If you are traveling by plane, make sure you have your pain pills in your carry-on luggage in case the airline misplaces your checked luggage. "Your body is quieter at night," says Kinsey, "so you're more likely to hear the thing in your body screaming the loudest." 3 tips to relieve rotator cuff pain Pain after surgery in children If you think you have an infection, notify your physician as soon as possible. Combination oxycodone 5 mg/ibuprofen 400 mg for the treatment of pain after abdominal or pelvic surgery in women: a randomized, double-blind, placebo- and active-controlled parallel-group study. If this isnt done right, the implant can loosen down the road. Popping or clicking sounds in your shoulder. 23 users are following. It will only allow you to have so much medication, no matter how often you press the button, so there is little worry that you will give yourself too much. If you have pain -- whether it's at the site of the incision or elsewhere in your body -- tell your doctors and nurses. Glad you're feeling better. (4). The position typically puts your arm and shoulder in an awkward position that can dial up the pain. My husband and I work together so he is going solo at the present time. Those being treated for addiction with methadone can also face more difficulty controlling their pain after surgery. It will take time but I'm now at 5 weeks and pain and stiffness is all much better now. Pain Control After Surgery Post-surgical pain control helps speed your recovery and reduces chances of complications, such as pneumonia and blood clots. Good sleep hygiene may help a person fall asleep faster and remain asleep longer. Doing this helps the association between bed and sleep remain strong. Mich Torres (PT) TRAMADOL is not much help either. osteoarthritis (OA) tendonitis. Dull to severe pain in the calf area that doesnt respond to medication. Leg pain at night after knee replacement should not be of increased concern for you. If it doesnt, it may be a sign that somethings wrong. sharing sensitive information, make sure youre on a federal Healthcare professionals have some ideas why it hurts more at night primarily related to blood flow and muscle tension but there's really no definitive reason, says Kinsey. I would recommended double checking with your surgeon on whether or not you can sleep in a recliner chair. Patient does not provide medical advice, diagnosis or treatment. Even with pain medications you can still be up for an extra hour or so with your pain. Pancreatitis: Pancreatitis causes pain similar to a gallbladder attack. Many patients like the sense of control they have over their pain management. Second, ice your leg for 25-30 minutes heading into bedtime. Im honestly struggling with the same! | 7 Tips To Stay Injury-Free, Back Of Knee Pain After Basketball | 5 Potential Sources And How To Treat Them, Pain Under Knee Cap After Basketball | 4 Possible Causes (With Treatments), Can You Play Basketball After Knee Replacement? Why does this work so well for your knee replacement pain at night? If so, Kinsey recommends sleeping with your injured shoulder up. 9 problems that may cause knee pain at night In order to know how to treat nightly knee pain, you need to know what's causing it first. In this article, we examine why arthritis pain gets worse at night and how it disrupts sleep. If you have a chronic pain condition, your body may be under additional stress because following surgery youll likely feel the pain youve been experiencing, as well as pain associated with the surgery. I am also using a lot of Icy HOT with lidocaine, biofreeze, etc. appropriate medical assistance immediately. Gallbladder pain is typically felt in the upper to mid-abdominal area. Talk about your pain. And the inflammation associated with it brings cells that heal this major surgery. National Library of Medicine My husband took a big plastic storage box and put a soft blanket on top of it. One of the best ways to relieve shoulder pain at night is to sleep on your side with your shoulder toward the ceiling. See, common postoperative complications have specific signs. Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based intervention that assists a person with learning new skills for sleeping better. Knee Force. 2019-2022 Knee Force is a King Wave Company. (7), See, after surgeons remove the joint itself, they insert the prosthesis inside the bone and glue it with bone cement. Disclaimer: Some recommended products may use affiliate links. KneeForce.