Painful legs and feet at night

Nighttime Leg Pain is a Symptom of PAD

Left untreated, PAD can lead to amputation

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Does leg pain frequently interrupt your sleep? Are you in the habit of hanging your foot off the edge of the bed to relieve the discomfort? Is sleeping upright in a chair the only way you can get rest?

These might be more than normal effects of getting older. Pain in your legs and feet at night, or when you’re trying to sleep, is a symptom of peripheral artery diseasePeripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. (PADPeripheral Artery Disease, a potentially life threatening disease where plaque, like calcium, builds up along blood vessel walls, narrowing the arteries and reducing blood flow to the legs and feet.). And nighttime leg pain could mean you have the worst form of PAD — critical limb ischemiaAlso potentially known as CLI, the most severe and deadly form of peripheral artery disease. (CLI).

Aches and pains from PAD are the result of narrowed, hardened arteriesArteries are blood vessels that carry blood to your heart and other parts of your body. in the legs, limiting blood flow to your legs and feet. With CLI, the obstructed blood flow is so considerable and widespread that nighttime pain attacks in your legs or feet can last minutes to hours long.²⁰

Leg pain could be a sign of something worse

Many CLI patients are at significant risk for amputationTo surgically remove all or part of a limb (leg, foot or toe) if they don’t seek treatment. Things can get worse from there — CLI has been linked to putting a patient’s life at risk.⁴

Nighttime leg pain can be a sign of a serious condition. Know the warning signs.

Only a health care professional can diagnose you with PAD. Don’t put it off. Make an appointment with your doctor now, or use our Find a Doctor tool to locate a PAD specialist near you.

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Only a health care professional can diagnose you with PAD. Our Symptom Quiz can help guide the conversation about your treatment options.

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Peripheral artery disease (PAD) is a common and often underdiagnosed circulatory disease where blood flow to the legs and feet is restricted by the narrowing of blood vessels due to plaque buildup.

Left untreated, PAD can lead to amputation and put you or your loved one’s quality of life and long-term health at serious risk.

(By clicking you are leaving this website and going to the Cardiovascular Systems, Inc. website where you can find a PAD specialist in your area.)

Is Leg Pain at Night A Warning Sign of Vascular Disease?

Is leg pain at night often interrupting your sleep? It could more than a normal sign of getting older. Pain in your legs and feet at night, or when trying to sleep, is often a symptom of peripheral artery disease (PAD).

Peripheral artery disease leg pain can occur anywhere in your leg, but the most common places to feel pain are in the muscles of your calf, thigh or buttocks. The pain can range from mild to so severe you can barely walk a very short distance. PAD is a progressive disease. For some people, pain only occurs during the daytime. Others have pain when resting or at night.

The leg pain or muscle cramping caused by PAD is known as claudication. Symptoms of claudication can be triggered by activity, especially walking or climbing stairs. However, once you stop and rest for a few minutes, it’s not uncommon for the pain to subside.

Nighttime leg pain could be a sign of the worst form of PAD – critical limb ischemia (CLI). With CLI, the pain attacks in your legs or feet can persist for minutes to hours. Leg pain at night can be a sign of a serious condition, and only a healthcare professional can diagnose you with PAD.

What is Peripheral Artery Disease?

Peripheral Artery Disease is a circulatory disease in which blocked arteries reduce blood flow to the extremities, most commonly, the legs and feet. PAD is a relatively common condition – in fact, an estimated 8.5 million people, and nearly 15% of people over the age of 70, in the United States have been diagnosed with it.^i,iii

What Causes Peripheral Artery Disease?

PAD is caused by atherosclerosis, or of the arteries. Hardening of the arteries is a condition that causes both coronary artery disease, which can lead to heart attacks, and PAD, which, if severe enough, can lead to amputation of a limb, or even death. ² And like coronary artery disease, PAD is a serious condition.

So…What is Atherosclerosis?

