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How to Deal with Lower Leg Pain at Night

by Jaydee Vykoukal, PT, DPT April 05, 2022 0 Comments

woman sleeping

Lower leg pain is relatively common, with our legs taking a lot of the impact with our daily activities. However, suffering from consistent lower leg pain at night, or any other time of the day, isn’t necessary with the right understanding and treatment. Today, we will review common causes and remedies for lower leg pain, particularly at night. Keep reading to learn more about lower leg pain at night. 

Common Causes of Nighttime Leg Pain

The most common reason for nighttime leg pain is related to cramping of the calf, often referred to as a charley horse. What is actually causing the cramping can be secondary to a lot of different underlying issues. Some of these root issues include:

  • Sedentary lifestyle

    Too much time spent sitting can result in stiff ankles and other lower leg muscles. When the muscles are not properly stretched on a regular basis, it can result in muscles shortening and cramping at night when you are resting.

  • Standing

    Alternatively, too much standing can also have a negative effect. Leg cramping from excessive standing is often a result of too much fluid in the foot from a gravity dependent position.

  • Poor sleep position

    Sometimes a specific foot position is enough to trigger a muscle cramp. One common position that causes calf cramps is having the toes pointed for too long while sleeping.

  • Dehydration

    Lower leg muscle cramps are much more common in the summer when heat is high and lots of sweating is normal. Drinking enough water throughout the day is important no matter what season to prevent cramps.

  • Nutrient deficiency

    Low electrolytes, such as calcium, potassium, or magnesium levels in the blood, can lead to overexcitement of the neural pathways that facilitate muscle contractions. This can be caused by poor nutrition or losing too many nutrients via sweating, diarrhea, or  vomiting without proper replacement.

  • Muscles soreness

    Getting in a tough workout can lead to excessive sweating and sore muscles, both of which can trigger cramping.

  • General health

    Chronic medical conditions like diabetes, arthritis, cardiovascular issues (high blood pressure), and nerve dysfunction can lead to oversensitive nerves and cramping. Sometimes, medication use associated with these diseases can also cause muscle cramping.

  • Aging

    Changes in the health of the nervous system, such as loss of nerve connections after approximately 50 years of age, can lead to cramping as well.

  • Pregnancy

    Hormones and fluid changes during pregnancy can lead to neural sensitivity and cramping too.

    In addition to cramping, other causes of leg pain can include:

    • Peripheral artery disease or varicose veins- due to poor blood perfusion of blood vessels in the legs, leading to pain and claudication.
    • An acute injury such as a fracture, tendonitis, sprain or shin splints
    • Nerve damage and/or back pain caused by changes in the spine, such as arthritis, stenosis, and sciatica
    • A blood clot, leading to severe pain, swelling, and redness from reduced blood flow
    • Restless leg syndrome at night

Tips for Reducing Lower Leg Pain at Night

Once you have an understanding of what is causing your symptoms, you can try these home remedies for providing relief from lower leg pain and help you get a more restful night sleep.

More Lower Leg Pain Relief Options

1. Check Your Sleeping Posture

Resting with the feet in a position that shortens the calf muscles can lead to cramping when the toes are being pointed into plantarflexion. Sleeping on your back or stomach is more likely to lead to having your ankle in this compromising position. Instead, try sleeping on your side or with your feet hanging off the edge or end of the bed to keep the ankle in a more neutral and relaxed slightly bent position.

Proper Sleeping Posture

2. Try Using Positioning Pillows

When it comes to a better sleeping position, pillows can do wonders. For example, having a pillow between the knees can reduce strain on the low back, hips, and ankle- not only minimizing the potential for cramping but other pain related problems with sleep. For more support, try using a full body pillow to feel well supported in a side-lying position. This will make it significantly less likely that you will roll onto your stomach or back in the middle of the night due to discomfort.

3. Wear a Nighttime Splint

If you are having trouble keeping your foot in a neutral position at night, a soft night splint is an excellent option for holding your ankle and foot in a more ideal position. Simply place it on your lower leg at night before sleeping. Make sure it is not too tight and always check your feet each morning to make sure you aren’t causing any skin abrasions, which is especially important if you have peripheral neuropathy from diabetes.

4. Elevate Your Legs

If you do spend a lot of time on your feet each day or want to address swelling, elevating the legs can feel great. You can use a bed wedge to elevate your legs when resting in bed prior to sleep or even leave it under your legs for part of the night if it is comfortable. When addressing swelling, it’s important not use this method if it is caused by congestive heart failure or a blood clot.  

5. Utilize Cold Therapy

Use of an ice pack has more than one benefit, including short term pain relief and swelling management. You can place ice on the lower leg while elevating your legs for double duty on swelling management. Using ice while sleeping is not recommended since you don’t want to apply it for more than 20 minutes at a time. Instead, you can apply it every few hours for 15-20 minutes at a time as needed during the day. Try icing your lower leg right before going to sleep for the best pain relief benefits. You can also alternate your ice pack with the use of a heating pad, as long as your injury isn’t new or excessively swollen.

Alternating Hot & Cold Therapy

6. Try Self Massage

Use of your hands or a massage tool can give your sore crampy muscles some nice relief thanks to the effects of relaxation and increased blood flow. Massage your legs before bed, in the middle of the night, or in the morning as needed for 5-10 minutes at a time. Massage tool options include cold rollers, vibrating balls, or even a full foam roller. Simply use your tool of choice to rub up and down along your muscles. Press as hard you can without tensing up while moving the tool around.

Self Massage Tips, Tricks & Techniques

7. Stretching Before Bed

Finally, a good ankle stretch can also help significantly with nighttime pain. You can use tools like a stretch strap as needed. Stretch right before bed and in the morning for the best results. Stretching is also important after ankle strengthening exercises, running, and other general workouts to minimize soreness and stiffness later.

Stretches for Lower Legs

When to See a Doctor

Anytime you feel unsure about your symptoms and need some guidance, it is best to get in touch with a trusted healthcare professional. This is of particular importance if your symptoms are chronic or are affecting your quality of life. They may be able to recommend further treatment options such as lifestyle changes, physical therapy, medications (such as over the counter anti-inflammatory meds like ibuprofen or naproxen, or stronger prescribed options), and more.

Additionally, if your symptoms are severe or associated with significant swelling, you should call your doctor immediately for medical advice. A blood clot, also known as a deep vein thrombosis (DVT), is often associated with intense calf pain and pressure and is a medical emergency and needs to be addressed as soon as possible. 

Relieve Lower Leg Pain at Night

With a plan in place for your lower leg pain at night, you can expect to start resting easy soon. Poor sleep at night can exacerbate your sensitivity to pain as well. Thus, once you feel in control of your nighttime pain you should notice a gradual improvement in your overall symptoms. This ultimately means a better quality of life with fewer limitations from unnecessary pain and suffering from the lower leg.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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