Legs aching at night can be caused by various factors, ranging from common and benign to more serious underlying conditions. Common causes include muscle cramps (often due to dehydration or electrolyte imbalances), muscle or tendon inflammation from injury or overuse, and circulation problems such as peripheral artery disease (PAD) or venous insufficiency including varicose veins. Other causes can include restless leg syndrome, peripheral neuropathy, bone fractures, and nerve compression like sciatica. Pain may worsen at night due to reduced blood flow when lying down or when the muscles are resting and not actively helping blood circulation. Some medications, pregnancy, and age- related changes can also contribute to leg pain at night.

Common Causes of Leg Pain at Night

• Muscle cramps : Involuntary muscle contractions, often linked to dehydration or low electrolytes.
• Peripheral artery disease (PAD) : Narrowed arteries reduce blood flow, causing pain especially during inactivity.
• Venous insufficiency and varicose veins : Poor blood flow in veins leads to pressure buildup and aching.
• Restless leg syndrome (RLS) : Neurological condition causing uncomfortable sensations and urge to move legs at night.
• Peripheral neuropathy : Nerve damage causing tingling, burning, or numbness.
• Injury or overuse : Muscle or tendon inflammation, or bone fractures.

Why Pain Worsens at Night

• Reduced blood flow when lying flat.
• Lower blood pressure and metabolic rate during sleep.
• Lack of muscle movement reduces vein blood return, causing pooling.
• Increased susceptibility to muscle cramps or spasms during rest.

If leg pain at night is persistent, severe, or accompanied by other symptoms (like swelling, redness, or significant discomfort), it is advisable to consult a healthcare provider for diagnosis and management.