Throbbing Knee Pain
By - Sean Byers

Published: Last Updated: Category: Knee Pain

Tips for Living with and Finding Relief for Your Throbbing Knee Pain

  • To better understand what is causing your throbbing knee pain, it is essential to note exactly where the pain occurs in or around the knee.
  • It is crucial to describe the pain you’re noticing, as a throbbing pain may mean something different from clicking, popping, burning, or stinging.
  • You should try your best to alleviate the pain you are experiencing as quickly as possible, so it does not become a more significant issue. You can do some home remedies on your own, such as RICE treatments.
  • The National Institutes of Health published a study where randomized controlled trials were used to test the efficacy of PT (physical therapy) treatments in patients with patellofemoral knee pain.
  • Whenever you seek advice from a medical professional, the best thing you can do is provide them with as many details regarding your pain as possible.
  • Be prepared to provide your doctor with details that could help identify your pain, such as lifestyle, nutrition, physical activity, and any trauma you may have experienced to the affected area.

If you are living with throbbing knee pain, you are not alone. Health Report Live provides you with the information you need to understand and find relief for your knee pain.

If your knee pain is a response to a chronic condition, Health Report Live can also provide you with ways to live a more comfortable life with said condition.

Have you been living with throbbing knee pain? Follow our comprehensive outline below for information on causes, symptoms, and treatments for knee pain.

Throbbing Knee Pain

Many different reasons and conditions can result in a “throbbing” sensation in or around the knee. Before delving deeper into those, let’s briefly discuss how knee pain occurs, so you can better understand why common causes of knee pain may occur.

When you think about how the knee moves, the space between your femur bone and the bend of your knee must be large enough for your kneecap to go up and down within the socket (thus allowing you to move).

Knee pain is most often rooted in either the patella or the kneecap. When those areas become inflamed, the tissues surrounding the kneecap will tighten, reducing the amount of room available for the kneecap to move.

The pain then results in the kneecap attempting to move through inflamed cushioning, resulting in increased irritation and thickening of the tissues. The joint fluid may also dry out, resulting in friction, pain, and the throbbing sensation you’ve been experiencing.

What To Know About Your Throbbing Knee Pain

Where Is Your Pain?

To better understand what is causing your throbbing knee pain, it is essential to note exactly where the pain occurs in or around the knee. Depending on where you are feeling the pain or tension, it could be easier to narrow down how to treat the pain.

If you sustained an injury to the affected area, it could be easy to determine where the pain originated. Still, if the pain is seemingly occurring out of the blue, it could be stemming from an area you may not have even considered – and where you are feeling the pain could be an indication of the source of the issue.

When Do You Feel Better Or Worse?

Depending on when your pain feels more or less severe, this could also indicate what exactly is causing your knee pain. 

Some people notice the pain more when they wake up since the body has been sedentary for so long during sleeping hours. Others see it more at the end of the day, after moving around the affected area during daily activities.

You may also notice the pain during certain activities, such as bending, squatting, or kneeling on your knee in specific ways. These symptoms can outline what may cause your knee pain, so be sure to bring all this up with your medical professional if seeking professional advice.

How Do You Describe Your Pain?

If you describe your knee pain as “throbbing,” it could be due to overexertion, as the blood vessels work overtime. It is essential to describe the pain you’re noticing, as a throbbing pain may mean something different from clicking, popping, burning, or stinging pain.

It is also essential to describe other features of the pain you are experiencing; for example, is it dull and constant? Is it severe only when you move in specific ways? Do you notice it more with daily tasks or physical activity? 

Would you describe it as acute or chronic? These are all great questions to keep in mind when investigating the cause of your knee pain.

Is Anything Strange Happening?

While “strange” is undoubtedly a relative term, you know your body best. If something abnormal is going on within your own body, you would likely notice something out of the ordinary.

Do you notice you can’t move in the ways you usually can? Is there a new pang in the way you move that never used to be there? Do simple tasks seem more difficult due to your discomfort? These are all indications that something in your body may need fixing.

How to Know if Knee Pain is Serious?

It can sometimes be challenging to determine when an injury or source of pain is “serious.” As a good rule of thumb, you should typically consult a medical professional if your pain becomes unbearable. Especially if it’s inhibiting your ability to go about your daily life or if it has become chronic (meaning it has lasted for three months or longer).

