Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article you will find out everything you need to know about Knee pains and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Introduction
Aching knees at night can disrupt your sleep, impact your mood, and reduce your quality of life. Whether you’re an athlete, an active adult, or simply struggling with knee pain that worsens after a long day, understanding the root causes and effective solutions is essential. This guide, based on the latest clinical evidence and expert insight, explores why knee pain is often worse at night, how to find relief, and the role of advanced treatments like Prolotherapy.
Understanding Aching Knees at Night
Aching knees at night is a symptom, not a diagnosis. It refers to discomfort, throbbing, or pain in one or both knees that becomes more noticeable or severe during the evening or while lying in bed. This pain can be sharp, dull, or aching, and may be accompanied by stiffness, swelling, or a feeling of restlessness.
Nighttime knee pain can be caused by a variety of underlying conditions, from osteoarthritis and overuse injuries to inflammation and poor sleep posture. Identifying the cause is the first step toward lasting relief.
Common Causes of Aching Knees at Night
- Osteoarthritis: The most common cause, especially in adults over 50. Cartilage breakdown leads to pain, swelling, and stiffness, often worse at night (Versus Arthritis, 2023).
- Patellofemoral pain syndrome: Pain around the kneecap, aggravated by activity or prolonged sitting.
- Tendinitis: Inflammation of the tendons, such as patellar or quadriceps tendinitis, can flare up after activity.
- Bursitis: Inflammation of the fluid-filled sacs (bursae) in the knee, often causing pain at rest.
- Meniscal tears: Cartilage injuries can cause pain, especially when the knee is bent at night.
- Rheumatoid arthritis: An autoimmune condition that can cause severe nighttime pain and stiffness.
- Overuse or injury: Repetitive strain, sports injuries, or trauma can lead to inflammation and pain that worsens at night.
- Restless legs syndrome: Sometimes mistaken for knee pain, this neurological condition causes uncomfortable sensations in the legs at night.
Citations: NHS, 2023; Arthritis Foundation, 2023
Risk Factors
- Age (risk increases with age)
- Previous knee injuries
- Obesity or being overweight
- Repetitive activities (running, squatting, kneeling)
- Family history of arthritis or joint disease
- Poor sleep posture or unsupportive mattress
- Systemic conditions (e.g., diabetes, autoimmune diseases)
Symptoms and When to Seek Help
Symptoms of aching knees at night can vary in intensity and duration. Common symptoms include:
- Aching, throbbing, or sharp pain in one or both knees
- Stiffness or swelling, especially after activity
- Difficulty falling or staying asleep due to discomfort
- Restlessness or the urge to move your legs
- Reduced range of motion or difficulty straightening the knee
Seek medical attention if:
- Pain is severe or sudden
- You experience redness, warmth, or fever (possible infection)
- You cannot bear weight or your knee gives way
- There is significant swelling or deformity
Diagnosis
A healthcare professional will diagnose the cause of your aching knees at night by:
- Taking a detailed medical history and asking about your symptoms, activity levels, and sleep habits
- Performing a physical examination, checking for tenderness, swelling, and range of motion
- Ordering imaging tests (X-ray, MRI, or ultrasound) if structural damage or arthritis is suspected
- Blood tests if an inflammatory or autoimmune condition is suspected
Early diagnosis is key to effective treatment and preventing further joint damage.
Citation: NHS, 2023
Treatment Options
Treatment for aching knees at night depends on the underlying cause, severity, and your overall health. Most people benefit from a combination of self-care, medical treatments, and lifestyle changes.
Self-Care and Lifestyle Changes
- Rest and activity modification: Avoid activities that worsen pain, such as deep squats or high-impact exercise.
- Ice therapy: Apply ice packs for 15–20 minutes before bed to reduce inflammation.
- Heat therapy: Warm compresses or baths can help relax stiff muscles and joints.
- Elevation: Elevate your legs with a pillow to reduce swelling.
- Gentle stretching: Regular stretching of the quadriceps, hamstrings, and calves can relieve tension.
- Supportive mattress and pillows: Use a knee pillow or place a pillow under your knees for comfort.
