Knee Pain at Night: Why It Gets Worse and How to Sleep Better

During the day the knee is busy, and so are you. Then you lie down, the house goes quiet, and the ache you barely noticed suddenly takes center stage. Many people with knee trouble know this pattern: the knee hurts most exactly when you want to rest.

There are good reasons for it, and most of them can be eased with small changes to your evening and your sleeping position.

Why knee pain often gets worse at night

• Fewer distractions. During the day the brain is busy with other things. In a quiet, dark room it pays much more attention to signals from the knee.
• Lying still. A joint that does not move for hours tends to stiffen. That is why the first movements after lying down or waking up often hurt the most.
• Pressure from your position. Lying on your side with one knee on top of the other, or with the leg fully bent, puts pressure on sensitive spots.
• The day catches up with you. A long walk, a lot of stairs or hours on your feet often show up in the knee only several hours later.

The most common causes of night pain

• Osteoarthritis. Worn joints often ache after a busy day and stiffen after rest. With more advanced wear, the pain can also appear at rest.
• An irritated bursa on the inner side. A small fluid-filled sac below the knee on the inner side can become irritated and hurts especially when the knees press against each other in bed.
• Overload. If you did more than usual, the tissues around the knee may be irritated and protest toward the end of the day.
• Inflammatory joint conditions. Pain and stiffness that are worst in the second half of the night and in the morning, with swelling in several joints, should be checked by a doctor.

8 tips for a calmer night

• A pillow between the knees. If you sleep on your side, a firm pillow between the knees and ankles keeps the legs in line and stops the knees from pressing on each other.
• A small pillow under the knees. If you sleep on your back, a slight bend can ease tension. Keep it low so the knee does not stay strongly bent all night.
• Move gently before bed. Sitting on the bed, slowly bend and straighten the knee 10 times. A joint that has just moved settles more easily.
• Keep the knee warm. Many people notice that cold makes stiffness worse. A warm blanket or a soft sleeve can help.
• Cold in the early evening after a hard day. If the knee is swollen or warm after activity, 10 to 15 minutes of a wrapped cold pack in the early evening can calm it down.
• Spread out your activity. Several shorter walks during the day are easier on the knee than one long effort late in the afternoon.
• A short, easy walk after dinner. Ten relaxed minutes keep the joint moving without tiring it.
• If you wake up, do not lie there stiffly. Bend and straighten the knee a few times or change position. Lying tense and still often makes the pain worse.

Can you wear a knee sleeve at night?

Many people like wearing a soft sleeve in bed because it keeps the knee warm and gives a gentle feeling of support. That is fine as long as it fits comfortably: it should not leave deep marks, cause tingling or numbness, or squeeze harder than during the day. If you have circulation problems, ask your doctor first. You can read more about what a sleeve can and cannot do in our article on 7 myths about knee sleeves, and about the difference between a sleeve and a brace in this guide. If the pain is on the inner side, see our guide on pain on the inner side of the knee.

When to see a doctor

• the pain wakes you night after night, even though you follow these tips
• the knee is red, warm or swollen, or you have a fever
• the pain is constant, does not change with position and keeps getting worse
• the calf is swollen, warm or painful
• you feel generally unwell or are losing weight without trying

Night pain is exhausting, but it is often a sign that the knee needs a better balance of movement and rest. After a few changes to their evening routine, many people find that they sleep better.

A sleeve you will actually wear

The best sleeve is the one that does not end up in a drawer. The KeenTrove Bamboo Knee Sleeve is made for exactly that:

• soft, breathable bamboo, comfortable even in summer
• fits snugly but does not dig in behind the knee
• does not lock the knee, so you move naturally
• wear it under your clothes during the day and in bed at night

With 60 days to get your money back, you have nothing to lose.

See the bamboo knee sleeve →

Note: this article is for information only and does not replace an examination by a doctor. If you have circulation problems or diabetes, or have recently had knee surgery, talk to your doctor before wearing compression.