Essentially, if your pain affects your ability to live comfortably, it has already become severe enough to consult with your primary physician. They will be able to give you a better idea of how to proceed with treatment.

Various Symptoms of Throbbing Knee Pain

Risk Factors

In addition to the throbbing pain you’ve been experiencing, you may notice additional symptoms or risk factors contributing to your discomfort. These may include, but are not limited to:

  • A lack of muscle strength
  • Muscle strength imbalance (i.e., some muscles feeling weaker and others feeling stronger)
  • Muscle coordination issues
  • A lack of flexibility
  • Gait issues, such as poor walking and running biomechanics

When to See a Doctor

If you notice any of the symptoms mentioned above in addition to your knee pain, that could be an indication to seek the advice of your medical provider. If your knee pain begins to hinder your daily life or becomes chronic (lasting longer than three months), it might be time to consult with your doctor. 

Many people who experience pain try to ignore or “push through” the discomfort; however, this could exacerbate the problem and make it more challenging to solve. 

Sharp or dull pain in the knee should be taken seriously and not ignored – a doctor, sometimes via x-ray, can help identify the issue and help you begin the steps toward finding relief.

Possible Causes of Throbbing Knee Pain

Now that we’ve outlined the anatomical reasons knee pain occurs (and when you should seek professional assistance), we can get into more specifics of what conditions may be causing your knee pain.

Common causes of knee pain may include, but are not limited to:

Runner’s Knee

This condition is also known as patellofemoral pain syndrome or anterior knee pain syndrome. It occurs when the cartilage beneath the kneecap is strained, ripped, or otherwise injured due to an accident or overuse. It may also be due to gait issues, such as abnormalities with stride.

Common symptoms of the runner’s knee include a dull pain in the kneecap or rubbing and “clicking” sounds/sensations. It is a good rule to hold off running until these symptoms cease.

Mechanical Problems

As previously mentioned, knee pain could be due to mechanical problems, such as gait or balance issues in walking, running, and moving. 

Indications of a balance or gait disorder may include increased feelings of imbalance, “toppling” sensations (such as tripping over your own feet or continually rolling your ankles), or feeling as if the world is spinning around you.

A doctor can help identify balance/gait disorders and may recommend graded strength, dynamic stability, and capacity training exercises to help resolve the issues at hand. These exercises target the quadriceps, glutes, hamstrings, feet/ankles, and core muscles, which reduce pain and the likelihood of future flare-ups.

Types of Arthritis

Arthritis is a common condition that may lead to throbbing knee pain. The three most common types of arthritis include:

Osteoarthritis

Osteoarthritis is the most commonly occurring form of arthritis that people experience, known as “wear and tear” knee arthritis. Because the joint no longer has enough cushion between the bones, this generates unpleasant friction. 

With osteoarthritis of the knee, the knee cartilage will thin out, thus causing painful sensations.

Rheumatoid Arthritis

Rheumatoid Arthritis is the second most commonly occurring type of arthritis that people experience, known as “inflammatory” arthritis. Rheumatoid arthritis is a chronic autoimmune disease that causes swollen and inflamed joints of varying severity.

Infectious Arthritis

Infectious Arthritis, while this is slightly less common, you should still be aware of the indications of infectious arthritis. 

Also known as septic arthritis, this is a painful infection of the joint that festers due to bacteria traveling from another region of your body to the affected joint or joint fluid. This bacterium can stem from surgery, open wounds, or injections.

Additional symptoms of arthritis may include, but are not limited to:

  • Muscle cramps
  • Inflammation
  • Stiffness
  • Pain in the affected area that may spread to other parts of the body
  • Sounds of joint cracking, clicking, or popping
  • Limping or other abnormalities with gait
  • Feeling warm in the afflicted joint
  • Limited ROM (range of motion)
  • Increased pain when participating in specific activities
  • Swelling
  • Feeling weak in the affected area(s)

Bursitis

Bursitis is known as a ligament injury since it affects the inner workings of your knee. Outside your joints are “bursae,” or tiny fluid sacs that act as cushions. When the bursae in your knee become inflamed, it restricts the ability of your tendons and ligaments to move freely over the joint. 

This inflammation is a common knee condition found in cyclists, so if you are noticing knee pain and frequent the bike trails, be sure to ask your physician about the possibility of bursitis.