- Weight management: Maintaining a healthy weight reduces stress on the knees.
Medical Treatments
- Pain relief: Over-the-counter medications such as paracetamol or ibuprofen.
- Topical treatments: Anti-inflammatory creams or gels applied directly to the knee.
- Physical therapy: A physiotherapist can design a program to strengthen muscles, improve flexibility, and correct biomechanics.
- Injections: Corticosteroid or hyaluronic acid injections may be considered for persistent pain.
- Assistive devices: Knee braces or orthotics can provide support and reduce strain.
- Treatment of underlying conditions: Managing arthritis, gout, or other systemic diseases is crucial.
Citations: Arthritis Foundation, 2023; NHS, 2023
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat aching knees at night. Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with aching knees at night.
As prolotherapy is helping to treat the root cause of aching knees at night, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Rehabilitation and Recovery
A structured rehabilitation program is essential for long-term relief. This may include:
- Gradual return to activity under professional supervision
- Strengthening exercises for the quadriceps, hamstrings, and hip muscles
- Balance and proprioception training
- Education on joint protection and pacing strategies
- Regular follow-up to monitor progress and adjust the plan
Recovery time varies depending on the cause and severity of your knee pain. Most people see improvement within weeks to months with consistent care.
Citation: PhysioPedia, 2023
Prevention Tips
- Warm up before exercise and cool down afterward
- Maintain a healthy weight
- Wear supportive footwear
- Strengthen and stretch the muscles around your knees
- Avoid repetitive high-impact activities
- Use proper technique during sports and exercise
- Address biomechanical issues with orthotics if needed
Regular check-ups with a physiotherapist can help identify and address risk factors before they lead to chronic pain.
Case Studies
Case Study 1: Osteoarthritis-Related Night Knee Pain
Background: Mary, a 62-year-old retired teacher, experienced worsening knee pain at night due to osteoarthritis.
Treatment: She received a combination of physiotherapy, weight management advice, and prolotherapy.
Outcome: Mary reported significant pain reduction and improved sleep within three months.
Case Study 2: Patellofemoral Pain in a Runner
Background: Tom, a 35-year-old recreational runner, developed aching knees at night after increasing his mileage.
Treatment: He underwent a tailored rehab program and received prolotherapy injections.
Outcome: Tom returned to running pain-free and now incorporates regular strength training.
Case Study 3: Night Pain from Bursitis
Background: Linda, a 48-year-old office worker, suffered from knee bursitis that flared up at night.
Treatment: She received anti-inflammatory medication, physical therapy, and prolotherapy.
Outcome: Linda’s night pain resolved, and she is now able to sleep comfortably.
FAQs
Q1: Why do my knees ache more at night?
Nighttime pain can be due to reduced movement, inflammation, or underlying conditions like arthritis. Lying still may also make you more aware of discomfort.
Q2: Can I exercise with aching knees at night?
Gentle, low-impact exercise is usually safe and beneficial. Avoid activities that worsen your pain and consult a physiotherapist for guidance.
Q3: Is prolotherapy safe for aching knees at night?
Prolotherapy is considered safe when performed by a qualified practitioner. It is minimally invasive and has a low risk of complications.
Q4: When should I see a doctor?
If you have severe pain, swelling, redness, or cannot walk, or if symptoms persist despite self-care, consult a healthcare professional.
Q5: How long does it take to see results from treatment?
Most people notice improvement within a few weeks, but full recovery may take several months depending on the cause and treatment plan.
Conclusion
Aching knees at night can be frustrating and exhausting, but effective solutions are available. By understanding the underlying causes, seeking early diagnosis, and following a comprehensive treatment plan—including innovative options like prolotherapy—you can achieve lasting relief and restful sleep.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let aching knees at night control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating aching knees at night, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with aching knees at night and providing effective treatment options to alleviate them.
He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
LinkedIn profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
References
- NHS. (2023). Knee Pain
- Versus Arthritis. (2023). Osteoarthritis
- Arthritis Foundation. (2023). Why Does Arthritis Hurt More at Night?
- PhysioPedia. (2023). Knee Pain
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.