What you need to know about nighttime throbbing knee pain

Knee pain is a common discomfort that many people struggle with insomnia caused by the pain. My knee hurts at night, it hurts. A throbbing or sore knee can prevent you from getting restful sleep, which can leave you exhausted. Not knowing why is an added frustration.

This article will help you understand what causes knee pain, why it often gets worse at night, and what you can do to make yourself feel better.

Causes of throbbing knee pain

No single condition can cause nighttime knee pain — throbbing pain can come from a variety of musculoskeletal disorders or injuries. Therefore, your healthcare provider may consider several potential causes.

Some of the most common sources of nighttime knee pain include a runner’s knee, osteoarthritis, bursitis, or injury. Some of these conditions, such as runner’s knee, may resolve after your knee rests. Others, like osteoarthritis, are chronic in nature.

With the right diagnosis, your healthcare provider can give you the treatment you need to rest more easily.

runner’s knee

Runner’s knee is one of the most common causes of knee pain in athletes. If you have runner’s knee, you may experience pain behind the kneecap. Many people with this condition report similar symptoms, such as dull or radiating pain near the knee or a rubbing sensation near the kneecap.

Runner’s knee is an umbrella term that refers to this form of knee pain. It can have various reasons. For example, you may overuse your knees by jumping instead of running. Some people are also more prone to runner’s knee because their kneecap may not properly cover and protect the joint.

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

Runner’s Knee: Overview and More


Unlike most mild cases of runner’s knee, osteoarthritis symptoms are not temporary. Osteoarthritis is a chronic disease, so patients should consult their healthcare provider for a long-term treatment plan.

In a healthy knee, soft tissue, including cartilage, cushions the three bones. These tissues are shock absorbers that support your body weight when you walk or fall. The cartilage in the knee helps the knee bend without the bones rubbing against each other.

In knees with osteoarthritis, these soft tissues degenerate due to wear and tear. This can cause the knee bones to rub against each other, leading to irritation and inflammation. Your knee may feel stiff when you try to bend or stand.

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

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Osteoarthritis pain may feel like stiffness, pain, swelling, or throbbing. These symptoms may appear more pronounced at night because osteoarthritis pain flares up during rest.

Knee Osteoarthritis: An Overview and More


Bursitis can cause painful swelling of the kneecap or one side of the knee. On your knees, there are small sacs of fluid that help tendons glide smoothly over your joints. These sacs are called bursae. In bursitis, these sacs swell, which can cause knee pain.

Bursitis, like a runner’s knee, can be triggered in several different ways. The most common cause of bursitis is putting too much pressure on the knee, such as kneeling or squatting without wearing a knee brace or brace. Sometimes the bursa becomes inflamed after hitting the knee during an injury.

Bursitis, like a runner’s knee, is usually caused by overexertion. However, bursitis is less common than runner’s knee.

This condition also exhibits several symptoms that differ from runner’s knee, such as swelling. In moderate to severe cases, the inflamed bursa may become visible as a lump on the knee. Bursitis symptoms may feel like warmth, pain.

Bursitis: Overview and More

Other knee injuries and conditions

Because the knee is the largest joint in your body, it is prone to injuries and strains. If you fall or hit your knee, you may experience pain from the bruise. If you break any of the three bones in your knee, you may experience weakness, severe pain, or a throbbing sensation.

Rheumatoid arthritis may present with similar symptoms to osteoarthritis, but this autoimmune disease may require different treatments than the typical wear and tear of aging.


Knee pain can be caused by overexertion. When it does, it’s called runner’s knee, although it’s not always caused by running. In these cases, rest is usually resolved. Knee pain can also be caused by chronic diseases such as bursitis, osteoarthritis, or rheumatoid arthritis.

Why knee pain is worse at night

Many knee conditions, such as runner’s knee and bursitis, improve after a few weeks of rest. However, your knee pain may get worse at night. What is the medical reason behind this?

you are trying to relax

You may notice mild to moderate pain when your body is at rest, and may be easier to ignore when you are engrossed in your busy thoughts during your waking hours.