With ligament injuries such as bursitis, the tissue becomes inflamed due to overuse or repetitive activity. Even simply standing too long could irritate bursae, so don’t rule out this condition if you don’t necessarily consider yourself “active.” 

Gout

Did you know that over 8 million Americans are affected by gout? The body’s natural reaction to aberrant crystal formations in the joints, known as “tophi,” causes this form of arthritis. Chronic gout patients may notice tiny but solid lumps in or around their affected joint(s). 

These deposits can cause severe discomfort and stiffness in the affected area and long-term bone or cartilage damage. If you are experiencing gout in your knee, it could be causing your throbbing pain and may also make walking or standing difficult (potentially causing you to lose your balance or develop problems with gait). 

Tendonitis

Tendons are fibrous tissues that connect muscles to bones. Tendonitis is a condition in which one or more tendons become inflamed. Repetitive actions commonly inflame the patellar tendon, which is located in the knee.

Tendonitis can occur in any tendon in the body, but it commonly manifests in the knee. Inflammation of a tendon can result in throbbing knee pain, swelling, and discomfort.

Dislocation

Knee dislocations can happen due to a fall or another type of trauma. You may be living with the symptoms of dislocation if you’ve recently fallen or slipped, thus resulting in your throbbing knee pain.

When the kneecap becomes dislocated, it doesn’t sit comfortably in the groove, thus stretching or tearing the supporting tissues. A doctor can help re-set the kneecap to glide comfortably once again and heal. 

Additional symptoms of a dislocated kneecap may include:

  • Severe, stinging-like pain
  • Sounds or feelings of “popping” within the kneecap
  • Inability to fully straighten the knee
  • Immediate swelling of the kneecap following a trauma to the area
  • Inability to walk

Iliotibial Band Syndrome

Iliotibial band syndrome refers to pain on the outer edge of the knee/kneecap, as opposed to the front of the knee like some other conditions. This syndrome is another condition that frequently occurs in runners due to the knee’s repetitive bending and stretching motion. However, this condition can develop due to any sort of knee overuse.

The IT band is a dense bundle of fibers that runs from the top of the tibia to the outside of the thigh. When the IT band becomes excessively tight, it becomes difficult to move seamlessly over the knee, causing pain and swelling. 

Iliotibial (IT) band syndrome can be avoided by stretching thoroughly before strenuous activity (such as running or other physical feats) to keep the band from tightening up. 

Hip, Foot, or Ankle Problems

Sometimes, knee pain can stem from another part of your body, such as your hips, feet, or ankles. These body parts all encompass what’s known as the same “kinetic chain” as the knees.

This essentially means that all movements within the kinetic chain influence one another; therefore, if you are experiencing pain in your knee, it could be stemming from a condition that has developed in the hip or vice versa. 

A physician can help you determine the source of your pain in order to treat that area accordingly and help you find relief from the discomfort that’s manifesting itself in your knee. 

Overuse

Overuse of the knee due to certain physical labors, sports, and other activities, is a common cause of throbbing knee pain. If you’ve sustained a sports injury to the knee, it is likely from overuse and could cause sprains.

In fact, according to a study published by The National Institutes of Health, “cyclists with overuse-related pain or injuries in their knees present an increased medial projection of their knees and an altered activation of the vastus medialis and vastus lateralis muscles.” 

Essentially, what this means is that increased activity can result in decreased mobility and ROM (range of motion).

Pain from overuse (or over-exertion during physical activity) can typically be resolved by resting the knee and applying hot or cold compresses, but it would also be wise to consult your physician if your pain becomes severe or lingers after your home treatments.

Fracture

Fractures are most commonly caused by trauma, such as a hard fall or a collision. Fractures to the knee occur when one or more of the bones in or around the knee (such as the patella or kneecap) break.

A cast or splint can be used to treat some mild patellar fractures until the bone heals. The bits of bone in most patellar fractures, on the other hand, slide out of place when the injury occurs. In these cases, knee surgery is required in order to repair and stabilize the kneecap, in addition to allowing for better recovery function.

Injured Meniscus / Meniscus Tear

Between the shinbone and the thighbone, the meniscus serves as a shock absorber. It is composed of tough cartilage, but it can become ripped or torn if your knee twists too quickly while you are still putting weight on it (for example, while participating in sports).

If you have injured your meniscal area, it can be detected during a physical examination. To help establish the origin of your signs and symptoms, your doctor may move your knee and leg into different positions, watch you walk, or ask you to squat in order to verify the cause of the pain.

