A wide variety of musculoskeletal conditions can cause knee pain.
Some acute conditions like runners knee may resolve after you rest your knee.
Other chronic conditions like osteoarthritis may require ongoing care and management.
Illustration by Theresa Chiechi for Verywell Health
Sometimes knee pain isn’t due to an underlying condition.
Illustration by Theresa Chiechi for Verywell Health
1.
Knee Osteoarthritis
Unlike runners knee, symptoms ofosteoarthritis(OA) are not temporary.
OA is a chronic aging-related condition in which cartilage gradually wears away in joints.
Swelling and throbbing are also common symptoms that may seem more pronounced at night.
As with allautoimmune diseases, RA is characterized by an inappropriate immune assault on normal tissues and cells.
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With RA, thesynovial membranecovering the knee joint is the target of the inflammatory attack.
Severe cases may requirearthroscopic surgery.
Knee Bursitis
Bursitisis the inflammation of the cushioning sacs between joints, calledbursae.
Symptoms include a swollen kneecap, pain when bending the knee, and nighttime knee pain.
Sometimes, a bursa can become inflamed after an impact injury to the knee.
Bursitis is commonly treated with rest, ice tool, and NSAIDs.
In severe cases, the inflamed bursa may need to be surgically removed.
Nighttime attacks (“flares”) are 2.4 times more common than attacks during the day.
Symptoms include intense pain, swelling, redness, and warmth to the touch.
Gout can be managed by eating alow-purine diet.
Gout flares can be eased with NSAIDs, cortisone injections, or ice packs.
An anti-inflammatory drug calledColcrys (colchicine)can also help treat and prevent gout symptoms.
Osgood-Schlatter Disease
A common cause of knee pain in growing adolescents is called Osgood-Schlatter disease.
Osgood-Slatter disease symptoms tend to be worse at night and first thing in the morning.
Why Is Knee Pain Worse at Night?
There are several possible reasons why knee pain worsens at night.
These are used for a prescribed period as their overuse can lead to stomach ulcers and bleeding.
Severe pain may require a short course ofopioid drugslikehydrocodone.
On the other hand, cold from an ice pack can reduce pain, inflammation, and swelling.
Some people benefit from applying both, alternating between heat and cold therapies.
Overheating the body can make knee pain worse.
Acupunctureis a popular form of alternative medicine that many patients use to cope with mild to moderate arthritis symptoms.
The American College of Rheumatology has listedacupunctureas a conditional recommendation for osteoarthritis.
Medline Plus.Anterior knee pain.
Johns Hopkins Medicine.Patellofemoral pain syndrome (runner’s knee).
American Academy of Orthopaedic Surgeons.Arthritis of the knee.
2023 Jul 29:101855. doi:10.1016/j.berh.2023.101855.
National Institutes of Arthritis and Musculoskeletal and Skin Diseases.Rheumatoid arthritis: diagnosis, treatment, and steps to take.
Arthritis Foundation.Rheumatoid arthritis and sleep.
American Academy of Orthopaedic Surgeons.Meniscus tears.
2014;5(5):597-602. doi:10.5312/wjo.v5.i5.597
American Academy of Orthopaedic Surgeons.Prepatellar (knee cap) bursitis.
Centers for Disease Control and Prevention.Gout.
Choi HK, Niu J, Neogi T, et al.Nocturnal risk of gout attacks.Arthritis Rheumatol.
An exploratory cross-sectional study in patients with hip and knee osteoarthritis.Fam Pract.
2023 Feb 9;40(1):75-82. doi:10.1093/fampra/cmac074
National Health Service (UK).NSAIDs.
Food and Drug Administration.Hysingla (hydrocodone bitartrate) label.
Nurcan C, Karadag M.Superficial heat and cold applications in the treatment of knee osteoarthritis.Osteoarthritis Progress Basic Res Treat.
- doi:10.5772/60534
American Academy of Sleep Medicine.Healthy sleep habits.
2017;6(3):190-198. doi:10.21037/tp.2017.04.05
