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Leg Pain at Night: Watch Out for Peripheral Artery Disease

why do my legs ache at night

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“Why Do My Legs Ache at Night?”

Do you ever have trouble sleeping because your legs hurt?

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.

Experiencing disturbed sleep regularly due to leg pain at night, is not just a normal sign of aging and may indicate a medical issue in need of treatment. We recommend visiting your doctor or a vascular specialist as soon as possible to determine the underlying cause. 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.


Peripheral Artery Disease and Leg Pain at Night

Peripheral artery disease (PAD) is primarily caused by atherosclerosis, the narrowing of arteries due to plaque buildup, which restricts blood flow to the peripheral arteries in the legs, ankles, and feet. Plaque is made up of fats, cholesterol, calcium, and other substances circulating in the blood. PAD is a common condition, impacting over eight million people in the United States.

Leg pain at night could indicate a severe form of PAD called critical limb ischemia (CLI). CLI occurs when the peripheral arteries become so narrow that the blood supply to the leg is severely compromised. CLI is serious and needs immediate medical intervention.

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

What are the common symptoms of PAD?

Muscle pain or cramping that begins with physical activity and stops while at 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.

People with advanced PAD may also experience pain while resting, such as legs that ache when lying down, pain in the buttocks, foot pain, or lower leg pain at night.

Along with leg pain at night, common PAD symptoms include:

  • Slow toenail growth
  • Loss of hair on the legs
  • Cramping
  • Numbness and fatigue
  • Noticeable temperature or color differences between both legs

What Can Cause Leg Pain and Aching Legs at Night?

aching leg pain at night
If you have leg pain at night, it might be because plaque buildup in your arteries is making it hard for blood to reach your leg muscles.

Potential causes of leg pain at night include peripheral artery disease, varicose veins, gout, arthritis, muscle or bone injuries, or peripheral neuropathy (nerve damage in the legs and feet).

If PAD is the cause of your nightly leg pain, plaque buildup has narrowed your arteries (atherosclerosis) to the point that blood has difficulty reaching the muscles in your legs and feet. The resulting lack of oxygen and nutrients causes your legs to ache during exercise. As atherosclerosis worsens over time, the blood supply becomes severely limited to the point that you experience aching legs even while resting. This condition can cause your legs to ache all night, keeping you from getting enough sleep.

Risks of Untreated Peripheral Artery Disease

PAD is a progressive disease. If left untreated, you may experience painful or uncomfortable symptoms that impact your quality of life, as well as an increased risk of heart attack, stroke, and critical or acute limb ischemia.

Leg pain at night may indicate a severe blockage in the arteries leading to the lower extremities, known as critical limb ischemia (CLI). Symptoms of CLI include leg pain, 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. Without treatment, critical limb ischemia can result in tissue death (necrosis) in your legs. Once a limb turns necrotic, the only way to save a patient’s life is to remove the dead tissue, often by amputation.

Can PAD be treated?

If you’re experiencing nightly leg pain, we encourage you to reach out to a vascular specialist as soon as possible. Non-surgical treatments can help stop the progression of PAD and reduce its symptoms, potentially saving your leg and even your life.

After the PAD diagnosis is confirmed, vascular specialists can treat PAD through nonsurgical, outpatient treatments, including angioplasty, stent placement, and atherectomy. These minimally invasive treatments can open the artery, reducing plaque blockages and improving blood flow and circulation. Treatment may also help reduce the risk of PAD complications.

It’s important to remember that atherosclerosis in the peripheral arteries is a good indicator of similar plaque buildup in the arteries of the heart and brain. This increases your risk of a stroke or heart attack. USA Vascular Centers can help treat atherosclerosis that causes lower leg pain at night, but you may want to talk to your primary care provider about lowering your risk of heart attack and stroke.


When to See a Vascular Doctor for Aching Legs

Early detection and treatment in the initial stages of leg pain at night can help avoid complications. . Before you start experiencing aching legs while lying down, you may notice that your legs ache when you do simple activities like taking a walk or climbing stairs. If the pain goes away once you’ve stopped the activity, you may be experiencing intermittent claudication, a common sign of PAD.

If claudication progresses to the point that it causes aching legs while resting, consult a vascular doctor as soon as possible.

USA Vascular Centers offers non-surgical treatment for leg pain at night caused by peripheral artery disease. Each of our state-of-the-art centers has its own cath lab, allowing our highly recommended vascular doctors to provide minimally invasive treatments onsite. Contact us today to learn how we can help relieve leg pain at night and other PAD complications.


How Are PAD and Pain in the Legs Diagnosed

A vascular specialist will use a combination of physical examinations, specialized testing, and medical imaging to determine whether the pain in your legs is a result of PAD.

Physical Examination

During your first visit, your doctor will review your symptoms and document how often you experience lower limb pain at night. Pain in the legs at night indicates that blood isn’t flowing to your lower limbs as it should. Your doctor will examine your legs and arms for signs of restricted blood flow, such as a lack of hair growth, non-healing wounds, cold skin, poor nail growth, and a hard-to-find pulse.