Tumor in the Knee 

A tumor of the knee, also known as osteosarcoma, is another potential cause of throbbing knee pain. While we don’t want you to jump to conclusions, you should definitely consult your doctor to conduct some tests if your throbbing knee pain does not dissipate.

The discomfort may not be persistent at first, and it may be greater at night. If the tumor is in a leg bone, the pain often worsens with movement and could potentially cause a limp.

Swelling in the affected area is another common symptom, though it may not appear right away. You may also be able to feel a lump or mass in the affected area, depending on the location of the tumor. A physician can help you identify osteosarcoma and advise you on treatments if the tests come back positive.

Osgood-Schlatter Disease

This is typically a condition that develops in childhood and leads to swelling of the tibia. Since Osgood-Schlatter Disease typically lands in this specific area, pain management plans will focus on areas surrounding the knee where the tibia is attached in order to relieve pain, reduce inflammation, and improve functional ability.

Other Knee Injuries, Disorders, Infections, and Conditions

As you likely have already realized, there are many reasons why you may be experiencing throbbing knee pain. In some cases, the severe pain could be due to a previous or underlying injury, disorder, infection, or condition to the knee.

Even minor injuries can leave you feeling weak and fatigued. Additional reasons why you may be living with your knee pain may include patellofemoral syndrome, tears (especially in the ACL anterior cruciate ligament or MCL medial collateral ligament ), injured cartilage, and more. Fortunately, no matter the case, an orthopedic or orthopaedic professional should be able to help.

Degenerative Tissue Disorders

Degenerative tissue disorders, such as degenerative knee joint disease, can certainly cause throbbing knee pain.

As stated by a study published by the National Institutes of Health, “The consensus, which includes the definition, pathophysiology, epidemiology, clinical manifestation, diagnostic criteria, and treatments of DKOA, is intended to be used by first-line doctors, including pain physicians to manage patients with DKOA.”

Essentially, what this means is that a doctor can successfully identify and treat your degenerative knee joint disease with specific, targeted methods. If you believe you may be living with DKOA (degenerative knee osteoarthritis) or another degenerative tissue disorder, consult with your doctor today.

Connective Tissue Disorders

Any disease that affects the components of the body that bind certain structures together is known as a connective tissue disorder. These illnesses can be caused by family heredity or certain aspects of your lifestyle/environment.

Treatments for connective tissue disorders vary based on the person and the ailment of the issue. Vitamin supplements, physical therapy, and pharmaceuticals may be used as treatments for these disorders.

Metabolic Problems

There are many metabolic facets that could be leading to your throbbing knee pain or could be worsening the situation. In some cases (such as those stemming from arthritic or inflammatory conditions), you may experience relief from some simple nutritional or lifestyle changes.

According to a study published by the National Institutes of Health, “There is a correlation between the number of metabolic disorders, the severity of hypertension and severity of osteoarthritis symptoms. Hypertension and decreased HDL-cholesterol were positive risk factors for increased osteoarthritis symptomatology.” 

Infection

There are certain ways in which an infection can stem in or around the knee (see infectious arthritis listed above). Infections within the knee could potentially be dangerous; therefore, it is important to treat the issue at hand right away.

Knee infections are mainly caused by germs and can arise after knee replacement or joint replacement surgery or trauma. Infections in the knee joint area or deep layers of the knee might lead to significant problems, so it is important to talk to your physician if you believe you may have an infection in your knee.

Complications

Of course, just like any other form of pain, knee pain can lead to further complications if not addressed and treated appropriately. While knee problems are not always serious, if left untreated, some knee injuries and medical disorders (such as osteoarthritis) can lead to severe pain, joint deterioration, and disability.

Furthermore, any knee injury you sustain (even mild ones) increases your chances of having further complications in the future. If you are experiencing knee pain of any sort and you are noticing complications from said pain, it is a good rule of thumb to consult with your primary physician.