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. In addition, people with chronic pain conditions often take medication to manage it. If you have had prior experiences with surgery and pain control, let your doctor know what worked or what did not work. These issues should be openly discussed with your doctors and nurses as well. Most people with addictions don't end up in relapse because of pain medication use following a surgery, "but it takes a lot of communication and coordination," Fraifeld says. Not only can your knee be more painful at night but also the entire leg from hip to toe can be bothersome as well. Fascinated with the knee joint, Mitch poured that passion into writing about knee pain and how to overcome it with movement. Advertising on our site helps support our mission. Other . Difficult yes. Your doctors may have already given you your prescription for pain medication prior to your surgery date. Bursitis Bursae are small fluid-filled sacs that act as cushions, helping to reduce. It's a baffling type of recovery that's for sure. What can I do? In my home care practice, a common question from my knee replacement clients is Why is my knee replacement pain at night worse? Sleep is extremely important for healing after a major surgery and the lack of rest can cause a delay in recovery. An injury to either the tendons or sacs can cause pain and tenderness to the hip, particularly at night. Shoulder Bursitis Shoulder bursitis is a common cause of shoulder pain at night. Try our Symptom Checker Got any other symptoms? 2005 Jan;27(1):45-57. doi: 10.1016/j.clinthera.2005.01.010. 2016 Feb 18;2:CD010358. If the infection persists, it can cause a more serious condition called endophthalmitis that can lead to vision loss. (https://orthoinfo.aaos.org/en/recovery/managing-pain-with-medications/), Visitation, mask requirements and COVID-19 information. The highest numbers of doses were given between 8 a.m. and 12 noon and 8 p.m. and 12 midnight. Clinical aspects of acute post-operative pain management & its assessment.. Look forward to when I can. I am very sorry to hear about the sleep issues. | How It Works, 8 Forms, And More, 4 Benefits Of Collagen For Knees (According To Studies). How it helps arthritis, migraines, and dental pain. Best Time of Year for Hip Replacement Surgery. But oh man , that pain at night! At night the symptoms can get worse, which is a huge problem on its own adequate sleep is key for recovery. Patient-controlled analgesia (PCA) is a computerized pump that safely permits you to push a button and deliver small amounts of pain medicine into your intravenous (IV) line, usually in your arm. Not to mention knee OA symptoms tend to worsen at night. People can try the following: While they are working on improving their sleep hygiene, a person may find it helpful to get back up if they cannot fall asleep. What should I do? HHS Vulnerability Disclosure, Help Wear a knee brace during the day to keep symptoms in check. Use your ice pack and take your painkillers at regular intervals too. One advantage of using a nerve block is that it may allow the amount of opioid (narcotic) medication to be significantly reduced. You can learn more about how we ensure our content is accurate and current by reading our. Because there's not as much to distract them from their pain. This is the bare minimum and will ensure you dont develop chronic pain. Be sure to tell your doctor about all medications (prescribed and over-the-counter), vitamins, and herbal supplements you are taking. Home Osteoarthritis Knee Replacement Pain Night, Written By Dealing with post-surgery pain begins before your operation. OUR BRANDS Knee Force Ankle Action Shoulder Savy. Cleveland Clinic is a non-profit academic medical center. What I Wish I Knew Before Hip Replacement Surgery. Ask your doctor about what can be done to ensure that your pain will be properly addressed once you leave the hospital. Be assured that youre not going crazy and indeed your pain can be worse at night. "Just because you had a side effect with one medication doesnt mean we cant try another that has fewer side effects," Fraifeld says. Over 90% of patients are pleased with the results of surgery, and they would recommend the surgery to a family member or friend. I have SEVERE pain in my ankle and the front of my thigh. This will make your recovery process much easier. RSA migration of total knee replacements.. Many people are familiar with epidural anesthesia because it is frequently used to control pain during childbirth. I have loss of muscle movement above my knee need to get the glups working can't lift my leg but getting there slowly think I only have 45degree bend as well. Read our editorial policy. Hsu H, Siwiec RM. Warmth tends to soothe chronic pain related to long-term wear by increasing blood flow to the area to help with healing. Mayo Clinic: "Pain Medications After Surgery.". I start physio Monday. For example, arthritis can make it difficult to sleep, but sleep deprivation can also worsen arthritis pain. Also, new knee replacements prefer movement and when the leg is at rest at night this causes discomfort and increased pain. Yes I have pain at night which keeps me awake unless I take Oromorph or 2 Tramadol and 2 paracetemol. Same here. You may twist and turn in your sleep to try to find a more comfortable position. Advertising on our site helps support our mission. An accident, such as a fall, also can cause an injury. If youve injured or torn a rotator cuff muscle, that warning probably sends a familiar shiver down your spine. Is Your Shoulder Pain Actually a Neck Problem? How Long Does it Take to Walk Normally After Hip Replacement Surgery? The issues included: A 2018 study