Leg Pain at Night: Causes, Treatment, Exercises

Getting quality sleep each night is essential for your overall well-being, but it can be challenging if you have leg pain at night. “It’s common to notice uncomfortable sensations more at bedtime, not because sleep makes pain worse, but because there are fewer distractions,” says Courtney Fitzpatrick, PT, DPT, a Hinge Health physical therapist.

When leg pain prevents you from falling or staying asleep, it can lead to a difficult cycle, as sleep helps you tolerate and recover from pain. Finding ways to get comfortable at night is key for breaking the pain-sleep cycle and relieving leg pain at night.

Here, learn more about why your legs ache at night and how to address nighttime leg pain, especially with exercises recommended by our Hinge Health physical therapists. 

Causes of leg pain at night 

Leg pain can be frustrating, especially when it interrupts your sleep. Addressing your discomfort often starts with understanding what might be contributing to it. Some common reasons for nighttime leg pain include:

• Nerve irritation. Nerves like space and movement. When tight muscles compress or irritate a nerve running through your lower back or hips, you may experience pain or even tingling in your legs. “You may notice this more at night, especially if your sleeping position puts extra pressure on the nerve,” says Dr. Fitzpatrick. 

• Too little activity. Not moving enough during the day can lead to muscle stiffness, which may contribute to leg discomfort or aches at bedtime.

• Muscle soreness. Whether you tried a new workout, spent an extra hour gardening, or walked more than usual, your legs may feel more sore — especially by the end of the day. “Muscle soreness is like feedback from your body,” Dr. Fitzpatrick says. “It might need time to adjust, which is why easing into new activities can be helpful.” 

• Muscle strain. Sometimes, when your body isn’t prepared for movement, muscles can become overstretched or strained. This may cause discomfort that becomes more noticeable at night.

• Muscle cramps. Staying hydrated is important for keeping your muscles healthy. If you get leg cramps at night, it may help to increase your water or electrolyte intake during the day, suggests Dr. Fitzpatrick.

• Edema. Some health conditions (like heart, kidney, or vein issues) can cause fluid to build up in the legs — a condition known as edema. Swelling from edema often becomes more noticeable at night, especially after a day of sitting or standing. 

Symptoms of leg pain at night

Nighttime leg pain can feel different for everyone. Some common symptoms include:

• Aching or throbbing sensations in the legs

• Cramping or tightness in the calf muscles

• General stiffness in the legs 

• Tingling or numbness in the legs 

• A feeling of aching or heaviness in the legs 

How movement can soothe leg pain 

Movement is medicine. Whether your leg muscles feel tight from too much activity or not enough, gentle movement can often help ease discomfort. Stretching your lower back and hips can be especially soothing if nerve irritation is contributing to your leg pain. “Targeted stretches can help increase blood flow to sore areas, improving flexibility and mobility in your leg muscles,” Dr. Fitzpatrick says. “Stretching at night can help your body and mind relax before bed.” 

These exercises are designed to help alleviate leg pain at night, whether it’s related to nerve irritation in your low back or cramping leg muscles. Try these moves when you’re winding down for bed, or in the middle of the night if leg pain wakes you up. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for leg pain at night

Leg pain at night can often resolve with conservative treatments. These include: 

• Try physical therapy and targeted exercises. Targeted exercises can help address muscle tension and give your nerves more space to move comfortably. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Find your movement sweet spot. Staying active during the day can help prevent discomfort at night (not to mention help you sleep). But overdoing it can also contribute to discomfort, which is why it’s so important to listen to your body and find your movement sweet spot — where you feel challenged but comfortable. 

• Try heat or cold therapy. While ice can help reduce swelling and inflammation, heat typically helps improve blood flow and alleviate muscle stiffness. At bedtime, it may be more relaxing to wind down with a heat pack. Choose the method that works best for you.

• Stay hydrated. Drinking enough water throughout the day helps keep your muscles healthy and functioning well. “We need water to pull nutrients into our cells, which supports muscle healing and performance,” says Dr. Fitzpatrick. For uninterrupted sleep, aim to hydrate earlier in the day and limit fluids an hour or two before bedtime.

• Tweak your sleep position. There’s no one “right” sleep position for leg pain. Instead, try to find what’s comfortable for you. If you’re a side sleeper, consider putting a pillow between your knees to increase your comfort, says Dr. Fitzpatrick. If you sleep on your back, adding a pillow or two underneath your knees may help you get more comfortable. 

• Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for leg pain at night. It’s important to make sure that you are safely able to take these medications, based on your medical history. 

• Address your stress. When you don’t get enough sleep, you’re more sensitive to pain and stress. Anything you can do to relax your mind and body before bed can help you get better sleep and reduce pain, says Dr. Fitzpatrick. In addition to gentle stretching, try soothing activities like meditation, deep breathing, or keeping a gratitude journal as part of your nighttime routine.

• Try TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

When to see a doctor

Leg pain at night often improves on its own with conservative treatments. But if your leg pain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Worsening numbness

• Balance issues

• Bowel and bladder changes

• Weakness in your legs 

• Worsening or persistent fever, chills, swelling, drainage, or redness (signs of infection)

PT tip: Prioritize self-care

Practicing self-care strategies, such as following sleep hygiene tips and adopting a bedtime routine, can help you sleep better and reduce leg pain at night. “When you’re in pain, and your sleep is affected, it’s important to be gentle with yourself,” says Dr. Fitzpatrick. “Focus on what you can control during the day, like eating nourishing food, hydrating, connecting with supportive people, and moving your body as much as you can.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Cheatle, M. D., Foster, S., Pinkett, A., Lesneski, M., Qu, D., & Dhingra, L. (2016). Assessing and Managing Sleep Disturbance in Patients with Chronic Pain. Anesthesiology Clinics, 34(2), 379–393. doi: 10.1016/j.anclin.2016.01.007

2. Sivertsen, B., Lallukka, T., Petrie, K. J., Steingrímsdóttir, Ó. A., Stubhaug, A., & Nielsen, C. S. (2015). Sleep and pain sensitivity in adults. PAIN, 156(8), 1433–1439. doi: 10.1097/j.pain.0000000000000131

3. Hsu, D., & Chang, K.-V. (2020). Gastrocnemius Strain. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534766/

4. Blyton, F., Chuter, V., & Burns, J. (2012). Unknotting night-time muscle cramp: a survey of patient experience, help-seeking behaviour and perceived treatment effectiveness. Journal of Foot and Ankle Research, 5(1). doi: 10.1186/1757-1146-5-7