Joint pain is something many people struggle with, and one of the most frustrating things about it is how it often gets worse at night. You might find that during the day, you can manage your pain, but once you lie down to sleep, the ache or stiffness seems to intensify. This is not just in your head. There are real reasons why joint pain feels worse at night, and understanding them can help you find ways to feel more comfortable and sleep better.
One of the main reasons joint pain gets worse at night is because of how your body works while you sleep. When you are active during the day, your muscles and tendons help support your joints. They keep things stable and can even take some of the pressure off the bursae, which are small fluid-filled sacs that cushion your joints. But when you lie down to sleep, your muscles and tendons relax. This relaxation means there is less support for your joints, and the bursae can become more irritated, especially if you have a condition like bursitis. This is why people with bursitis often notice their pain gets worse at night. The lack of muscle support can lead to small movements or changes in joint position while you sleep, which can irritate the bursa even more [1].
Another reason joint pain feels worse at night is because of changes in your body’s natural rhythms. Your body has something called a circadian rhythm, which controls many of your bodily functions, including how much inflammation you have. At night, your body produces more pro-inflammatory cytokines, which are chemicals that can make inflammation worse. This means that even if your joint pain was mild during the day, it can feel much worse at night because your body is naturally more inflamed [1].
Hormones also play a role in nighttime joint pain. One important hormone is cortisol, which helps reduce inflammation. Cortisol levels are usually highest in the morning and lowest at night. When cortisol is low, your body’s ability to fight inflammation is weaker, so any existing joint pain can feel more intense. This is why people with conditions like osteoarthritis or rheumatoid arthritis often wake up with stiff, painful joints in the morning or during the night [1].
Blood flow to your joints also changes when you sleep. When you are lying down, blood flow to your joints can slow down. This reduced circulation means that your joints don’t get as much oxygen and nutrients, which can make them feel stiffer and more painful. This is especially true if you have arthritis, because the lack of blood flow can make the stiffness and pain worse when you wake up [4].
Temperature and humidity can also affect joint pain at night. Many people notice that their pain gets worse when the temperature drops, which often happens at night. Cold air can make muscles and tendons tighten up, which puts more pressure on your joints. This can make the pain feel sharper or more intense. Humidity can also play a role, as changes in the air can trigger flare-ups in some people [1].
Another factor is how your body processes pain signals at night. During the day, you are distracted by activities, work, and other things going on around you. At night, when everything is quiet, you are more aware of your body and any pain you are feeling. This can make the pain seem worse, even if it hasn’t actually changed. Also, your body’s natural pain relief systems are less active at night, so pain signals can feel stronger [1].
Sleep itself can also make joint pain worse. When you sleep, your body goes through different stages, and some of these stages can affect how you feel pain. For example, people with fibromyalgia often don’t get enough deep sleep, and their sleep is frequently interrupted. This means they wake up feeling unrefreshed and more sensitive to pain. The lack of restorative sleep can make joint pain feel worse the next day, and it can also make it harder to fall asleep the night after [5].
Certain medical conditions can also make joint pain worse at night. Osteoarthritis, for example, causes pain and stiffness in the joints, and this can make it hard to sleep. The pain often gets worse with activity and improves with rest, but stiffness is most noticeable after periods of inactivity, like when you wake up in the morning or during the night [3]. Rheumatoid arthritis is another condition that can cause joint pain to get worse at night. Flare-ups can be triggered by stress, illness, or even changes in the weather, and the pain can be more intense when you are trying to sleep [3].
Ankylosing spondylitis is a type of inflammatory arthritis that affects the spine. People with this condition often have pain and stiffness that is worse in the morning or at night, especially if the pain improves with exercise and worsens with rest. This is because the inflammation in the spine can be more active at night, and the lack of movement can make the stiffness worse [6].
There are also some things you can do to help manage nighttime joint pain. Gentle exercise during the day can help reduce pain and stiffness, making it easier to sleep at night. Finding a comfortable sleep position can also make a big difference. For example, using pillows to support your joints or sleeping on your side instead of your back can help take pressure off painful areas [2]. If you are having trouble sleeping because of joint pain, it is important to talk to your doctor. They can help you find treatments that work for your specific condition and may recommend things like physical therapy, medication, or even cognitive behavioral therapy for insomnia [2].
In some cases, joint pain at night can be a sign of a more serious problem. If you have pain that wakes you up from sleep, especially if it is worse in the morning or improves with exercise, it is important to see a healthcare professional. They can help determine if you have a condition like ankylosing spondylitis or another type of inflammatory arthritis that needs special treatment [6].
Joint pain at night is a common problem, and it can be caused by many different factors. Understanding why it happens can help you find ways to feel more comfortable and sleep better. Whether it is due to changes in your body’s natural rhythms, reduced blood flow, or the effects of certain medical conditions, there are steps you can take to manage your pain and improve your quality of life.
Sources
[1] https://int.livhospital.com/bursitis-flare-up-at-night/
[2] https://www.blua.bupa.com.au/more-conditions/bone-hip-knee-and-joints/osteoarthritis-how-to-sleep-better-with-joint-pain
[3] https://nec24.com/blog/what-causes-joint-pain-all-over-body
[4] https://www.manipalhospitals.com/jayanagar/blog/arthritis-joint-pain-worst-at-night-or-early-morning/
[5] https://www.franciscanhealth.org/community/blog/fibromyalgia
[6] https://www.mayoclinic.org/diseases-conditions/ankylosing-spondylitis/symptoms-causes/syc-20354808