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

Since most joint pain is caused or worsened by inflammation, a moderate amount of cortisol can help your body manage this inflammation. But when your body relaxes, such as when you want to sleep, cortisol in your body decreases to reduce swelling and irritation in your knees.

nocturnal inflammation

When you sleep, your body is at rest. Time spent lying still can leave your joints feeling stiff and inflexible when you wake up. While overwork can cause knee pain, moderate activity can help keep your joints healthy. Low-impact activities like walking, swimming, and yoga can keep your joints loose and flexible.

This movement actually helps your tendons stay supple and circulates fluid to help lubricate and protect your knee joint. People with chronic conditions such as arthritis tend to experience better health outcomes and less pain when participating in a regular exercise program approved by their healthcare provider.

Lack of sleep makes pain worse

It’s easy to fall into the cycle of not being able to sleep due to knee pain. Lack of sleep can actually make your pain worse. Sleep is essential for recovery and rejuvenation. Without sleep, you don’t have much energy to devote to recovery because you need to focus your body’s processes on staying alert and awake.

If knee pain causes you to toss and turn at night, you may accidentally strain your knee further by sleeping in an uncomfortable position.


Knee pain seems to get worse at night simply because you’re more likely to notice it when you’re not engaging in other activities. When you have a chronic disease like arthritis or don’t get enough physical activity, you may wake up with inflammation and soreness. Lack of sleep can also aggravate pain and your ability to tolerate it. If your knee pain interrupts your daily life and persists after a few days of rest, talk to a healthcare provider.

Does insomnia disrupt your sleep?

what can you do

Your exact treatment will depend on your specific injury or knee condition. For example, your healthcare provider may recommend that you take certain medications, make lifestyle changes to promote better sleep, or consider other treatment options.

treat pain

To help reduce pain, many people use non-steroidal 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 healthcare provider may prescribe stronger narcotic pain relievers, such as hydrocodone. These drugs can help relieve severe pain, but can be addictive. Talk to your healthcare provider before taking any new medicines.

Knee Pain Treatment Options

Develop good sleep hygiene habits

While pain can disrupt your sleep, you can create a more restful night when you incorporate the following sleep hygiene strategies into your routine:

  • Avoid long naps during the day.
  • Keep your bedroom cool and dark.
  • Avoid heavy food or exercise before bed.
  • Discuss taking melatonin supplements or other sleep aids with your healthcare provider.
  • Don’t use your phone or computer before bed, as blue light from screens can disrupt sleep.
  • Use pillows and a supportive mattress to avoid back or knee strain.

Consider other treatments

Acupuncture is a popular form of alternative medicine that many patients use to manage mild to moderate arthritis symptoms. The American College of Rheumatology lists acupuncture as a “conditional recommendation” for osteoarthritis. People may consider consulting their healthcare provider to incorporate acupuncture into their normal treatment plan.

You can alternate using hot or cold compresses on your knee to reduce pain and swelling. A knee pillow can also help support and stabilize a sore knee when you are trying to fall asleep.


Knee pain can be caused by repetitive stress injury (called “runner’s knee”), osteoarthritis, bursitis, or other conditions. It might be more noticeable at night because you’re resting, but it doesn’t have to disrupt sleep. Heat packs and ice packs, as well as complementary therapies such as NSAIDs, prescription pain relievers, and acupuncture can help manage discomfort. Maintaining good sleep habits can also help you fall asleep and stay asleep.

VigorTip words

Nighttime knee pain can feel like a never-ending, exhausting cycle, especially if you’re dealing with a chronic condition like arthritis. Fortunately, you can work with your healthcare provider to develop a treatment plan that is right for you.

When you receive a diagnosis of knee pain, you can start exploring treatment options, such as medication, rest, physical therapy, or ice on the knee. When you combine these pain management strategies with sleep hygiene, you give yourself the best chance of getting a good night’s sleep.

Frequently Asked Questions

  • Which is best for knee pain relief, cold or hot?

    Use both. Start with heat, which increases blood flow and provide some initial relief, followed by ice to prevent blood from building up and swelling in the area around the joint (which can cause the knee to jump).

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  • Why is Arthritis Pain in the Knee Worse in the Morning?

    At night, your legs don’t move, which can cause the muscles and tissues around the already swollen joints to tighten. This can increase stiffness and pain around the knee.

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    Home Remedies for Knee Pain

  • Is Nighttime Pain Common After Knee Replacement?

    Yes. It is estimated that more than half of joint replacement patients wake up at night with pain. Sleep disruption and pain should subside two to three weeks after surgery.

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