritis patients have several treatment options to reduce pain and prevent further damage to the knee.

Osteoarthritis pain can be felt as stiffness, pain, swelling, or throbbing. These symptoms may seem more pronounced at night, as osteoarthritis pain can be worse during rest periods.


Bursitis can cause painful swelling above the kneecap or on the side of the knee. There are small fluid sacs in the knee that help the tendons slide smoothly over the joints. These sacks are called bags. When bursitis occurs, these fluid sacs swell, which can cause knee pain.

Bursitis, like a runner's knee, can be triggered in a number of ways. The most common cause of bursitis is too much pressure on the knee, such as when kneeling or squatting without knee pads or braces for support. Sometimes the bursa can become inflamed after being struck by a knee during an injury.

Bursitis is similar to a runner's knee in that it is often caused by overexertion. However, bursitis is less common than a runner's knee.

This condition also presents with various symptoms, such as swelling, that are different from those of a runner's knee. In moderate to severe cases, the inflamed bursa can become visible as a lump on the knee. Symptoms of bursitis can be felt as hot, painful aches and pains.

Other injuries and conditions

Since the knee is the largest joint in your body, it is prone to injuries and sprains. If you fall or hit a knee, you may bruise. If any of the three bones in your knee are broken, you may experience weakness, sharp pain, or a strong throbbing sensation.

Rheumatoid arthritis can show symptoms similar to osteoarthritis, but this autoimmune condition may require different treatment than joint damage caused by the wear and tear typical of aging.

If you have knee pain that interrupts your daily life and does not go away after a few days of rest, consider seeing your doctor.

Why is the night worse?

Many knee conditions, such as runner's knee and bursitis, can improve after a few weeks of rest. However, knee pain can be worse at night. What are the medical reasons for this?

You try to relax

When your body is at rest, you may notice mild to moderate pain that is easier to ignore when your mind has been busy with thoughts during your waking hours.

Also, when you sleep, your body makes less cortisol. While high levels of cortisol can lead to heart disease, healthier levels can help your body reduce inflammation.

Since most joint pain is caused or worsened by inflammation, moderate amounts of cortisol can help your body deal with this inflammation. But when your body is relaxed, like when you are trying to sleep, there is less cortisol in your body to reduce swelling and irritation in your knees .

Night swelling

When you sleep, your body rests. Long hours of lying down can make your joints stiff and less flexible when you wake up. Although overexertion can cause knee pain, moderate activity can help maintain joint health. Light activities like walking, swimming, and yoga can keep your joints relaxed and flexible.

This movement can actually help keep your tendons flexible and circulate fluid that helps lubricate and protect your knee joints. People with chronic conditions like arthritis tend to experience better health outcomes and get sick less when they participate in a regular exercise program approved by their healthcare provider.

Lack of sleep makes the pain worse.

It is very easy to get stuck in a cycle when you cannot sleep due to knee pain. Lack of sleep can make your pain worse. Sleep is vital for healing and rejuvenation. Without sleep, you will have less energy to expend on healing as you need to focus your bodily processes on being awake and awake.

If nighttime knee pain makes you toss and turn, you may accidentally straighten your knee further by falling asleep in an uncomfortable position.

What can you do about it

The exact treatment will depend on your specific knee injury or condition. Of your medical options, your healthcare provider may recommend that you take certain medications, lifestyle changes to improve sleep, or consider other treatment options.

Heal the pain

To relieve pain, many people use nonsteroidal anti-inflammatory drugs (NSAIDs). Some common NSAID pain relievers include Advil, Motrin, and Aleve. These basic NSAIDs are available at your local pharmacy.

However, your doctor may prescribe a stronger pain reliever, such as hydrocodone. These medications can help relieve severe pain, but they can be very addictive. Check with your healthcare professional before taking any new medicine.

Practice good sleep hygiene

While pain can interrupt your sleep, you can make your night more restful by incorporating the following sleep hygiene strategies into your daily routine:

  • Avoid sleeping a lot during the day.
  • Make your bedroom cool and dark.
  • Don't eat heavy foods or exercise before bed.
  • Talk to your doctor about taking melatonin supplements or other sleeping pills .
  • Avoid using phones or computers before bed as the blue light from the screen can disrupt sleep.
  • Use a pillow and mattress for support to avoid straining your back or knees.

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Consider additional treatments

Acupuncture is a popular form of alternative medicine that many patients use to control mild to moderate symptoms of arthritis. The American College of Rheumatology has listed acupuncture as a conditional recommendation for osteoarthritis . People may consider talking to their doctor about including acupuncture as part of their regular treatment plan.

Alternatively, you can apply hot or cold compresses to the knee to relieve pain and swelling. A knee pillow can also help support and stabilize a sore knee while you try to sleep.

Get the word of drug information

Knee pain at night can seem like a never-ending and debilitating cycle, especially if you're struggling with a chronic condition like arthritis. Fortunately, you can work with your doctor to come up with a treatment plan that is right for you.

Once you are diagnosed with knee pain, you can begin to explore treatment options, such as medication, rest, physical therapy, or applying ice to your knees. By combining these pain management strategies with sleep hygiene, you have the best chance of getting a good night's sleep.

Frequently asked questions

  • Use both. Start with heat, which increases blood flow and provides some relief, but then apply ice to prevent blood from pooling and swelling around the joint (which can cause knee throbbing).

  • At night, your leg does not move, causing the muscles and tissues around the already swollen joint to contract; which increases stiffness and pain in the knees.

  • Yes. It is estimated that more than half of people who undergo joint replacements wake up in pain at night. Sleep disturbances and pain should go away two to three weeks after surgery.

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