Joint pain may worsen during the night due to fluid buildup or chemical processes in your body that cause inflammation. But at-home treatments and adjustments to your daily and nighttime routines may help you get a good night’s sleep.

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If you have a condition that causes joint pain, you may have found that the pain can be worse at night. Joint pain at night is not usually a medical emergency. But it can severely limit your ability to get a good night’s sleep.

Most joint pain is due to arthritis, inflammation of the joints. This includes:

According to the Arthritis Foundation, 4 in 5 people with arthritis have trouble sleeping.

But other common conditions can also contribute to joint pain at night, such as:

This article will discuss why your joints may ache or hurt more at night. We’ll also provide tips on managing joint pain at night and explain when to see a doctor.

There are many theories as to why your joints might hurt more at night. Possible reasons include:

Fluid buildup

When your body is at rest, fluid accumulates in and around your joints, causing swelling and inflammation. This causes the muscles and tissues surrounding your joints to become tight and stiff. The result is joint pain during the night and upon waking.

Cytokines

At night, some of your cells release cytokines, small proteins that help activate your immune system. Some cytokines help to make you sleepy. But they can also generate inflammation, which can increase joint pain.

Body position

Your sleep position can put pressure on joints, making existing joint pain worse. For example:

  • If you have hip or shoulder pain on one side of your body, try to avoid putting pressure on that joint by sleeping on your other side.
  • You can worsen wrist pain if you sleep with your wrists bent.
  • Neck pain may worsen if you’re a stomach sleeper and your neck remains twisted to one side for hours at a time.

Mattress and pillow

Your mattress and pillow may also be part of the problem. A too-soft, unsupportive mattress may not provide enough cushioning to support the proper alignment of your spine. This can put pressure on tender joints.

If your pillow is too high, too low, or lumpy, it may force you to hold your neck and shoulder joints in an unnatural position while sleeping. This can irritate your nerves and generate joint pain.

The underlying cause of joint pain may determine how best to manage it. For example, if you have jaw pain due to a temporomandibular joint (TMJ) disorder, wearing a night guard might be a good way to reduce it.

You can typically manage joint pain at night with at-home treatments. A trial-and-error approach may be needed before you learn what works best for you. Here are 10 things to try:

1. Exercise

Strong, supple muscles help take pressure off of painful joints. Exercises like stretching and yoga can help people with conditions like rheumatoid arthritis or osteoarthritis. Other good choices include:

You may consider working with a physical therapist on exercises for specific joints and muscle groups.

2. Apply heat

Some people find that using heating pads or compresses on painful joints before sleep provides nighttime relief. You may also find that taking a warm bath before bed reduces pain and provides relaxation.

When you apply heat to an aching joint, the blood vessels in that area increase in size. This increases blood and oxygen circulation in and around the joint, reducing stiffness and pain.

If your joint pain is due to an injury, check with a healthcare professional before using heat. For injuries, applying cold during healing may be a better choice.

3. Apply cold

Cold packs decrease blood flow to the joint, reducing swelling and inflammation. The numbing sensation caused by applying cold or cool compresses can also help reduce pain.

Try using a cold pack directly on the painful joint for 10 to 20 minutes before going to sleep. You can also try immersing yourself in a cold or cool bath for as long as you feel comfortable.

4. Try over-the-counter (OTC) pain medication

OTC pain relievers, including those that reduce inflammation, may be helpful. These include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen. Look for extended-relief versions that last for 8 hours or more, so your pain doesn’t return during the night.

Make sure to follow package directions and don’t overuse. If OTC pain meds aren’t enough, talk with a healthcare professional about prescription drugs for pain.

If you have high blood pressure, heart disease, or kidney disease talk with a doctor about which OTC pain reliever would be best for you. Some may cause you to retain water, which can cause kidney problems or raise your blood pressure.

5. Use topical treatments

Topical treatments are medications you apply directly to your skin. Some ointments can provide targeted pain relief. Look for gels, sprays, and lotions that contain active ingredients such as:

  • Menthol: Menthol can provide a cooling sensation to your skin, helping to mask pain.
  • Camphor: Camphor can provide both cool and warm sensations to your skin and numb nerve endings.
  • Arnica: Arnica has anti-inflammatory properties and supports enhanced circulation.
  • Capsaicin: Capsaicin reduces the amount of a specific pain transmitter in your nerves.
  • Salicylates: These plant-based chemicals can help reduce inflammation.

6. Consider glucosamine and chondroitin supplements

Glucosamine and chondroitin are compounds found in cartilage, the connective tissue that cushions and surrounds your joints. Research into their benefits for joint pain has produced mixed results. But some people find that taking these supplements as directed helps to reduce joint pain from osteoarthritis.

Since the Food and Drug Administration (FDA) does not regulate supplements, be sure to look for the “USP-verified” mark on these products. That means it’s from a trusted manufacturer.

7. Meditate

If joint pain wakes you up at night, it can be hard to go back to sleep. But research suggests that meditation may help you manage chronic pain of all types, especially during the night and before bed.

A 2018 review of studies found that meditation changes the way your brain processes pain signals, reducing your sensitivity to pain. It can also reduce anxiety and help you relax.

Many gyms and yoga studios offer classes and workshops in meditation. There are also meditation apps to guide you through long and short meditation exercises.

8. Upgrade your mattress and pillow

If your current mattress is too soft or older than 8 years old, consider getting a newer model suited for joint pain relief.

You may also benefit from a pillow designed to reduce knee or neck pain.

9. Create a soothing sleep environment

Proper sleep hygiene habits won’t necessarily reduce joint pain, but they will make it easier for you to fall asleep, despite it.

Ensure your room is dark, cool, and quiet. Turn off electronic devices at least 1 hour before trying to sleep. You may also benefit from listening to relaxing music, meditating, or reading a good book before you turn the lights out.

Aromatherapy may also be helpful for soothing sore joints and for promoting relaxation.

10. Move and stretch when you wake up

Morning stretches won’t necessarily help you with nighttime pain, but they may help relieve stiffness and pain when you first wake up. Moving right when you wake up helps to move fluids out of inflamed joints and reduces swelling.

Try stretching your arms and legs and flexing your fingers and ankles before you get out of bed. You can do this with your knees bent, lying chest-down, or sitting.

Chronic nighttime pain can cause sleep deprivation and exhaustion. It may also significantly reduce your ability to partake in daily activities and enjoy life. Let a healthcare professional know if your joint pain doesn’t respond to at-home treatments.

See a doctor if you notice any of the following symptoms:

  • You have intense joint pain that lasts for several weeks or longer.
  • Pain is waking you up from sleep consistently.
  • You experience sudden swelling or warmth around the joint or can’t move it easily.
  • Your joint pain is accompanied by fever.

A doctor may prescribe oral, topical, or injected medications to help reduce your symptoms.

Joint pain at night has various underlying causes, from injuries to arthritis. It can be exhausting and debilitating. But you don’t need to live with pain.

Many at-home treatments, such as OTC medications and heat or cold compresses, can help. Lifestyle changes like exercising or improving your sleep hygiene can also help.

If your joint pain is severe or doesn’t respond well to at-home treatments, visit a healthcare professional. They can assess your symptoms and provide further treatment options.