You lie down and your knees start to throb, or they knock together uncomfortably when you’re on your side. Then in the morning they feel stiff for the first few steps. Knee aches often feel louder at night, and a few small changes can help you settle.

Why knees can ache more at night

During the day, movement and distractions can take your attention away from aches. At night, lying still with nothing else to focus on, you may notice them more. Many people with long-standing knee pain say night-time is when it bothers them most.

The way your knees rest in bed can matter too. Knees can be sensitive to pressure and to being held in one position for a long time.

On your side

When you lie on your side, your knees can press against each other, bone on bone. A pillow between your knees, ideally reaching down to your ankles, can cushion them and keep your top leg level with your hip. Many people find this one change makes a big difference.

On your back

A pillow under your knees can feel comfortable when they ache. A large pillow, though, can keep your knees bent for hours, which may leave them stiffer and harder to straighten in the morning. A small, flatter pillow may suit you better. Some people prefer a pillow under their calves, so their knees can rest a little straighter.

Morning stiffness

Knees often feel stiff after hours of rest. This usually eases within the first half hour of moving. Gently bending and straightening your knees a few times before you get out of bed can help them loosen before they take your weight.

What you do in the day affects your nights

Too little movement can leave knees feeling stiff. A lot more than usual can leave them achy. Many people find their nights go better when their daytime activity is steady from day to day, rather than a lot one day and very little the next. Exercise is one of the main recommendations for long-standing knee pain, and building strength around your knees may help them feel more comfortable at night too.

Sleep and pain affect each other

A broken night can make you more sensitive to discomfort the next day, which can make the following night harder too. Getting your knees comfortable in bed can help break that cycle.

Something to try this week

If you sleep on your side, try a pillow between your knees and ankles, and notice how your knees feel in the morning.

What to take away

• Use a pillow between your knees and ankles when lying on your side.
• Try a smaller pillow under your knees, or one under your calves.
• Bend and straighten your knees before getting out of bed.
• Keep your daytime activity steady from day to day.

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