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Leg Pain at Night: Watch Out for Peripheral Artery Disease

Man experiencing leg pain at night

“Why Do My Legs Ache at Night?”

Do you ever have trouble sleeping because your legs hurt? 

If you regularly lose sleep due to leg pain at night, it’s important to keep in mind that pain in the legs at night is not a normal sign of aging. Instead, aching legs at night may indicate that something is wrong. We recommend visiting your doctor or a vascular specialist as soon as possible to determine the underlying cause.

One potential cause of leg pain at night is peripheral artery disease (PAD). PAD is a common yet serious vascular condition that can cause life-altering symptoms. For instance, you may experience severe leg pain and cramping that impact your ability to walk or climb stairs. PAD can also increase your risk for dangerous health issues like heart attack, stroke, and limb amputation. 

Fortunately, minimally invasive PAD treatment is available that can alleviate your symptoms, improve your mobility, and reduce your risks of developing serious complications. At USA Vascular Centers, our trusted vascular surgeons can diagnose and treat PAD from the comfort of our state-of-the-art outpatient facilities. We’ll help you figure out the cause of the leg pain at night and create a personalized treatment plan to address your needs. 

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Peripheral Artery Disease and Leg Pain at Night

Peripheral artery disease impacts over eight million people in the United States. PAD is primarily caused by atherosclerosis, which is a narrowing or blockage of arteries due to plaque buildup. Plaque builds up in the arteries when excess fat and cholesterol circulate in the bloodstream. 

PAD is a progressive disease. If left untreated, you may begin to develop painful or uncomfortable symptoms that impact your daily activities.

Click on the image below to discover more symptoms of PAD.

Along with leg pain at night, common PAD symptoms include slowed toenail growth, loss of hair on the legs, cramping, numbness or fatigue in the legs, and noticeable temperature or color differences between both legs. 

Muscle pain or cramping that begins with physical activity and stops during rest (intermittent claudication) is the most common symptom of PAD. This leg pain can be mild, moderate, or severe, most commonly affecting the calves, thighs, and buttocks. 

However, some individuals also find that their legs ache while resting. This can involve aching legs when lying down, aching legs at night, pain in the buttocks, foot pain, or lower leg pain at night. 

What Can Cause Leg Pain and Aching Legs at Night?

Potential leg pain causes include varicose veins, injury, infection, and disease. If the leg pain at night results from peripheral artery disease, here’s why your legs hurt: your arteries have become narrow because of plaque buildup (atherosclerosis), limiting blood flow to the muscles in your legs and feet. 

The muscles don’t function as they should without adequate oxygen and nutrients, causing aching legs during exercise. Over time, atherosclerosis worsens to the point where you experience aching legs when lying down. This means your legs may also ache all night long, keeping you from getting enough sleep. 

Risks of Untreated Peripheral Artery Disease 

Leg pain at night can indicate a severe blockage in the arteries leading to the lower extremities, known as critical limb ischemia. This dangerous condition can develop as a complication of PAD. When this occurs, pain in the legs may be accompanied by open, non-healing sores (arterial ulcers), thickened toenails, shiny skin on the legs, diminished leg pulse, and dry gangrene (dry, black skin) in the affected area. No wonder your legs ache with PAD.

Without treatment, critical limb ischemia can result in tissue death in your legs. Once tissue dies, the only way to save a patient’s life is to amputate the dead tissue. This may mean amputating part of your foot or leg to keep you alive. Critical limb ischemia and amputation can increase your risk of serious PAD complications and even death.1 

That’s why we encourage you to reach out to our vascular doctors as soon as you notice leg pain at night. If PAD is causing your leg pain at night, our doctors can diagnose and treat it, helping lower your risk of severe complications. 

It’s also important to remember that when you have atherosclerosis in the arteries leading to your legs, you probably have it in the arteries leading to your heart and brain. USA Vascular Centers can help treat atherosclerosis that causes lower leg pain at night and hip and upper leg pain at night. Still, you may want to talk to your primary care provider about how to lower your risk of heart attack and stroke.