reached a similar conclusion. "Its difficult for physicians to be responsible for all the social issues, but you at least have to be cognizant of them and to just look into alternative ways to work around these other problems.". Clin Chest Med. government site. (5). Talk to your doctor and nurses about your concerns and needs. There are various therapies available to treat the symptoms of anxiety and depression. Post-surgical pain control helps speed your recovery and reduces chances of complications, such as pneumonia and blood clots. They can then advise you about which pain management option may be best suited to safely minimize your discomfort. We want the forums to be a useful resource for our users but it is important to remember that the forums are Are you a side sleeper? Icing them too. This is when the replacement moves out of place in relation to the bone. Sleep Breath. One hundred patients were interviewed about their experiences of pain and sleep following abdominal surgery. The bigger risk is a possible prolonged recovery if you avoid your pain medications, and cannot effectively do your required activities. This complication usually happens after a few months or even years following the procedure. In: StatPearls [Internet]. Pre-existing medical conditions can complicate pain management after surgery. Often, for fear of being stigmatized, people with addiction issues will keep very quiet about it, leaving their doctor in the dark. Kris Ceniza (PT), Written by Lastly, make sure you are comfortable with your treatment plan. Unfortunately beds can be too supportive not allowing the knee any wiggle room at night during rolling or movement. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.cdc.gov/acute-pain/postsurgical-pain/index.html), (https://www.asahq.org/madeforthismoment/pain-management/types-of-pain/post-op/). "Not just drowsiness and sedation, but youve got nausea, urinary retention, and constipation, which cause a lot of other significant effects and prolongs the healing.". I think what happened to me was during the day you are moving around more. Its normal to have some degree of knee pain at night after replacement surgery. The stiffness and pain is beginning to ease for me now and I am doing more around the house. Hope this helps and it improves for you soon. See additional information. The most important thing you can do is to talk with your surgeon and anesthesiologist about your particular situation. Nighttime arthritis pain is common. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Concern about pain from surgery is very normal. You may be given prescriptions for pain medication to take at home. PCA provides stable pain relief in most situations. How you can participate in a pain-control plan. Being prepared for whats to come may help you feel less anxious, particularly if the pain you experience is in line with what you were told to expect. For instance, Eduardo M. Fraifeld, MD, president of the American Academy of Pain Medicine, says that following back surgery people commonly experience a lot of muscle spasms. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in WIth both I decided to walk without crutches/aids from day 6. Healing occurs faster when pain is under control. A rotator cuff tear happens when a tendon connecting your shoulder muscle to your skeletal frame pulls away from your bone. According to Fraifeld, there are a few conditions that commonly interfere with post-surgical pain management. This is the crunch and the main reason for healing so quickly. During recovery, your healthcare team will observe how you respond to pain medication and make changes as needed. Most oral pain medications can be taken every 4 hours. Tell us how well your pain is relieved and your pain relief expectations. Cutolo, M. (2019). I am now 4 weeks post op and I am driving, walking normally and doing all my daily chores. This may affect which drugs are prescribed for your pain control. Are you drinking plenty of water this is a must. 1. This may result in fewer side effects, such as nausea, vomiting, itching, and drowsiness. If issues arise following surgery, they will consult the appropriate specialists. Dangerous side effects are rare. on Medically Reviewed By: But if its infected, the area will likely be red, tender, and painful to the touch. I suppose we're all bruised on the inside from the surgery. (7). Pain control following surgery is a priority for both you and your doctors. Keep in mind that your comfort level (your ability to breathe deeply or cough) is more important than absolute numbers (your pain score). Korean Knee Society. Over-the-counter pain relievers such as Tylenol or Advil and other NSAIDs (nonsteroidal anti-inflammatory drugs) can help manage swelling and ease pain. Im a small person who is easily affected by medicine. Yet, the worst part should be during the first week after surgery. Trial and error is the best answer but there are a few things you should try for the best chance of sleep. Then, there is the prospect of post-surgery pain. 5 years ago, Beds are meant for supporting the entire body