Night Knee Pain Is Not to Be Ignored
Experts warn that pain that worsens at rest requires a medical examination, while physical symptoms such as walking difficulties may indicate cognitive decline.
Experts warn that pain that worsens at rest requires a medical examination, while physical symptoms such as walking difficulties may indicate cognitive decline.
Knee pain is a common complaint that, especially after age 40, is most often attributed to joint wear and tear. However, experts warn that there are patterns of pain that should never be overlooked, as they can signal more serious conditions-from rare forms of bone cancer to neurodegenerative diseases like dementia.
"Most knee pain in people over 40 comes down to joint wear and tear, and that remains the most likely explanation," said Dr. Sayed Nadem Abbas, a surgeon and regenerative medicine specialist at The Knee Pain Clinic. However, pain that behaves unusually requires special caution.
"What is often overlooked is pain that doesn't follow the usual rules-pain that is worse at rest than when you're active, or that wakes you up during the night," explained Dr. Abbas. With osteoarthritis or exertion-related pain, symptoms typically ease with rest, so nighttime pain is a sign that something else is wrong.
People with healthy knees usually don't experience pain at night. Typically, there is a specific cause for such pain, and several different health conditions can trigger it.
Dr. Kim Stearns, an orthopedic surgeon, agrees with this assessment: "People with healthy knees generally don't have nighttime pain. There's usually a reason for it, and multiple conditions can cause it."
Nighttime knee pain can be caused by a range of conditions, including rheumatoid arthritis, gout, tendinitis, prepatellar bursitis, Osgood-Schlatter disease, or injuries. Dr. Abbas also notes that vitamin D deficiency can be linked to unexplained joint pain.
The UK's National Health Service (NHS) states that, although very rare, such pain can also be a symptom of bone cancer. Around 550 cases of this disease are diagnosed annually in the UK. Dr. Abbas specifically highlights chondrosarcoma, one of the most common types of primary bone cancer, which is more prevalent in adults over 40. Nevertheless, experts emphasize that nighttime pain doesn't automatically mean the worst-case scenario, but it is essential to consult a doctor.
In the context of serious conditions that manifest with physical symptoms, dementia experts point out that mobility issues can also be early indicators of cognitive decline. It is estimated that around 90,000 people in Croatia suffer from some form of dementia.
"The ability to maintain balance and walk smoothly actually requires enormous brain power because you have to process a lot of different information," notes Dr. Stephanie Nothelle, a geriatrician and associate professor at Johns Hopkins School of Medicine. Therefore, difficulties walking, balance problems, and frequent falls can indicate dementia.
Dr. Jori Fleisher, an associate professor of neurological sciences at Rush University in Chicago, says that in dementia with Lewy bodies, changes in posture, shuffling feet, or a noticeably slowed gait may be visible. Additionally, loss of smell can be one of the earliest signs of Alzheimer's disease. "Sometimes the person doesn't notice the change themselves, but loved ones comment, 'Hey, something was burning on the stove, and you didn't smell it,'" explains Dr. Fleisher.
Whether it's unusual joint pain or subtle physical changes, experts agree that seeing a doctor early is crucial. "The magic line that moves someone from mild cognitive impairment to dementia is the point where one of these impairments starts to interfere with daily functioning," says Dr. Nothelle. "Early detection can be very helpful for many reasons, including planning and having a say in your future."
Dr. Fleisher concludes: "As scary as we know this is, diagnosis, knowledge, and early detection are power."
