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Old 01-17-2012, 06:01 PM   #1
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Nighttime knee pain-- please help?

About one week out of every month I wake up every night with excruciating knee pain. I wake up several (sometimes 10) times a night with a terrible ache in my right knee. My knee locks at 90 degrees and it takes me about a minute to be able to straighten it out. Once I get it straight, the pain slowly subsides over the next 5-10 minutes and I'm able to fall back asleep...until it wakes me up again. It jolts me awake and feels like my kneecap is being torn away from my femur. Several times my roommates have come running into my room because I cried out when the pain woke me up.

To my knowledge, I haven't injured my knee. Even if I did, these episodes recur at seemingly random times. I do have undiagnosed low back pain that I see a physical therapist for, but my knee pain flares don't seem to coincide with back pain flares. I have pronated ankles, which could be putting strain on my knees, but then why wouldn't it hurt all the time? I have very hypermobile joints and sometimes that knee feels like it begins to partially dislocate. But I'm only 22, so it can't be any sort of normal degeneration. I've had x-rays (negative), RA tests (negative), and a host of other tests for genetic and acute issues (infections, etc.; all negative). My knee never seems swollen, hot, or red, so there's no fluid accumulation.

I sleep on my side with my legs bent and a pillow between my knees (on recommendation of my PT). I have tried sleeping with my legs at different angles, straightening out one or both, and sleeping on my back. But if I'm in one of those "flare" weeks, it doesn't matter. OTC pain relievers and ice don't help. I'm running out of ideas and patience.

Does anyone have insight into this? I've had people suggest tendon problems, meniscus problems, ligament problems, cartilage problems, and pretty much everything else, but the fleeting episodes make my doctors shy away from any of these diagnoses.

 
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Old 01-22-2012, 08:07 PM   #2
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Re: Nighttime knee pain-- please help?

I have extreme knee pain at night time (and at daytime), but I have almost bone on bone in my knee due to lack of cartildge. I , also am a side sleeper and sleep with a pillow between my knees. My knee hurts if it is bent or straight and it is like it is locked. To me it seems like you havea knee issue.

 
Old 01-23-2012, 03:58 PM   #3
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Re: Nighttime knee pain-- please help?

Thanks for responding, nana b. I've often wondered about my cartilage, but no one else seems worried about it. As I recall when I had my x-ray, they said the space between the bones would allow for sufficient cartilage, indicating that it was probably fine.

I go to physical therapy once a week for my back and I asked my PT about it today. He says it's not swollen, hot, bruised, tender, or otherwise obviously inflamed. He also said that most young women can straighten one leg and lift it until almost 90 degrees with the upper body without feeling much tightness, and I can't even get close. My left leg will go about 120, but my right will barely go a foot off the table before I get a lot of tightness in my low back and lower calf (in my left, it's more of a behind-the-knee tightness). I said in my first post that I had hypermobile joints, and I do. The only test on the Brighton score that I don't pass is that I can't bend double and rest my palms on the floor (or touch my toes, even). But my PT gave me a few non-weightbearing exercises to do and it seems to at least improve circulation in my knee which makes it feel warmer and slightly better, so I'm going to see if it improves. If not, I can't continue not sleeping so I'm going to have to go back to my PCP and see what she says.

 
Old 01-25-2012, 10:36 PM   #4
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Re: Nighttime knee pain-- please help?

Sounds like you have a joint mouse i.e. loose body in the knee. Won't show on xray.
Ask your PT.
James

 
Old 01-26-2012, 06:01 PM   #5
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Re: Nighttime knee pain-- please help?

Quote:
Originally Posted by james079 View Post
Sounds like you have a joint mouse i.e. loose body in the knee. Won't show on xray.
Ask your PT.
James
Interesting. I haven't managed to come across that one in my endless Google searches.

As long as I can remember, that knee has always (usually painlessly) popped when extending from an angle >90 degrees. I never thought much of it, because my left hip also regularly pops and many of my other joints pop periodically. If it was a loose body, it could have been stationary/fixed (which according to many sources can be more or less asymptomatic) but somehow recently got dislodged and causes me pain. It could, at times go somewhere that it doesn't cause as much pain, leading to the "episodes." Very odd. I will bring it up with my PT. Thank you very much, James!

 
Old 01-26-2012, 06:50 PM   #6
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Re: Nighttime knee pain-- please help?

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Originally Posted by perfectann View Post
Interesting. I haven't managed to come across that one in my endless Google searches.

As long as I can remember, that knee has always (usually painlessly) popped when extending from an angle >90 degrees. I never thought much of it, because my left hip also regularly pops and many of my other joints pop periodically. If it was a loose body, it could have been stationary/fixed (which according to many sources can be more or less asymptomatic) but somehow recently got dislodged and causes me pain. It could, at times go somewhere that it doesn't cause as much pain, leading to the "episodes." Very odd. I will bring it up with my PT. Thank you very much, James!
You are exactly right. I have them in my ankles and only rarely give trouble. When they do migrate to the joint I shake my foot around and most of the times they get shunted back from whence they came.
James

 
Old 01-26-2012, 08:44 PM   #7
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Re: Nighttime knee pain-- please help?

As we age we can get loose cartilage and floaters can hurt. Even if you don't recall an injury something as simple as a slight twist can cause a problem. When you see PT or your doctor describe your symptoms in detail (where the pain is, does it radiate, is there any swelling, what happens after the episode, etc)
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Old 01-26-2012, 09:00 PM   #8
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Re: Nighttime knee pain-- please help?

Quote:
Originally Posted by SpineAZ View Post
As we age we can get loose cartilage and floaters can hurt. Even if you don't recall an injury something as simple as a slight twist can cause a problem. When you see PT or your doctor describe your symptoms in detail (where the pain is, does it radiate, is there any swelling, what happens after the episode, etc)
While this is true, at age 22 it would be unusual. It may well be a osteochondritis dissicans causing the grief. Small pieces of cartilege come off the joint surface at times with a tiny attachment of underlying bone. Seems to happen at puberty when proper bone is being formed.
James

 
Old 02-03-2012, 06:58 PM   #9
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Re: Nighttime knee pain-- please help?

I missed PT this week because of a migraine, but I'll ask him next week. The exercises he gave me have helped (and helped my back, too), but it still lingers.

And yeah, I'm only 22 and already have problems, so I'm not looking forward to that whole "as we age" thing. My dad had Legg Perthes as a kid, and though it's mostly seen in males, I can't help but think it's made me somehow susceptible to joint/bone problems. But thanks for your help, guys. Fortunately my PT isn't one who rolls his eyes when I mention online research (unlike other docs I've run into).

 
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