Chiropractor Questions

What would cause middle of the night severe knee pain?

I am a completely healthy and fit 32 year old- know knee, bone or joint problems. Over the last couple of months in the middle of the night I wake up with a stabbing, unbearable pain in my left knee that comes out of nowhere. Moving my knee for the whole next day is painful, and then it goes away on it's own. What could this be?

17 Answers

Reactive synovitis or autoimmune?
This could be a variety of things. You really need to have it checked out. Some of the questions to answer would be do you run for exercise? How often and how far? Do you have a family history of this? Is there swelling or discoloration? A good thorough history is vital, as is a comprehensive examination of the knee, hips, ankles, feet, and possibly some blood work and a urinalysis.
My first guess would be osteoarthritis.
Have you check yourself for gout?
You need to be evaluated with a thorough history and physical eamination- and a few diagnostic tests. It could be a lot of things.
Osteoarthritis of the joint is one possibility
The knee pain could be a result of a pinched nerve from your low back. A detailed examination by a chiropractor will help in finding the root cause of the pain.
This could be many things, I recommend getting x-rays taken of the knee to see if there is anything unusual going on in the joint itself.
An MRI is recommended
It is most likely a meniscus tear. Movement during sleep catches the torn piece of cartilage. You should see an orthopedic surgeon and get an MRI. An arthroscopy can make it go away. 


James E. Gilbert, MD
You may have a floater. A piece of cartilage that has broken loose and moves around. See an orthopedic.
A post-traumatic injury can cause damage to cartilage and ligaments. Did you play sports in HS or college? This must be evaluated. This type of stabbing pain indicates meniscus damage in most cases. First, an X-ray is necessary, and then a follow-up with an MRI of the affected knee will tell more detail of the soft tissue.
The complaint you have is not normal by any means. I would have the knee looked at by an appropriate specialist.
It could be that your knee is unstable and the meniscus is getting caught. It’s common when we rest that our muscles relax and if our ligaments are too loose it can allow for the instability to create pain. An effective knee adjustment by a skilled chiropractor can help the meniscus Kay flat and then some rehab exercises can help prevent the pain at night.
Could be a torn meniscus, but I would certainly get checked out and get an MRI

This could be a number of things. Sometimes the capsular tissue of the knee creates a little "tag" known as a plica. These tags can get caught in between the bones of the knee and get pinched. This can cause a lot of sudden pain and even swelling at times. Plica are not always symptomatic, but can be in some patients.

You may also have physical stress-induced degradation of the cartilage of the knee, which caused a small chunk of cartilage to break off and this chunk can then become lodged in between bones in the knee (much like the plica) and cause a sharp pain and even difficulty moving.

Third cause could be a muscle around the knee that is either spasming or is strained by your sleeping position. This would explain the prolonged discomfort and difficulty you have with moving the knee the next day.

Hope this helps!
Could be what is called a Baker's Cyst. However that would be an interesting time for the symptoms to produce/onset. I would consult your primary care physician first to rule out a cyst, first.