The joint pain associated with OA typically gets worse during exercise and improves with rest. However, when OA is advanced and joints are significantly damaged, patients may experience pain while resting—especially pain at night that keeps them from sleeping. This problem can lead to daytime sleepiness, irritability, clouded thoughts, and depression.
Night pain associated with OA occurs predominantly in the hips and shoulders. It is aggravated by overuse of the joints and improves with several days rest. Individuals who suffer from night pain can benefit from some simple strategies, however.
People with night pain should identify those activities that cause or worsen their night pain, and then avoid or modify these activities so as to reduce the stress on joints. Such modifications might include using a cane when walking, using a motorized wheelchair if walking is too difficult, or using a “grabber” to pick up objects and reduce the amount of back bending necessary.
Use of a firm mattress that distributes the body weight evenly over a large area can also offload pressure on the affected joint. Newer, foam-based mattresses may offer advantages in this regard. Placing pillows between the knees or under the arm may also help to relieve OA-related pain, as may elevating the entire leg with a pillow. You should avoid placing a pillow under the knee so that the knee is flexed for long periods of time, however. Prolonged flexion of the inflamed knee can lead to a contracture of the ligaments and a reduced ability to fully extend the knee. If necessary, you can also try a variety of sleep positions.
If pain persists, taking pain medication before going to sleep may help you to get a good night's rest. Appropriate medications may include nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), narcotic medications (e.g., morphine or hydrocodone), or even antidepressants (e.g., amitriptyline), all of which have been shown to be effective in relieving chronic pain conditions. You should discuss the type and dosage of nighttime medications with your doctor before taking them.
In some cases, night pain caused by OA may be very difficult to endure. Intractable pain may be a sign that it is time to consider surgery.
Night pain caused by osteoarthritis may sometimes be very difficult to endure. Intractable pain may be a sign that it is time to consider surgery.
I experience night pain in my knee and fingers, but not on a regular basis. It seems to happen when I have tried to do too much during the day. Only rarely does it interfere with my sleep.