Preventions That Are Important to Note

While it is always a good idea to discuss any abnormal pain you are experiencing with your health care provider, there are some preventative measures you can take to try and avoid sustaining a knee-related injury. These include, but are not limited to:

  •   Stretching – One of the most significant strategies to avoid injuries is to stretch. Stretching helps to introduce water into the tissues, which is necessary for them to be elastic. This improves muscular flexibility and prevents them from stiffening or tightening, therefore lowering the risk of overstretching and/or tearing.
  •   Staying hydrated and eating well-balanced meals – Water makes up more than 70% of your body; therefore, water is required for it to remain supple and function effectively. Your body’s tissues are more prone to injury if you don’t get enough water and nutrition. It is a good rule of thumb to drink the recommended eight glasses of water a day and make sure to bring a water bottle with you while exercising.
  •   Keeping your abilities in check – Any physical activity you want to pursue requires preparation and practice. Begin small and gradually increase your efforts. Pushing your body above its existing limits increases your risk of injury since your body is unprepared for the physical demands placed on it.
  •   Using the proper tools – It is critical to have the proper equipment when participating in any form of physical exercise. Running shoes, hiking boots, and other protective gear can help you avoid injury and stay safe while participating in your favorite activities. When it comes to preventing injuries, they can make all the difference.

How To Diagnose?

Imaging Tests

Imaging tests are a great way to identify knee pain. Specifically, musculoskeletal ultrasound imaging tests can help identify multiple different conditions that could result in your throbbing knee pain.

Musculoskeletal ultrasound imaging is a technique that employs sound waves to look into a patient’s sore areas. It enables your medical professional to be able to examine the movement in specific joints, muscles, ligaments, and nerves in the problem area in order to determine the source of discomfort and how it should be treated. 

Lab Tests

Lab tests can also identify specific issues and conditions you may be experiencing within the knee.

If your doctor detects an infection or inflammation, blood tests and maybe an arthrocentesis technique (a procedure where a small amount of fluid is taken from within your knee joint with a needle and submitted to a laboratory for analysis) may be performed.

Potential Treatments for Throbbing Knee Pain

Medications

Knee pain can be treated with a variety of medications, both over-the-counter and prescription pharmaceuticals. Orally, by ingesting a pill, topically, by applying the medication to the skin, or intra-articularly, by injecting the medication directly into the knee joint. These types of medications may include, but are not limited to:

  • Over-the-counter medications
  • Prescription medications
  • Creams
  • Pain patches

Corticosteroids

  • Opioid pain relievers
  • Hyaluronic acid
  • Local anesthetics
  • Botox
  • Platelet-rich plasma
  • DMARDs

Therapy

Sports medicine or consulting with a physical therapist is a very common holistic treatment for any type of acute or chronic knee pain. In another study published by the National Institutes of Health, randomized controlled trials were used to test the efficacy of PT (physical therapy) treatments in patients with patellofemoral knee pain.

The comprehensive review found encouraging results, confirming that manual and physical therapy treatments were effective in pain relief and increased function, particularly when hip and knee muscles were strengthened across the entire kinetic chain. 

While this review refers specifically to patellofemoral knee pain, PT has been proven to be a successful treatment for many different conditions resulting in knee pain. If you have been living with knee pain, consulting with a physical therapist could be a great idea for you.

Injections

As previously mentioned, there are many different treatments for knee pain (see medications listed above). Specifically, when it comes to injections, there are a few that your doctor may recommend, depending on your condition. These include, but are not limited to: 

  •   Corticosteroids – these are the most common types of injections for knee pain. These are steroid injections that are especially common in cases of arthritic pain as a way to avoid knee surgery.
  •   Hyaluronic acid – these are typically used when corticosteroids do not work for knee pain. If you don’t have any clear evidence of inflammation, your doctor may recommend HA (hyaluronic acid) injections initially. If you have diabetes, HA may also be a better alternative because corticosteroids can cause blood sugar levels to rise.
  •   Platelet-rich plasma – Injections of platelet-rich plasma (PRP) are a recent treatment option for osteoarthritis joint discomfort (or other knee issues). The platelets are concentrated by centrifuging cells from the patient’s own blood to eliminate red blood cells and most white blood cells.

Surgery

In some cases, knee surgery may be necessary in order to help rectify the issue at hand. The most common type of surgery for knee pain is partial or full knee replacement surgery, although you may need a less severe surgical procedure for a torn meniscus or anterior cruciate ligament (ACL) injury.

With partial or full knee replacement, the extremities of the bones that make up the knee joint, as well as the kneecap, will be capped with metal and plastic pieces. Someone with severe arthritis or a major knee injury may benefit from this procedure.

