Leg pain when lying down can be caused by restless legs syndrome, poor circulation, or muscle cramps. See a doctor if it persists.
Common causes
- Restless legs syndrome.
- Poor circulation or peripheral artery disease.
- Muscle cramps.
- Sciatica.
- Deep vein thrombosis (DVT).
- Iron deficiency.
Restless legs
Affects about 10% of US adults. Urge to move legs, worse at night.
Home care
Stretch, walk, massage and raise the legs.
See a doctor
If pain persists.
Emergency
Swelling, redness and warmth in one leg can mean a clot.
Restless legs syndrome
RLS causes an urge to move the legs, with creeping, crawling or aching sensations, worse in the evening or when lying down, relieved by movement. It affects about 5% to 10% of adults. Causes include iron deficiency, pregnancy, kidney disease, neuropathy, certain medications and genetics.
Circulation
- Peripheral artery disease causes leg pain with walking, and sometimes at night when lying down because blood flow to the legs decreases.
- Deep vein thrombosis (DVT) causes pain and swelling, usually in one leg, with warmth and redness.
- Varicose veins and venous insufficiency can ache, particularly after standing.
Nerves and spine
Sciatica and spinal stenosis cause leg pain or numbness, worse lying down or at night in some cases.
Muscle and sleep related
- Nocturnal leg cramps.
- Overuse after exercise or standing.
- Dehydration and electrolyte imbalance.
- Growing pains in children, usually in the evening.
Other causes
Diabetes, thyroid problems, arthritis, fibromyalgia and some medications (statins).
Home care
- Stretch calves and hamstrings before bed.
- Warm bath or heating pad.
- Elevate legs.
- Regular exercise.
- Reduce caffeine and alcohol.
- Check iron levels, ferritin below 75 may contribute to RLS.
See a doctor if
Pain disturbs sleep regularly, one leg is swollen, red or warm, or there is numbness, weakness or skin changes.
Emergency
Sudden leg swelling and pain with chest pain or shortness of breath may indicate a blood clot in the lung. Call 911.
Restless legs and circulation
Leg discomfort that begins when lying down is a classic sign of restless legs syndrome (RLS), an urge to move the legs with crawling or aching sensations that eases with movement. It affects 5 to 10 percent of adults and is linked to low iron stores, pregnancy, kidney disease and some medicines. Peripheral artery disease can cause leg pain that changes with position, and sciatica from a pinched nerve can flare when lying flat. Muscle cramps, arthritis and in children growing pains, which affect 25 to 40 percent of kids, are other causes.
What helps and red flags
Stretching, a warm bath, regular exercise, limiting caffeine, alcohol and nicotine, and treating iron deficiency help RLS, and doctors often check ferritin levels. Elevate the legs or adjust sleep position for sciatica. Seek urgent care for a swollen, red, warm and painful leg, particularly one leg, because a deep vein thrombosis can travel to the lungs. Chest pain or shortness of breath with leg pain needs 911. See a doctor for symptoms that disturb sleep most nights.
Based on data from the NINDS and the Restless Legs Syndrome Foundation
