Knee Pain at Night: Most Common Causes and Treatments

What causes knee pain at night

If you are someone who suffers from stabbing knee pain at night when you are trying to sleep, know that you are not alone. This unfortunate sleep disturbance is overwhelmingly common in the United States, and approximately one in four adults experience chronic knee pain at night.

Nocturnal knee pain can keep you from falling asleep, wake you up in the night, and leave you feeling unrested in the morning. Sleep is restorative and without it, your chronic knee pain may take longer to improve. 

Certain treatments can set you on the path of healing and get you back to sleeping comfortably. Read on for the most common sources of nightly knee pain and tips for restful sleep.


What causes knee pain at night?

If chronic knee pain defines your daily activities, it’s likely that it also affects your sleep. The following are some of the most common causes of knee pain at night.

Torn Cartilage

Torn knee cartilage, also known as a torn meniscus, is one of the most common sources of chronic knee pain. Knee cartilage can tear during activities that involve abruptly or forcefully twisting or rotating the knee. The odds of a torn meniscus are higher when the activity involves putting your full weight on the knee while moving.


Arthritis of the knee is caused by inflammation in the joint tissues that hinders everyday activities. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Neither type of knee arthritis has a cure, but there are treatments available to help manage the pain and get you back to the activities you enjoy.


Knee tendonitis, or patellar tendinitis, is caused by inflammation in the tendon that attaches the kneecap (patella) to the shinbone. Knee tendonitis is characterized by dull aching pain, tenderness, and mild swelling.


Because of the many components within the knee, it is especially vulnerable to injury. Knee injuries include sprains, ligament tears, fractures, and dislocations. Some knee injuries can be treated with braces or physical therapy, but more extreme injuries can require surgery to correct.

Extensive Use

Certain intensive physical activities can lead to pain caused by overuse of the knee. Activities such as skiing, running, and biking can cause stress within the knee joint over time. Bursitis, tendinitis, tendinosis, and plica syndrome are all possible knee injuries from overuse. Certain health conditions can exacerbate knee pain caused by overuse. These include osteoarthritis, some auto-immune conditions, and bone infections.


Tips to sleep better at night

Identifying the underlying cause of your chronic pain is the first step to improving how it affects night sleep. There are a handful of things you can do before your knee pain is corrected in order to increase the quality of sleep you get at night. We recommend a combination of the following to complement knee pain treatments.

Place pillows between the knees

Adding a soft cushion between your knees when you are sleeping can improve sleep quality for multiple reasons. When your top knee rests against the lower knee while sleeping on your side, it may be adding pressure that can increase pain in an already tender area. 

Putting a pillow between your knees or thighs can also correct postural issues. The addition of the pillow will help you sleep in the natural alignment of your hips and pelvis. Improved sleeping posture can reduce strain on inflamed ligaments and muscles, and keep you sleeping longer.

Stretch before sleep

Stretching at night can help alleviate some knee pain and help you fall asleep faster. Just 10 minutes of gentle stretching before getting into bed will help your muscles relax and mentally prepare you for the night’s sleep.

The reason stretching can help ease nightly knee pain is that it provides a transition between the day’s activities and complete rest. Without some sort of wind-down, the stillness of sleep can be abrupt for your legs which may cause muscle spasms that wake you up.

Ensure mattress firmness

A bad mattress can make your knee pain worse at night. If your mattress is old or not firm enough, it may not adequately support your body weight, leading to unwanted pressure on certain parts of the body. If your mattress is too firm, your joints may have even more pressure on them than they would on a soft mattress while you’re laying down. Sleeping on a mattress that is not too soft and of medium firmness should improve nocturnal knee pain.


Treatments for knee pain

Consider the following treatments during the day to help increase the impact of those sleep tips.

  • Compression
  • Elevating the leg
  • Hot or cold compresses
  • Daytime rest


When should you consult a doctor for knee pain at night?

If your knee pain has become chronic enough to disrupt your nightly sleep, it’s time to reach out to a pain specialist. Our providers are board-certified in interventional pain management and offer a variety of options for procedures to tackle knee pain. 


Frequently Asked Questions

Is walking good for knee pain?

Certain causes of knee pain may be treated with gentle walking exercises. It’s important to avoid excessive walking, which may make knee pain worse.

How do I know if my knee pain at night is serious?

If your knee pain is waking you up at night and keeping you from feeling rested, you should seek medical evaluation.

What does arthritis in the knee feel like?

Knee arthritis can feel like stiffness or pain that varies with movement and changes in the weather, and that may increase over time. Locking joints and knees that click while walking are also signs of arthritis in the knee.

Is there a test for arthritis in the knee?

Arthritis in the knee is diagnosed with X-rays that allow medical professionals to see bone spurs or other variations in the joint and measure cartilage. Some providers may use MRIs and CT scans to confirm an arthritis diagnosis.