We all know how important a good night’s sleep is. More than just a break from the challenges of the day, sleep helps the body heal and better deal with life’s daily stresses. If you experience calf pain at night, a full measure of shut-eye may prove elusive. Here are some common causes of calf pain at night, along with suggestions to prevent and relieve it.

What are the different types of calf pain at night?

Lower leg pain at night is different for everyone who experiences it. Even if the causes are the same, the types of pain you feel may vary from person to person (and even from night to night!).

Three common types of calf pain at night include:

  • Leg cramps
  • Muscle soreness
  • Referred pain from other conditions

Leg cramps at night (a.k.a. charley horses)

You likely know how these cramps feel. They can last for a few seconds or stretch on for agonizing minutes.

Leg cramps occur when the gastrocnemius muscle of the calf spasms involuntarily. In addition to pain, this typically feels like your calf muscles are tight or knotted and can be so severe as to make it hard to flex your feet. About 60% of people experience nocturnal leg cramps at some point in their lives.

Muscle soreness

Muscle soreness is another very common type of lower leg pain at night.

We may not even realize it’s there until we turn out the light and lay down. Muscle soreness has many causes and can range from mild and fleeting to severe and debilitating.

Referred pain from other conditions

Referred pain is pain that does not necessarily originate from the calf itself but the calf is affected by it at night.

Lower leg pain in this instance may be a result of injury to another part of the body that forces the calf to compensate all day, resulting in soreness at night. For example, sciatica is a common cause of referred calf pain at night.

Why does calf pain at night happen?

Calf pain at night may be fleeting, or it may occur regularly. For those who regularly experience lower leg pain at night, there are a few common calf pain at night causes to look for, including:

  • Dehydration
  • Pregnancy
  • Sciatica
  • Shin splints
  • Parkinson’s disease
  • Deep vein thrombosis (DVT)
  • Varicose veins
  • Diabetic neuropathy
  • Torn or strained Achilles tendon
  • Injuries

Note that you should always talk to your doctor if you’ve been experiencing calf pain at night for an extended length of time, or if it becomes severe enough to limit your overall quality of sleep.

Dehydration

The simplest cause to remedy and one that is often overlooked, dehydration can cause leg cramps at night (and at any other time of day).

If you’re dehydrated, you may feel tired and your urine may be dark yellow (instead of the pale straw color of proper hydration). Muscles in all parts of the body may cramp and feel tense.

Pregnancy

Add pain in the legs at night to the long list of ways that pregnancy can make you uncomfortable!

The additional weight of a growing baby causes the arches of the feet to flatten a bit, forcing your calf muscles to work harder. This can create muscles soreness that you notice at night when you lay down to rest. Many pregnant women also experience sciatica in the lower legs as the baby grows and compresses the sciatic nerve.

Sciatica

Sciatica is a common cause of pain in the legs at night. The sciatic nerve is the longest and widest nerve in the body, originating in the lumbar spine and traveling across the buttocks and down the hips to end in each foot.

Any injury along the length of this nerve can result in referred pain anywhere along its length (including the calf). In addition to pain, calf pain at night caused by sciatica may be accompanied by tight muscles and restricted movement and numbness or tingling.

Shin splints

Shin splints affect the front of the calf and occur when the muscles and the tendons on the shins are overworked. The resulting inflammation can be painful, especially at night.

Simple activities like walking on flat ground may be restricted by painful shin splints.

Parkinson’s disease

Parkinson’s disease is a neuromuscular disease that has, as a primary symptom, involuntary muscle contractions. These contractions can affect any muscle group in the body, including the lower legs.

Deep vein thrombosis (DVT)

Deep vein thrombosis is a serious medical condition that can be fatal.

If you have long periods of inactivity (i.e., during a long flight or car ride), blood clots can form in the lower leg and travel through the blood stream to the lungs. This could cause a fatal pulmonary embolism. Treat this as a serious medical emergency, especially if you’re feeling other pulmonary embolism symptoms.

Varicose veins

Varicose veins occur when the walls and valves of your veins weaken and expand, sometimes due to age and sometimes as a result of another condition.

You can see these larger veins clearly at the surface of the skin as twisted, sometimes raised, and deep purple. If you have varicose veins and are on your feet throughout the day, you may experience an aching soreness in your lower legs at night.

Diabetic neuropathy

Nerves all over the body are damaged by continually fluctuating blood sugar levels that come with diabetes.

Diabetic neuropathy is a common complication that causes pain in the lower legs at night, following by tingling sensations and finally numbness.