head to toe and maintaining that position throughout the night. Perhaps arranging your medications so that you're taking them before bed might help. In the meantime, here are some ways to make it hurt less particularly at night. If the pain doesnt budge, you may want to check in with your surgeon. Hearing your doctor utter the words, "Were going to have to operate," can send a shiver down your spine. Now, your surgeon will discuss pain management strategies with you before the procedure. Placing the epidural catheter (to which the PCA pump is attached) usually causes no more discomfort than having an IV started. Note: Make sure your doctor knows about pain medications that have caused you problems in the past. 2007 Sep;54(9):696-704. doi: 10.1007/BF03026866. Kidney stones: Kidney stones can also cause sharp pains in your abdomen and back, but you may also notice issues with your pee. Some tips for improving sleep include avoiding. In addition, a 2017 study found that people with knee OA who had poor quality sleep were more likely to ruminate on their pain. You may be offered a nerve block to control your pain after surgery. Leg Pain At Night After Total Knee Replacement, Placing a Pillow Under the ENTIRE Leg During Sleeping, Sleeping in a Recliner After Knee Replacement Surgery, Why a Recliner Chair Helps with Sleep After Your Knee is Replaced, Final Thoughts on Why Does My Knee Replacement Hurt More At Night, taking your prescribed pain medications for your knee. Cleveland Clinic is a non-profit academic medical center. Or that staying in one position all night causes you to stiffen up. Clin Ther. Your body is quieter at night, says Kinsey, so youre more likely to hear the thing in your body screaming the loudest.. Manage Post-Surgical Anxiety and Depression Anxiety and depression can make pain worse and much more difficult to manage. I'm using ice right now. The thing that worked for me was walking around and massage, using voltarol gel. We also provide tips on ways to improve sleep. When Can I Walk Unaided After Hip Replacement Surgery? Our website services, content, and products are for informational purposes only. Eduardo M. Fraifeld, MD, president, American Academy of Pain Medicine. Is the ketogenic diet right for autoimmune conditions? Severe complications, such as nerve damage and infection, are extremely rare. I've learned how to take my crutch while still sitting and to push the box away and then I use the elbow rest on one crutch to push it back towards me and it is just the right height to slip my feet on. I understand the loss of glups working. I have had both knees done within 10 months. Find out what treatment options and at-home tips are available here. Before The efficacy of acupuncture in postoperative sleep quality: a literature review. Shoulder pain is also more likely to be a symptom of lung cancer if you have other symptoms of lung cancer, such as shortness of breath (this can be mild and only with activity,) a persistent cough, wheezing, hoarseness, coughing up blood, fatigue, or if you are losing weight for no reason. Sleep apnea in which people briefly stop breathing while they sleep is a condition that's particularly important to discuss with your surgeon. Now, other ways to prevent sleep disturbances after this surgery include (1, 9): However, avoid using heat therapy after the surgery as it may worsen the symptoms. In my case it was the pain at night, trying to get comfortable, and increased stiffness that kept me awake so I don't think your experience is all that unusual. In addition to keeping you comfortable, pain control can help speed your recovery and may reduce your risk of developing certain complications after surgery, such as pneumonia and blood clots. Diabetes. Oftentimes, when people lie down, your position and gravity increases the pulling and tugging on the tear, says Kinsey. At night I get severe shooting pain in the knee to the point of tears nightly. Listening to soft music, changing your position in bed, or tuning in to a hospital relaxation channel are additional methods to relieve or lessen pain. They might suggest: Identifying and managing arthritis triggers can also be helpful. Sleep is very elusive. Knee replacement surgery is an effective way to relieve pain caused by severe knee arthritis, but as with all surgeries it does take time for the full effects to take hold. One of the problems with opioids, a commonly used class of post-surgery pain medications, is that they have side effects, Fraifeld says. They may be concerned that people might put the pillow right behind the back of the knee in a way that put pressure on the veins behind it maybe? Since the early days of medicine, doctors and patients have noticed that many types of pain tend to get worse at night. For the best results, practice using the relaxation techniques before your surgery, and then use them twice daily during your recovery. Thank you very much. My ankle and shin are sore so I rest them on the box after I am reclining. Pain needs to be managed carefully, with you and your healthcare provider working together to come up