Why is Throbbing Knee Pain Worse at Night?

You’re Trying to Relax

As previously mentioned, knee pain can present itself differently at different times of the day (see When Do You Feel Better Or Worse? as well as for Tumor in the Knee). Pain worsening at night could be an indication of a tumor, but it could also be due to overexertion or another medical condition.

Cortisol (the anti-inflammatory hormone) is typically lower at night, so with certain conditions, this could present as increased pain and stiffness within the knee. If you’re just trying to relax and your pain seems to be getting worse, it could be an underlying condition that is feeding off of lowered cortisol levels.

Nighttime Inflammation

While inflammation is typically lowered at night, some conditions can lead to increased inflammation, especially in situations of overuse. If you have repeatedly been using your knee muscles and you’re noticing nighttime inflammation, this could be an indicator for you to take a rest and remedy the affected area(s).

Lack of Sleep Makes Pain Worse

Did you know that sleep and pain are connected? Well, they are! There’s a reason why doctors prescribe rest as part of rehabilitation treatments – it is important to rest both your body and your mind when you are not feeling your best.

Sleeping, sedentary hours are when a lot of healing happens within the body, so it is imperative to make sure you are getting a sufficient amount of sleep.

Useful Remedies That You Can Follow

Treat The Pain

Pain management should be your first and primary goal when dealing with any sort of knee pain. Regardless of the pain that you are experiencing, you should try your best to alleviate it ASAP, so it does not become a bigger issue. 

There are some home remedies you can do on your own, such as RICE treatments (rest, ice, compression using knee braces, elevation), in order to help ease your pain on your own. If these do not work, make sure to contact your doctor.

Time Medications

If you are taking medications for your pain, be sure to read the directions and follow your doctor’s orders (if taking prescription meds) carefully.

This will both reduce your risk of taking too much and help alleviate pain by making sure you are taking the recommended dosage before the pain has time to kick in once again.

Consider Knee Joint Injections

See our “injections” point, as listed above. These could significantly help alleviate your pain for certain knee conditions if more holistic therapies are not an option.

Knee joint injections could also reduce the necessity of surgery in the future if the condition is identified and treated early enough.

Establish A Nightly Routine

A nightly routine can do wonders for easing your pain, especially if that is when you experience knee discomfort the most. A warm shower or bath can help soothe the muscles, making it easier and more comfortable for you to fall asleep.

Warm compresses or nightly ice treatments to the affected area can also numb the tension and lead to better sleep throughout the night.

Practice Good Sleep Hygiene

See our point above about the power of a good nightly shower or bath. Certain materials of clothing can also help you feel cozier, making it more comfortable for you to sleep at night while you’re working to relieve your throbbing knee pain.

When it comes to pain in general, rest is best – so make sure you have a healthy nighttime routine to help you heal through your sleep.

Consider Additional Therapies

While we’ve covered many ways in which your throbbing knee pain can be treated, there are additional therapies you can try if these are not in the cards for you, such as acupuncture, hydrotherapy, or laser therapy. You can discuss which therapies could be beneficial to you with your medical provider.

Preparing For Your Doctor’s Appointment

What You Can Do

Whenever you are seeking advice from a medical professional, the best thing you can do is provide them with as many details regarding your pain as possible (see our “Where Is Your Pain?” “When Do You Feel Better Or Worse?” “How Do You Describe Your Pain?” and “Is Anything Strange?” points as mentioned above). 

These details will give your doctor a better idea of how to identify and treat your throbbing knee pain.

What To Expect From Your Doctor

Be prepared to provide your doctor with a series of details that could help identify your pain, such as lifestyle, nutrition, physical activity, and any trauma you may have experienced to the affected area. Your doctor may conduct a series of tests to better help determine the source of your pain, as mentioned above.

Don’t hesitate to ask your doctor any questions you may have, as these questions could also provide both you and the doctor better insight into why you are experiencing your throbbing knee pain.

For more information and answers for musculoskeletal pain, be sure to follow along with the rest of our Health Report Live articles.

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  28. https://www.mykneedoc.co.uk/why-is-my-knee-pain-worse-at-night/#:~:text=The%20levels%20of%20your%20natural,change%20in%20the%20small%20hours
  29. https://www.soundsleepmedical.com/blog/is-there-a-connection-between-sleep-and-inflammation/
  30. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/knee-replacement-surgery-procedure

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