Why does my knee hurt when I turn over in bed?

Why turning over is a trigger

When you roll over in your sleep, the thigh rotates while the foot often stays caught in the bedding. The knee twists slightly, without the muscle control you would have when awake. If the meniscus is torn, the loose edge can be pinched between the bones. A knee with arthritis or a swollen joint lining can also hurt when moved after being still for hours.

Likely causes

• Meniscus tear: a sharp, catching pain on the inner or outer joint line, sometimes with a click, then settling
• Knee osteoarthritis: a deeper ache and stiffness when you start to move after lying still
• Pes anserine bursitis or tendon pain: tenderness on the inner side below the joint when the knees press together
• IT band irritation: pain on the outer side when lying on that side or turning towards it
• A Baker's cyst: tightness or pain behind the knee when the leg is fully bent or straightened

Turning more comfortably

• Bend both knees and roll your whole body as one, rather than leaving the painful leg behind
• Keep a pillow between your knees so the top knee does not twist or press on the other
• Use loose bedding so your foot does not get caught
• If one side is painful, start the night on the other side
• Gentle knee movements before sleep can ease stiffness

When to see a knee specialist

Book an appointment if turning over regularly wakes you, if the knee also catches or locks during the day, if it swells, or if you remember a twist that started it. Seek urgent care if night pain is constant, or comes with fever or a hot, swollen knee.

At Aman Hospital in Doha, Dr. Gelber examines the joint line and the tendons around the knee, and arranges an MRI if a meniscus tear seems likely and the result would change treatment.