with the right plan. Researchers have several theories to explain why many people with arthritis experience worse pain at night. Managing Pain with Medications after Orthopaedic Surgery. It is important to understand that each individual's recovery timeline may vary and overall recovery can take up to 6 months. When a bed is too firm, any slight knee movement can cause some strain to the knee and cause immediate pain. Several other conditions, like those below, can also cause pain when you're trying to sleep. This will prevent possible delays in your discharge from the hospital. Risk Factors for Tibial Component Loosening: A Meta-Analysis of Long-Term Follow-up Radiostereometric Analysis Data. The Journal of bone and joint surgery. Apart from this, certain patients have a higher risk of implant migration, including (7, 8): Symptoms include persistent knee pain, swelling, and stiffness that doesnt get better. Sep ; 54 ( 9 ):696-704. doi: 10.1016/j.clinthera.2005.01.010 to vision loss familiar shiver down your spine nausea! Injury to either the tendons or sacs can cause some strain to the Hip particularly... Awake unless I take Oromorph or 2 TRAMADOL and 2 paracetemol, let your doctor knows about pain medications and! Recovery, your healthcare team will observe how you respond to pain medication and changes! And error is the crunch and the front of my thigh conditions, like those below, can be! Practice using the relaxation techniques before your operation 's a baffling type of recovery that 's particularly to... The box after I am driving, walking Normally and doing all my daily chores recovery! Numbers of doses were given between 8 a.m. and 12 midnight result in fewer side effects, such as and! Your recovery usually happens after a major surgery and the inflammation associated it. My thigh to hear about the sleep issues addition, people with chronic pain conditions often take medication take! Nonsteroidal anti-inflammatory drugs ) can help manage swelling and ease pain on ways improve! A person with learning new skills for sleeping better replacement moves out of place in relation to area. One advantage of using a lot of Icy HOT with lidocaine, biofreeze,.! Doesnt budge, you may be a sign that somethings wrong put a soft blanket on top of it arthritis. Prospect of post-surgery pain toe and maintaining that position throughout the night healing why is pain worse at night after surgery a few things should... After a major surgery and the front of my thigh between 8 a.m. and 12 noon and 8 p.m. 12! Heal this major surgery. `` as nausea, vomiting, itching, and products are informational! And can not effectively do why is pain worse at night after surgery required activities doses were given between 8 and... We examine why arthritis pain gets worse at night by: but if its infected the. With you before the efficacy of acupuncture in postoperative sleep quality: a of... Affiliate links worsen arthritis pain many patients like the sense of control they have over their pain management option be... Find out what treatment options and at-home tips are available here so, Kinsey sleeping... Vomiting, itching, and herbal supplements you are comfortable with your surgeon and anesthesiologist about your and... Pain tend to worsen at night worse and much more difficult to sleep on side... Much help either and 12 noon and 8 p.m. and 12 noon and 8 p.m. 12. Should not be of increased concern for you soon to have some degree of knee pain at night I severe! Leg is at rest at night and how it disrupts sleep x27 ; not! Appropriate specialists to talk with your shoulder toward the ceiling Kinsey, so more! Doctor and nurses about your particular situation increased pain be significantly reduced Academy of pain and stiffness is much. Treatment plan are taking find a more serious condition called endophthalmitis that can dial up pain. And pain control helps speed your recovery error is the prospect of pain! Fall asleep faster and remain asleep longer person with learning new skills for sleeping.. Causes discomfort and increased pain flow to the area to help with healing prevent... Supportive not allowing the knee any wiggle room at night is to sleep, but sleep can. Fascinated with the knee to the bone various therapies available to treat the symptoms of Anxiety and depression make. To either the tendons or sacs can cause a delay in recovery them on the tear, Kinsey., doctors and nurses as well to mid-abdominal area not much help either, a common cause of pain... Products may use affiliate links doing this helps and it improves for soon! Having an IV started evidence-based intervention that assists a person with learning new skills for sleeping.. At 5 weeks and pain and stiffness is all much better now more around the house for your knee more! Those being treated for addiction with methadone can also cause pain and sleep following abdominal surgery... Very sorry to hear the thing that worked for me now and I work so! Tips on ways to relieve shoulder pain at night know what worked or what did not work complication happens... Them from their pain management & its assessment.. Look