What Can Cause Leg Pain When Lying Down?

A doctor examining a lying down patient suffering from leg pain.

There are plenty of issues that can cause leg pain when you are on your feet. Tired muscles, strains, sprains and injuries can all be painful, but often these types of pains go away or lessen when you sit or lay down. What if you have leg pain when lying down? There are certain conditions both in the legs and back that can cause leg pain when lying down instead of when you are on your feet. If you notice leg pain that increases when you go to bed at night, there are a few conditions that can cause these symptoms.

Sciatica and Spinal Nerve Root Pain

One the reasons you may have leg pain when lying down is nerve pain. The peripheral nerves for the lower body exit the spinal column in the lower back and travel down through the pelvis and hips to the legs. The two large nerves that affect the legs are the sciatic nerves. There is a sciatic nerve for each leg that exits the spine in the lower back and runs through the hip area and down the leg. If the sciatic nerve is pinched or irritated, it can cause a wide variety of symptoms that are associated with sciatica.

Sciatica is not a spine condition, but a collection of symptoms caused by a compressed or irritated sciatic nerve. There are multiple spinal conditions that can result in sciatica symptoms, including herniated discs, muscle spasms, spondylosis and bone spurs, as well as non-spinal factors like obesity and diabetes. Sciatica can cause the following symptoms:

  • Lower back pain
  • Radiating pain through the hip
  • Shooting pain down the leg
  • Tingling or numbness in the leg
  • Weakness in the hip or leg

With sciatica, symptoms are almost always felt on one side. If you have sciatica symptoms or leg pain when lying down on one side or other positions, it will likely only be one leg with pain.

Cause of Sciatica Leg Pain When Lying Down

If you have sciatica pain that seems to increase when you are lying down to go to sleep, it may be caused by nerve compression in certain positions. Leg pain when lying down on one side is a common cause of sciatica, as direct pressure can be put on the nerve root. Usually, sciatica pain is caused when you are lying on the affected side – switching sides can be helpful. For some people, putting a pillow between the legs can stop leg pain when lying down on one side. However, addressing the cause of sciatica is the best way to relieve symptoms.

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Vascular Disease Can Cause Leg Pain

The circulatory system needs to work overtime to deliver blood supply to the extremities, especially in the legs. If you have throbbing leg pain when lying down, it may be caused by a vascular issue, not a nervous system problem. Achy, throbbing legs, especially in the lower leg, can be indications of a vascular problem. There are a few different types of vascular disease or conditions that can cause leg pain when lying down.

Peripheral Artery Disease (PAD)
Peripheral artery disease, or PAD, is a common vascular disease where the arteries become blocked and restrict blood flow to the extremities like the legs. PAD is caused by atherosclerosis, which is a hardening of the arteries. While PAD can cause pain when walking or climbing stairs, serious types of PAD can result in throbbing leg pain when lying down, often in the calves, thighs or buttocks.
Varicose Veins
When vein walls weaken and swell from excessive pressure, this can result in varicose veins. The lower legs are a common area for varicose veins. The enlarged veins are not only noticeable, but they can cause pain and cramping. It is common for pooling to occur with varicose veins, especially when resting. Throbbing leg pain when lying down can be caused by varicose veins when the blood pools in the calves.
Blood Clots
One of the most serious causes of leg pain when lying down is a blood clot. Deep vein thrombosis, or DVT, occurs when blood stays too long in the legs, resulting in the forming of a blood clot. DVT can occur in people who are bedridden, resulting in cramping pain in the leg. DVT can cause tissue damage and pain, but more importantly, the blood clot can break loose and reach the lungs or heart, which can be fatal.

A woman in bed massaging her calf due to pain.
Since there are serious health conditions that can be related to leg pain when lying down, it is not a symptom that should be ignored. When you have leg pain when lying down, it is important to have it diagnosed to determine the cause. Your doctor can determine whether it is a nerve or vascular condition and what treatment can protect your health and give you relief.