There are lots of things that can keep you up at night. It can be hard to figure out what to do when it’s leg pain. It seems like leg pain should subside at night. Your body is ready to rest and recover from the day’s activities. But if you’re wondering why your leg pain is worse at night, it could be a symptom of a more serious chronic condition.

Leg cramps 101

For some people, it’s not uncommon to wake up from feeling pain, especially if it’s something like a leg cramp. A leg cramp, also called a charley horse, can wake you out of a deep sleep.

The affected muscle may feel like it’s searing hot or totally frozen. This pain can be intense and last for as long as 10 minutes. This type of muscle cramping typically subsides if you can stand up, as gravity can help with your blood flow.

But if you find yourself experiencing leg pain worse at night more often and it’s affecting the quality of your sleep, you may have other problems. Chronic pain coupled with sleep disorders can increase your risks for things like cardiovascular disease, diabetes, cognitive difficulties, mood disorders and even cancer.

When researching why your leg pain is worse at night, it’s important to know what type of pain you’re dealing with, so you can manage it successfully.

leg pain worse at night illustration

Why leg cramps can be serious

Leg cramps can be the result of all sorts of things such as:

  • muscle fatigue from physical activity
  • not getting enough potassium, calcium or magnesium in your diet
  • medications serving as triggers (this can include medicine used to regulate high blood pressure and even some birth control pills)

Other things that contribute to leg cramps and leg pain at night can be sitting for long periods of time, standing on or working on concrete floors or even sitting improperly.

People who develop painful varicose veins often experience similar types of leg pain at night. This includes throbbing, tingling or heaviness in the legs. The appearance of varicose veins – if they look lumpy, bulging or twisted – can also be an indicator that they are getting worse.

Leg pain frequency

You may experience leg cramps once in a while and then see them quickly improve. It helps if you focus on stretching before and after physical activity. If that’s the case, then it’s likely nothing serious.

On the other hand, if you experience leg cramps regularly, muscle cramping for long period of time or painful (or worsening) varicose veins, it could be the sign of a blood clot or peripheral artery disease.

Blood clots can be serious medical conditions depending on your age and health. Blood clots in the hands can actually travel to the heart and cause a stroke or heart attack. It’s the same for blood clots in the legs.

Plaque build-up in your blood vessels can go mobile and travel to the heart. That’s why it’s crucial to not ignore nighttime muscle cramping accompanied by intense pain in the leg.

Leg cramp causes

Common causes of this type of pain include:

  • Sitting for long periods of time
  • Over-use of the muscles
  • Standing on or working on concrete floors
  • Sitting improperly

To stop nighttime leg cramps, stretch your calf muscles, stand up to straighten the legs and gently pull your toes upward. The muscle might feel tight or knotted. Massaging the calf after the cramp is over may also help.

leg pain worse at night in bed

Restless leg syndrome 101

While some leg pain happens during or after activity, restless leg syndrome occurs once your legs are resting. People with restless leg syndrome often feel sensations such as:

  • crawling
  • creeping
  • aching
  • burning
  • tugging
  • pulling

Living with restless leg syndrome

If you’ve never experienced restless leg syndrome, you may dismiss it as not being something that can disrupt your day-to-day life.

The truth is restless leg syndrome is extremely uncomfortable and painful. This chronic condition is exactly what the name indicates – your legs are restless when you’re trying to sleep. But the feelings associated with “restless” are hard to ignore.

What makes restless leg syndrome unbearable is the constant sleep disturbances. People who are diagnosed with restless leg syndrome don’t really have treatment programs or medication options, so they have to learn how to manage their leg pain at night.

Of course, an ongoing lack of sleep makes you more susceptible to health problems. That makes it even more important to discuss your leg pain at night with your health care team. 

Restless leg syndrome causes

While there’s no known cause, there are risk factors that make you more susceptible to developing the condition. These risk factors include:

  • heredity
  • pregnancy
  • aging

Restless leg syndrome can happen to anyone at any age, but it more commonly occurs as you get older. In addition, women are more likely to develop it than men.

leg pain worse at night trouble sleeping

Peripheral artery disease 101

Peripheral artery disease (PAD) is a  chronic condition that can trigger serious leg cramps – muscle cramping in the thigh muscle or calf muscle. This disease means there has been a narrowing of the peripheral arteries that pump blood to your legs, stomach, arms and head.  

In this case, the term “peripheral” means going away from the heart, towards the outer regions of the body. It is a progressive disease, so it’s important to seek medical advice as soon as possible if you experience worrisome symptoms related to leg pain at night.

PAD most commonly affects arteries in the legs, so if you experience chronic leg pain, that can be a symptom that requires medical advice. While the pain from peripheral artery disease leg pain can occur anywhere in your leg, most people feel it in the muscles of your calf, thigh or buttocks. The pain can range from mild to being so severe you can barely walk a very short distance.

For some chronic pain sufferers who have PAD, their leg pain only occurs during the day. Others experience leg pain when they’re resting or at night.

Peripheral artery disease risks

Again, the seriousness of this disease and your risk factors depend on things like your age, health and lifestyle. For example, factors that can increase your chances for peripheral artery disease, include:

  • Age – your risk for peripheral artery disease increases with age.
  • Health condition – high blood pressure or high cholesterol puts you at risk for PAD.
  • Smoking – if you smoke, you have an especially high risk for PAD.
  • Diabetes – if you have diabetes, you have an especially high risk for PAD.

Leg pain treatment options

If you’re a chronic pain sufferer, you know self-care is the best way to manage your condition, whether it’s living with a herniated disc, fibromyalgia, PAD or restless leg syndrome. Unfortunately, there just isn’t a magic cure, but you can do things to ease the pain and improve your quality of life.

Plus, the more you can do to stop the progression of your condition, the better off you’ll be. This is especially true for PAD because if the disease is left untreated, it can lead to heart attack and stroke. If you’ve been diagnosed with PAD, the single most important thing you can do is quit smoking.

You may be able to accomplish these goals with lifestyle changes, especially early in the course of peripheral artery disease. If you smoke, quitting is the single most important thing you can do to reduce your risk of complications.

leg pain worse at night smoking

While living with leg pain that worsens at night is difficult, understanding your leg pain at night helps you manage your pain so you get more rest. If you have leg cramps, restless leg syndrome or trouble sleeping due to leg pain, contact your doctor. You and your doctor will work together to diagnose and treat your leg pain.

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This post was updated in March 2019 with new information and resources. 

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  1. I have had several back surgeries. This last surgery was very complex, moving nerves back to where they go and placing hardware in the spine and pelvis. It has been 2 years since this last surgery. I now am having leg pains and leg cramps a lot. Even waking me in my sleep. I just don’t know what to do or who to see…

    • Hi Rick,

      I’m sorry to hear that you’ve had such a hard time with your back and are experiencing additional symptoms now. Have you checked with the last surgeon and/or your primary care doctor? It might also be worth consulting with a chiropractor. Hope you start to find some relief soon.


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