Atherosclerosis is a condition that’s common in older people in which fatty deposits accumulate inside the arteries, creating blockages. Theses blockages are made up of fats and cholesterol, and is referred to as plaque. As plaque builds up in the artery, the walls of the blood vessels begin to thicken, impeding blood flow.ⁱⁱ

It’s uncertain exactly what causes atherosclerosis, but many scientists and doctors believe that damaged arteries cause the plaque to form. Damage to arteries can be caused by:

High cholesterol
High blood pressure
Smoking ^iv

Other Signs of PAD

Know the warning signs. Leg pain is not the only symptom, there are a number of other signs that could indicate that you have PAD, including:

Cramping or aching after walking or climbing stairs that subsides with rest
Numbness or weakness in your legs
A cold feeling in your lower leg or foot
Sores that won’t heal on your legs, feet or toes
A weak pulse in your ankles or legs
Shiny skin and/or a bluish tint to your legs
Loss of hair on your legs
Slow growing toenails ^v

Just like with other cardiovascular conditions, there are things you can do to help manage PAD, such as:

If you smoke, quit
Exercise if your doctor says it’s okay
Lower your cholesterol level
Eat a healthy diet, including foods low in saturated fat
Avoid over the counter cold medications that include pseudoephedrine (Advil^® Cold & Sinus, Aleve-D^® Sinus & Headache, Claritin-D^®, Sudafed^®, Tylenol^® Cold, Zyrtec-D^®, others) because they constrict your blood vessels and may increase your PAD symptoms. ^v

If you think you may have peripheral artery disease, don’t put off seeing your doctor to discuss testing and PAD treatment options if needed. The sooner you get diagnosed, the sooner you and your PAD specialist can determine if you are a candidate for minimally invasive treatments to slow down or stop progression of the disease. Things can get serious if PAD is left untreated, including amputation, stroke or death. Finding PAD early can lower your risk of heart attack or stroke and save your limbs.

Sources:
ⁱ Selvin, E., Erlinger, T.P., Prevalence of and Risk Factors for Peripheral Arterial Disease in the United States Results from the National health and nutrition Examination Survey, 1999-2000. Circulation, 2004, 110: p. 738-743.http://circ.ahajournals.org/content/110/6/738.full (accessed 8/18/2016)
ⁱⁱ American Heart Association (2017). Retrieved from www.heart.org.
ⁱⁱⁱ Allison, M. A., Ho, E., Denenberg, J.O., Langer, R.D., Newman, A.B., Fabsitz, R.R., Criqui, M.H., Ethnic-specific prevalence of peripheral arterial disease in the United States. Am J Prev Med, 2007, 32(4): pp. 328-33. http://www.ncbi.nlm.nih.gov/pubmed/17383564 (accessed 8/18/2016)
^iv The Mayo Clinic (2017). Peripheral artery disease. Retrieved from: http://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/dxc-20167421
^v Mayo Foundation for Medical Education and Research (MFMER). (2015) Retrieved from: https://www.drugs.com/mcd/peripheral-artery-disease-pad

Restless legs syndrome: when the night turns to torture

Sally Abrams
BBC correspondent

December 26, 2017

Image copyright, Getty Images

Image caption,

Restless leg syndrome makes nights a torture

For many years, Mary Rose struggled to fall asleep or stay awake due to pain in her legs that felt like an insect attack.

"Imagine that you have a swarm of bees under your skin that fly and sting you. It hurts very, very much," she says, describing her feelings.

Mary Rose has a so-called restless leg syndrome that prevents her from sleeping at night.

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"I want to scratch my legs, get out of bed and walk around. sleep because my legs were twitching uncontrollably all night," she explains.

The symptoms were so painful that she did not want to go to bed in the evenings.

Mary Rose doesn't remember when the problem started, but doctors couldn't diagnose her for several years.

"People said you just had cramps. You should take quinine or put tree bark in your bed. So I did," she recalls.

Of course, it didn't get any better. She tried rubbing ointments on her legs to reduce the stinging sensation, but it didn't last the whole night. The doctors were also unable to help her relieve her pain.

The need not to sleep but to move

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One day she was advised to visit a sleep clinic in London, where she is currently undergoing treatment under the supervision of the doctor Guy Leschziner.

"Restless legs syndrome is a common nerve disorder that causes a person to feel the need to move, especially at night, and is most often accompanied by discomfort in the legs," says Leschziner.

"This condition affects about one in twenty people. It can cause severe sleep deprivation," he explains.

Sometimes Mary Rose only managed to sleep for a few hours, and sometimes even less.

