Is knee pain at night normal after knee surgery?

Why the night is harder after surgery

After an operation, the knee is swollen and the tissues are healing. During the day, movement and distraction help, and you may take pain relief more regularly. At night the knee is still, swelling settles into the joint, and long-acting pain relief may wear off in the early hours. Many patients find the second and third weeks after a knee replacement the most uncomfortable at night as they become more active during the day.

Typical timeframes

• Knee arthroscopy: night aching usually settles over one to three weeks
• ACL reconstruction or meniscus repair: often a few weeks, gradually improving as swelling reduces
• Knee replacement: night pain and difficulty finding a comfortable position commonly last several weeks and can continue on and off for some months

Every patient is different, and these are general ranges. What matters most is that the trend is towards improvement.

Sleeping more comfortably

• Take pain relief as prescribed, timed so it covers the night, and do not skip doses in the first weeks
• Ice or the cooling device you were given for 15 to 20 minutes before bed
• Lie on your back with the leg straight and a pillow under the calf, not under the knee, to keep the knee straightening
• If sleeping on your side, put a pillow between your knees
• Do your exercises during the day, but avoid a heavy session just before bed

Warning signs to report

Contact your surgical team promptly if pain is getting worse rather than better, if the wound becomes red, hot or leaks, if you develop a fever, or if the calf becomes swollen, tender or warm. Go to an emergency department for chest pain or breathlessness, which can signal a clot that has travelled to the lungs.

Patients of Dr. Gelber at Aman Hospital in Doha are given clear instructions on how to reach the team after surgery, and early review is arranged when anything is unexpected.