Leg pain when lying down can mean one of several things. First, it might mean that there is pressure on a nerve in that position. Even if the pressure is in the back, the pain might be in the legs. This is called referred pain. But there are other potential explanations. For instance joint pain that is worse in certain positions or severe lack of blood flow to the feet.
Nerve Leg Pain When Lying Down
Our spinal cord runs inside our spine. Then, nerves leave the spinal cord to reach the rest of the body. This happens through gaps in the spine called foramen. Lying down might cause the foramen to narrow. Obviously, if the foramen narrow, the nerves that pass through them might get pinched.
Sciatica is the pain we feel in our buttock and legs from pinching of the sciatic nerve. Sciatica leg pain is a common reason for leg pain when lying down. In fact, people who suffer from sciatica leg pain often say they can not find a comfortable position to sleep in. No matter how they twist and turn, lying down causes night leg pain.
Neuropathy or Sciatica?
Neuropathy is a different kind of nerve pain that is often worse at night. Still, neuropathy leg pain is different than sciatica leg pain. People with neuropathy usually describe burning, and problems with sensation in their feet. Sometimes they will also have similar symptoms in their hands. On the other hand, people with sciatica leg pain usually describe a dull, achy pain, that starts higher up in the leg, and goes down toward the thigh and calf.
Joint Leg Pain When Lying Down
Another source for leg pain when lying down are the joints. When we are lying in bed, that might put pressure on our lower spine or hips. Different positions can cause pain in different locations. Lying on our back reduces the natural curvature of our lower spine. This can create pressure on the lower back. On the other hand, lying on our side can put direct pressure on our hips. This can be especially painful if you have inflammation around the hip or thigh. One muscle and tendon that often cause such problems is the tensor fascia lata (or TFL).
Joint pain is often made worse because of tight muscles. Many people suffer from tight lower back muscles or from tight hip flexors. When we are in bed, our position might make the tightness worse. The constant tug of the tight muscles on our back and hips can hurt. This is especially true if we also have joint disease.
Spinal Stenosis is not a Cause for Pain when Lying Down
Spinal stenosis is the narrowing of the spinal canal from wear and tear. This narrowing can squeeze the nerves that make up the spinal cord. Obviously, this squeeze can cause back and leg pain. In fact, sometimes it can also cause an inability to walk properly that is not so different from intermittent claudication. But, spinal stenosis is not a cause for pain when lying down. In fact, it is known that leaning forward, sitting or lying down improve the symptoms of spinal stenosis. They are worse with standing and walking.
Leg Pain from Lack of Blood Flow
Lack of blood flow will cause severe pain. If the arteries are severely blocked, that will result in reduced blood flow to the legs. When we raise our legs in bed at night, gravity is not helping blood flow, because are legs are up. In people who have severe narrowing of the arteries, this will result in pain. This pain is called rest pain.
It is important to diagnose rest pain quickly. People with rest pain should receive prompt treatment to improve blood flow. Neglecting rest pain can result in painful wounds and even gangrene.
Vein Disease
Leaky vein valves can cause heavy legs. In fact, leg heaviness is a common symptom of venous insufficiency. The heaviness is worse as the day progresses. When we lie down and raise our legs, the pressure in our legs slowly resolves. But at first, people often describe heaviness, pressure and discomfort. So, ironically, even though raising our legs is helping, the first sensation is actually that of leg pain when lying down.
Cracked Skin
Dry skin on the soles of the feet might crack. When it does, this is called a fissure. Fissures might not hurt when we are standing on them. The pressure from our body’s weight might be enough to hold the fissure closed, and avoid pain. But, when we are lying in bed, our foot might swell a bit and the fissure might open up a bit. This can be quite painful. Sometimes pain from cracked skin is enough to keep people awake.
Luckily, the solution is easy. First, inspect your feet. If you can not do that on your own, ask someone to look at your feet for you. Once you identify dry skin on the soles or broken skin, make sure to moisturize it with a heavy emollient. Remember not to moisturize between the toes (because you might induce Athlete’s foot). If you use an emollient correctly, your pain should resolve quickly.
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