When to See a Vascular Doctor for Aching Legs While Lying Down

Earlier is better when it comes to seeking treatment for leg pain at night. Before you start experiencing aching legs while lying down, you may notice that your legs ache when you do simple activities, such as going for an evening walk or climbing a flight of stairs. If the pain goes away once you’ve stopped the activity, you may be experiencing intermittent claudication, which is one of the classic signs of PAD.2

Once claudication progresses to the point that it’s constant, causing aching legs while you’re lying down, it’s urgent that you seek out a consultation with a vascular doctor. With over 40 locations throughout the United States, USA Vascular Centers make it easy for you to get treatment for leg pain at night. 

Each center has its own cath lab, allowing our highly recommended vascular doctors to provide minimally invasive treatments onsite. If you don’t live close to one of our locations, we offer lodging and accommodations for out-of-town patients. Because treatment only takes a few hours, you can prepare for a quick trip to one of our centers to help relieve leg pain at night and other PAD complications.

How is PAD and Pain in Legs Diagnosed

PAD can be diagnosed using various diagnostic techniques. If you have leg pain at night, your doctor can give you a physical exam. This helps your provider assess whether you are losing hair on your legs, have stunted toenail growth, or are lacking a strong pulse in your ankles and feet. 

Pain in the legs at night indicates that blood isn’t flowing to your lower limbs as it should. This can cause your leg hair to stop growing in places, slow down your toenail growth, and make your pulse difficult to find.

Your doctor will also ask you what symptoms you’ve been experiencing. Document how often you experience lower leg pain at night or hip and leg pain at night, and bring that information with you to your appointment.

An ankle-brachial index test can then be performed. In this simple procedure, your provider measures the blood pressure in your arm and your ankle before comparing them. This helps them assess whether PAD may be causing restricted blood flow to your legs and leg pain at night. 

To pinpoint the location of arterial blockages, your provider may use ultrasound technology or angiography. An ultrasound uses sound waves to visualize the inside of your arteries. With angiography, contrast dye is inserted into your vascular system through a minimally invasive catheterization technique. Using X-ray imaging and other imaging technology, your provider can assess whether you have any PAD blockages causing leg pain.

The doctors at USA Vascular Centers are highly skilled in using these diagnostic tools to determine whether PAD may be causing your leg pain at night. Once they have figured out where your peripheral arteries are clogged with plaque, they can create a personalized treatment plan to address your aching legs at night

Treatment to Stop Leg Pain at Night Caused By PAD

Treatment for peripheral artery disease usually involves a combination of lifestyle modifications, medications, and, when necessary, minimally invasive, non-surgical procedures that help widen arteries and treat leg pain at night. Once you’ve reached the point where you constantly ask  yourself, “Why do my legs ache at night?” our doctors at USA Vascular Centers will likely recommend angioplasty, stent placement, or atherectomy.

During an angioplasty, a balloon-tipped catheter is inserted into your vascular system through an incision so small it doesn’t require stitches. Once the balloon reaches a clogged area, the provider inflates it, compressing the plaque against the artery walls. A stent placement takes this procedure a step further: a mesh stent is placed inside the artery to keep it from narrowing again. During an atherectomy, a catheter equipped with a blade or laser cuts the plaque off the artery wall and safely removes it from the vascular system. 

By opening narrowed arterial passageways, these treatments can help reduce leg pain at night and prevent you from experiencing serious PAD complications. At USA Vascular Centers, these non-surgical treatments require only local sedation, not general anesthesia. They take just a couple of hours from the time you enter the office to when you leave our doors. Recovery time is minimal, allowing you to enjoy reduced pain in the legs at night and much sooner during the day.

Schedule a Consultation With USA Vascular Today

If PAD makes your legs ache at night, our vascular specialists are here to help. We are confident that with proper treatment, you can soon get a good night’s sleep without leg pain at night and improve the quality of your life.

Schedule an initial consultation online today to explore your PAD treatment options and evaluate leg pain causes. We offer in-person appointments at more than 40 vascular treatment centers nationwide and convenient telemedicine options. No matter where you decide to visit us, we look forward to meeting you soon.

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Sources Cited:
1. Barnes, J. Aaron, Et Al. “Epidemiology and Risk of Amputation in Patients with Diabetes Mellitus and Peripheral Artery Disease.” Arteriosclerosis, Thrombosis, and Vascular Biology, June 25, 2020. https://www.ahajournals.org/doi/10.1161/ATVBAHA.120.314595.

2. “Peripheral Arterial Disease (PAD).” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, September 27, 2021. https://www.cdc.gov/heartdisease/PAD.htm.

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