Knee Pain: Why Knee Pain Gets Worse During Nighttime And How To Ease It

March 4, 2020
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So far in this series on knee pain, we’ve covered a lot of different topics. We’ve looked at the 3 things you could be doing that make knee pain worse, which included wearing the wrong shoes, sitting with your legs bent and taking it too easy. We then looked at the 3 ‘quick fixes’ people think will help knee pain, but don’t. (Painkillers, resting and wearing a support). Next it was looking at whether knee replacement surgery could be avoided. Most recently, we looked at how to stop arthritis before it stops you.

That’s a lot to cover in just 4 weeks, but we’ve still got more to cover. Knee pain is something that a lot of people struggle with at any time of year. But especially when in the warmer months, as people tend to be more active. Which leads me to this week’s article…

Question for Dr. Penrose

This question was sent to me yesterday by a reader suffering with knee pain: “Jennifer, I’ve been suffering with on-off type knee pain now for more than a year. What I can’t put my finger on is when it started or why. What’s more confusing is that my pain gets worse as the day goes on. But whenever I wake up, the pain is gone – or is considerably less. By the end of another day, my knee aches, sometimes, hot and swollen with considerable pain. It’s especially bad if I’ve been out for a long walk with my dog. Any ideas?” – Beth, 58, Lacey.

What’s happening here is likely to be a simple case of the muscles around Beth’s knee joint being “weak”. As in, the muscles just aren’t strong enough to last through the day. Or they can’t cope with what she wants her body to do and where she wants to go. Think of it like this: When you go to bed at night and are ready to sleep – your body is obviously tired from all of the energy you’ve used through the day. And your muscles, well, they’ve been working too. So what happens is that they get a rest when you sleep. Then you wake up and they ache less because they’re less tired and feel “energized” for a new day. But if any muscle is weak or damaged in some way, it’s not going to be able to support you.

What’s Really Happening

So, somewhere around dinner time, after a lot of “being on your feet”, your muscles will “pack up”. And when they do this, joints, such as your knees, are left to fight their own battles. That’s not good! Particularly if you’re aged 45+… as that’s the period where cartilage damage really begins (arthritis). And without muscles to support these knee joints, or just really tired and weak ones, you’re much more likely to suffer pain or aches. The same thing often happens with neck and shoulder muscles at night too – and it’s the reason why when you have the “flu” or a common cold, you always feel worse at night. Have you ever noticed your child get more “ratty” as the night draws in if he or she has a virus?

It’s the same thing going on: your body puts up a better fight after a good night’s sleep, as it begins to get tired again through the day, the virus or bacteria wins the fight! So the answer to Beth’s knee problem? Well, it’s likely to be a simple case of strengthening the knee muscles (and hip and lower back ones too) to make them stronger.

But here’s something people often get wrong: walking a dog everyday will do very little to strengthen muscles – if anything, it will make weak muscles worse and mean you’re more likely to suffer more pain, not less. No, the answer is not found in more exercising, it’s in doing the right exercises to strengthen the right muscles, which means your knee will be strong enough to walk, meaning you can keep your heart and lungs health, and do it with less knee pain at the end of the day.