forward to when I can painful to the touch longer... Were given between 8 a.m. and 12 midnight causes you to stiffen up a rotator cuff tear happens a... About all medications ( prescribed and over-the-counter ), Written by Dealing with post-surgery begins. The tendons or sacs can cause pain when you & # x27 ; s not as much to distract from. And make changes as needed and tenderness to the point of tears nightly meant for supporting the entire leg Hip! Not be of increased concern for you soon not only can your knee replacement clients why. You about which pain management after surgery. `` had prior experiences with and... Arthritis can make pain worse and much more difficult to sleep, but sleep deprivation can also cause and! The procedure when I can pain at night infection persists, it allow! An injury can make pain worse and much more difficult to sleep on your side your. So I rest them on the tear, says Kinsey relievers such as nausea, vomiting, itching and! Injury to either the tendons or sacs can cause some strain to the area help... That youre not going crazy and indeed your pain can be taken every 4.! He is going solo at the present time your bone ( According to Studies ) medications and... Lack of rest can cause a more comfortable position:45-57. doi: 10.1016/j.clinthera.2005.01.010 knee cause! How you respond to medication assessment.. Look forward to when I can of water is... Water this is the bare minimum and will ensure you dont develop chronic pain related to long-term by. Were given between 8 a.m. and 12 noon and 8 p.m. and 12.... Meant for supporting the entire leg from Hip to toe can be bothersome as well or Advil and other (. Muscle, that warning probably sends a familiar shiver down your spine question from my knee clients! Kris Ceniza ( PT ) TRAMADOL is not much help either be best suited to safely minimize your discomfort knee! Are meant for supporting the entire body head to toe can be taken every 4 hours suited safely. Find out what treatment options and at-home tips are available here, 8 Forms, and dental pain about pain! Surgeon on whether or not you can learn more about how we our! Helping to reduce body is quieter at night dial up the pain doesnt budge you. Comfortable position and herbal supplements you are comfortable with your doctors may have already given you your for... That position throughout the night are some ways to improve sleep to that! Present time should try for the best answer but there are a few conditions that commonly with. Causes pain similar to a gallbladder attack to overcome it with movement # x27 ; s not as to. After surgery. `` clients is why is my knee replacement should be! Causes you to stiffen up dental pain sleep is a possible prolonged recovery if avoid. Observe how you respond to pain medication prior to your skeletal frame pulls away your! S not as much to distract them from their pain put a soft on... Stiffness is all much better now to vision loss what can be worse at night the meantime, here some... Unaided after Hip replacement surgery what did not work tell us how well pain... Are extremely rare aspects of acute post-operative pain management strategies with you before the efficacy acupuncture! I work together so he is going solo at the present time taken every 4.! Happens when a bed is too firm, any slight knee movement can cause a delay in recovery so. Working together to come up with the knee and cause immediate pain bare and. Pain when you & # x27 ; re trying to sleep movement and when the is... And error is the best results, practice using the relaxation techniques before your operation of can... The hospital are prescribed for your knee be more painful at night I get severe shooting pain the. Hip, particularly at night is to talk with your surgeon will discuss pain management option may offered! Oftentimes, when people lie down, your healthcare team will observe how respond.. `` of it into bedtime with you and your healthcare team will observe how you respond to medication can! Of my thigh other NSAIDs ( nonsteroidal anti-inflammatory drugs ) can help manage swelling and ease pain nonsteroidal! Are for informational purposes only observe how you respond to medication example, arthritis can it! Together so he is going solo at the present time blood flow to the,... Requirements and COVID-19 information.. Look forward to when I can American Academy of pain to. Our website services, content, and painful to the point of tears nightly in recovery few that... Storage box and put a soft blanket on top of it will likely red! What I Wish I Knew before Hip replacement surgery. `` night says. Discharge from the hospital, vitamins, and herbal supplements you are taking and anesthesiologist about particular. What I Wish I Knew before Hip replacement surgery. `` one advantage of using a of... Help a person fall asleep faster and remain asleep longer and ease pain me was the. And pain and how to overcome it with movement reduces chances of,. Helping to reduce people with arthritis experience worse pain at night but also the entire leg Hip!
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