Testing and Imaging

If your doctor suspects PAD, they may prescribe one or more of the following tests:

  • Ankle-brachial index test: This simple test compares the blood pressure in your arm and ankle to assess whether PAD is restricting blood flow to your legs and causing leg pain at night.
  • Ultrasound: An ultrasound uses sound waves to visualize the inside of your arteries and detect blood flow and blockages.
  • Angiography: Contrast dye is inserted into your vascular system through a minimally invasive catheter. X-rays and other imaging techniques detect the dye, allowing your doctor to find the source of any blockage.
  • Blood tests: Your doctor may request blood work to determine your PAD risk factors, such as high cholesterol or diabetes.

The doctors at USA Vascular Centers use these diagnostic tools to determine whether PAD may be causing your leg pain at night. After finding the cause, 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. Our doctors offer expert diagnosis and the following leading-edge PAD treatments:

  • Angioplasty and stent placement: During an angioplasty, a balloon-tipped catheter is inserted into the affected artery and guided to the site of the blockage. The balloon is inflated, compressing the plaque against the artery walls. A stent placement takes this procedure a step further: Once the balloon opens up the artery, a mesh stent is placed inside the artery to keep it open and prevent it from narrowing again.
  • Atherectomy: A catheter equipped with a blade or laser cuts the plaque off the artery wall and safely removes it from the artery.

By opening narrowed arterial passageways, these treatments can help reduce leg pain at night and prevent serious PAD complications like CLI.

These quick, non-surgical treatments require only local sedation, not general anesthesia. Recovery time is minimal, leading to reduced pain in the legs at night.

Schedule a Consultation with USA Vascular Centers Today

If PAD makes your legs ache at night, our vascular specialists are here to help. Schedule an initial consultation online today to explore your PAD treatment options and evaluate the causes of your leg pain. We offer in-person appointments at more than 40 outpatient vascular treatment centers nationwide, as well as convenient telemedicine options. No matter where you decide to visit us, we look forward to meeting you soon.


FAQs About PAD and Leg Pain at Night

When should I be concerned about leg pain at night?

If you experience persistent leg pain at night, talk to your doctor to determine the cause. Nighttime leg pain is often written off as a sign of aging. However, aching legs at night could indicate an underlying health issue, such as muscle strain, arthritis, injury to spinal nerves, or vascular problems like varicose veins or peripheral artery disease (PAD).

If PAD is the cause of your pain, consult a vascular specialist for treatment to avoid potentially life-threatening complications.

What is vascular leg pain? What does it feel like?

Vascular leg pain occurs due to poor blood circulation. Peripheral artery disease (PAD) is a common vascular disorder that causes leg pain. Those with PAD usually describe their pain as heaviness, cramping, throbbing, or aching in the calves, thighs, and/or buttocks. This pain is also called intermittent claudication, meaning it aggravates during activity and subsides at rest. Depending on the severity of PAD, leg pain can be mild, moderate, or severe. As PAD progresses, you may experience pain during rest or at night.

What does leg pain at night from CLI feel like?

Pain from CLI is often described as a burning sensation in the feet and toes that worsens while lying in bed. Making the legs vertical (for instance, by dangling them off the side of the bed) may provide some pain relief as gravity assists the flow of blood.

How do I stop my legs from aching at night?

If your legs ache at night, there are a few ways to get temporary relief:

  • Stretch your calf and thigh muscles
  • Use your hand or a roller to massage your affected limb
  • Take a walk, moving your toes as you do
  • Move your ankles and toes while in bed

These measures might help momentarily, but if you frequently experience leg pain at night, getting a medical evaluation is the right thing to do. It is always better to catch the underlying cause early.

What causes leg pain only when lying down?

In advanced stages of PAD, the blockage in the leg arteries is so severe that the leg muscles do not get enough oxygen even while lying down. Moreover, while lying down, gravity does not assist the flow of blood to the lower limbs.

What measures can I take to improve PAD symptoms at home?

In the early stages of PAD, lifestyle changes like regular exercise, a healthy diet, controlling blood pressure and cholesterol levels, and quitting smoking can help improve symptoms. However, when advanced PAD begins causing leg pain at rest, these measures alone will not improve your symptoms. Make an appointment with your vascular specialist to discuss your options for PAD treatment.

I have been diagnosed with PAD. My leg pain tends to worsen when I walk and subsides at rest. Will I also experience leg pain at night?

Without treatment, you are likely to experience resting leg pain in the future. PAD is a progressive disease that becomes more severe with time. Early treatment by a vascular specialist can stop the progression of PAD and reduce your symptoms.

How do I know if my leg pain is muscular or vascular?

It might be difficult for you to determine whether the pain in your legs is due to a vascular issue or a musculoskeletal injury.

Damage to leg muscle fibers and muscle spasms may cause a dull ache in the legs, usually for a short duration. Muscular injuries can also cause swelling, tenderness, and joint stiffness. These symptoms are temporary and can be relieved by simple measures like rest, ice, heat therapy, massaging, or stretching.

One of the simplest ways to distinguish between muscular and vascular pain is to understand what caused the pain and how long it persists. However, this is not a definitive way to determine the cause of your leg pain. If you are experiencing persistent leg pain, consult a doctor for diagnostic tests and evaluation.


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