"I had nights when I didn't sleep at all. If I was very tired, I would sleep, then wake up for an hour or two, and sometimes get out of bed," she says.

Restless legs syndrome is often hereditary, but it also occurs for other reasons. This can be, for example, a lack of iron in the body or pregnancy, and, usually, it is easy to cure the disease.

For some people, simply avoiding coffee, alcohol, and certain medications, and doing light exercise (stretching and foot massage) is enough. But in some cases, medical treatment is also required.

Mary Rose's condition required medication, so Leschziner resorted to varying medications to control his symptoms. This appears to be working as long as the patient does not decrease the dosage.

"I don't have restless legs anymore!" she says happily. "It's true that sometimes I have severe attacks when I have to get out of bed and walk around. But it's my fault because I forget to take my pill."

Distraction strategy

Although the treatment is working, Mary Rose still cannot get a full night's sleep.

"I regret to admit that even though my legs are more controllable, it didn't help my sleep patterns. I still wake up at around 3 am," she says.

According to Leschziner, this is normal.

"What you're describing is fairly common among people who have lived with a sleep disorder for many years. Sleep is a learned habit," he says.

The dread of the coming night and the constant interruption of sleep can last for many years.

Image copyright, Getty Images

Image caption,

Audio books and music can help reduce brain activity and help a person fall asleep

He said that sometimes people need to relearn how to sleep in order to understand that the bed is for sleeping, not for torment associated with a heavy night.

Mary Rose has developed her own strategy for dealing with insomnia.

"Listening to audiobooks or music, my brain starts to slow down, after which I'm ready to sleep. But that doesn't mean I get more than two hours of sleep," she says.

"Essentially, it means you're distracting yourself," says Leschziner. "By thinking about the story or the music you're listening to, you no longer have to think about the process of falling asleep, and so your brain switches to passive mode and then sleep starts as if by accident.

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Pain in the legs, unfortunately, is familiar to many, and it worries not only the elderly. It is impossible to unequivocally answer the question of why the legs hurt so much. What to do in this case? - There can be many causes of pain - from simple fatigue with high physical exertion or uncomfortable shoes to injuries and serious illnesses. In the first case, it is enough to rest or change shoes, and everything will pass. In the event of an injury, a recovery period is required. If the pain in the legs is constantly disturbing, you should undergo an examination in the clinic. Moreover, the sooner you see a doctor, the easier it will be to cope with the disease.

Possible causes of pain in the legs:

Trauma (contusion, fracture, sprain, etc.).
Disease of the spine, accompanied by pinching of the nerve roots, leading to shooting pains in the leg.
Arthritis or arthrosis resulting in damage to the joints of the legs.
Disease of the blood vessels of the lower extremities. One of the most common disorders of the vascular system is varicose veins. With untimely treatment, it can develop into thrombophlebitis, the final stage of which is vessel thrombosis. Thrombosis is not only accompanied by a sharp pain in the leg, but also threatens with more serious consequences - blockage of the veins of the lower extremities or even pulmonary embolism. Atherosclerosis of the arteries of the lower extremities is also widespread, accompanied by pain in the calf muscles. Instead of pain, cramps may develop, heaviness in the legs can be felt.
Damage to muscle tissue (muscle inflammation, fibromyalgia, etc.).

The nature of pain in the leg may differ in various diseases, it can be aching, acute, appear below the knee or in the thigh area, etc. To determine the cause of the pain, it is necessary to analyze other symptoms, as well as undergo certain diagnostic tests. To do this, you need to see a doctor. If spider veins appear or other manifestations of blood vessel diseases are obvious, you should make an appointment with a phlebologist. If it is impossible to determine the cause of the pain on your own, you can contact a therapist, after examination he will refer you to a neuropathologist, phlebologist or other doctor.

The First Phlebological Center in Moscow provides diagnostics and treatment of vascular diseases. Experienced doctors and modern equipment help to achieve effective results in diseases of varying degrees. But still, you should not wait until your legs hurt very much. Timely contacting the clinic will help to cure the disease in the early stages, preventing serious complications.

Diseases of the veins at the initial stage are not accompanied by visible changes. The first symptoms may be pain in the leg, excessive muscle tension, a feeling of heaviness, swelling. Later, inflammation of the skin over the affected area is observed, and the pain intensifies.