Torn or strained Achilles tendon

Often the first indication of an Achilles tendon tear or strain (tendinitis) is pain in the calf. This can feel like soreness and quickly change into a stabbing pain in the lower leg whenever the foot is moved.

Other injuries

Strains, sprains, and broken bones in the legs can all result in calf pain at night that ranges from a dull ache to a sharp pain.

What Causes Calf Pain At Night And How To Relieve It | Arizona Pain

When should I see a doctor about calf pain at night?

If you are experiencing calf pain at night that seems unrelated to minor muscle overuse or that changes over time, talk to your doctor.

While it may be easily related to an underlying medical condition, it is possible that lower leg pain at night could be a symptom of something serious. At a minimum, talking to your doctor about calf pain at night can set your mind at ease and help you get a good night’s sleep.

Note that new calf pain after long periods of inactivity or travel can be caused by a blood clot, and this is an emergency medical situation that requires immediate attention. If your regular doctor is not immediately available, go to the nearest emergency room for treatment.

How to relieve calf pain at night

Of all of the causes of calf pain at night, there is one that is very simple to treat: dehydration. Ensuring that you get adequate amounts of water during the day for your body and activity level is crucial and is an easy treatment for pain caused by an electrolyte imbalance.

For all other conditions that can cause calf pain at night, here are some treatment options, broken down by each cause.

Pregnancy

In many cases, leg cramps at night will resolve themselves shortly after the baby is born. As long as there is no threat of blood clot, sometimes leg and foot massages can help relieve muscle soreness.

Some expectant mothers report good pain relief (and better sleep) when they use a transdermal magnesium spray, stretch regularly, and use a heating pad to relax tight, sore muscles.

Sciatica

The best way to treat calf pain at night caused by sciatica is to treat the underlying condition.

If a herniated disc is causing sciatic pain that extends into your calf, treating that may immediately relieve your pain. Otherwise, physical therapy and stretching can relieve pain, as can regular exercise.

Shin splints

Shin splints are best treated with a period of rest and ice, as well as the proper use of NSAIDs for pain and inflammation.

To prevent shin splints from occurring, proper stretching and warm-ups are important. Additionally, wearing supportive, properly fitted shoes can help exercise safely and in comfort.

Finally, you may need to reevaluate your training program. Shin splints often occur after you increase your mileage or distance when running or walking. If you’re suffering from severe pain, you may need to decrease your training program or switch to a few weeks of low impact exercise instead.

Parkinson’s disease

Treating lower leg pain in Parkinson’s patients is all about managing this progressive disease while making patients as comfortable as possible.

For lower leg pain at night, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium can go a long way to relieve inflammation and pain. Other treatments like soaking in an Epsom-salts bath and gentle massage and stretching can also help to prevent calf pain at night.

Deep vein thrombosis

Deep vein thrombosis is more likely in patients who are inactive and overweight. Important treatments for this include losing weight and increasing activity. If you need to be sitting for long periods of time, compression socks can help prevent clots.

Additionally, for those who are particularly at risk, medications like blood thinners may be in order. Talk to your doctor before travel or other long periods of inactivity if you have risk factors for this serious condition.

Varicose veins

Calf pain at night from varicose veins can be prevented with the use of support stockings during the day.

Additionally, alternating between standing and sitting can help to give your legs a rest. If the pain of your varicose veins becomes unbearable, talk to your doctor to explore other treatment options.

Diabetic neuropathy

The key to preventing calf pain at night caused by diabetes is to work hard to get your blood sugar under control.

The cause of diabetic neuropathy is nerve damage caused by fluctuating blood sugar levels. It makes sense that finding a balance in diet and medication can help prevent further damage. Work with your doctor to find that balance, and then follow your treatment recommendations going forward.

Torn or strained Achilles tendon (and other injuries)

For active people with tendinitis, torn Achilles tendon, or other injuries that lead to calf pain at night, the recommended treatment may be the hardest for them: rest. Activity can cause further inflammation and irritation to an already-inflamed and irritated muscle or tendon. Taking time off from vigorous activity gives the injury time to heal properly.

During the acute phase of injury, applying ice in a 20-minutes-on, 20-minutes-off schedule can provide relief and decrease inflammation. NSAIDs can provide temporary relief of pain and inflammation as well, but take care to follow directions for use. Long-term use of even over-the-counter NSAIDs can cause serious side effects. Depending on the severity of your injury, you may also need to consider physical therapy, braces, or surgery with your doctor.

Each cause of calf pain at night is as unique as the person experiencing it. If lower leg pain at night is keeping you up, it may be time to talk to a pain specialist. If you’re in Arizona, contact the team at Arizona Pain for more help with your calf pain at night. 

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