Pain in the legs is not uncommon. But for most of us it occurs when we stand or walk for long periods. Sudden bursts of strenuous physical activities like running will understandably result in leg pain by the end of the day if you are accustomed to it. After all the legs are the most hard working parts of the body. Not only does it have to bear the entire weight of the body, it also has to contend with impact when we walk and run. But what about pain when we are not using our legs? Like when sitting or sleeping.
While leg pain in these cases could be the consequence of a hard day at work, it may also be a symptom of some underlying disease. It is not an uncommon symptom. The pain typically involves the lower leg and especially the calf, as well as the feet. The types of diseases that can cause leg pain while sitting or sleeping vary, but it usually involves the circulation and nerves of the leg. At times there may be other symptoms such as :
- Cramping particularly of the calf muscles and foot muscles.
- Paleness of the skin over the legs and even a blue discoloration.
- Darkening of the skin on the legs occurring over a long period of time.
- Preceded or followed by numbness and tingling of the legs.
- Open sores (ulcers).
Many of the causes of leg pain while sitting or sleeping are the same as leg pain while walking.
Narrowed Leg Arteries
The arteries of the legs carry oxygen and nutrients for the muscle, joints, ligaments, skin and bones. But these arteries may become narrowed. This is known as peripheral arterial disease of the legs. The most common cause of PAD is the build up of fatty plaques in the artery wall thereby causing a partial obstruction. It ultimately reduces the blood supply to the legs. Eventually a blood clot can completely occlude the artery leading to acute limb ischemia.
A typical symptom of PAD is pain in the legs, especially the calf muscles. This is known as claudication. Initially the pain is only when exercising but as the condition worsens, it can also occur at rest like when sitting and sleeping. Some patients find relief from the leg pain when sleeping by hanging the leg over the side of the bed. This helps blood flow to the feet due to the action of gravity. However, medical treatment is ultimately required to restore blood flow to the legs.
Weak Leg Veins
The leg veins carry blood from the feet to the heart. However, the leg veins have a more difficult task than other veins in the body. The blood in it has to fight against gravity to reach the trunk. Valves in the leg veins allows for blood to pass upwards slowly, being pushed by the muscles in the feet that act like a pump. When the walls of the vein weaken, the vein distends and the valves fail to act as required. This condition is known as varicose veins.
Typically the veins are visible on the surface of the skin as a tangled mass or like a spider’s web. Sometimes varicose veins can be painful. The pain is more likely to occur when stationary – either when standing, sitting or lying down for a long period of time. It occurs due to the pooling of the blood in the legs as a result of the distended vein wall and incompetent valves. Walking around and elevating the legs tends to ease the pain slightly as gets the blood circulating again.
Blood Clot in the Legs
A blood clot can occur in any artery or vein of the leg but it more often occurs in the deep veins of the lower leg. It is often a consequence of a sluggish circulation in the lower legs and this condition is known as deep vein thrombosis (DVT). While the clot can obstruct the drainage of blood from the legs, there are several alternative routes that can still allow for some degree of drainage. The bigger risk with DVT is that the blood clot (thrombus) can dislodge, travel through the veins and block the blood vessels from the heart to the lungs. This is known as a pulmonary embolism and is potentially fatal.
Deep vein thrombosis (DVT) may not present with many symptoms other than leg pain. In half of all cases there are no symptoms, not even pain. Typically the pain in DVT is a cramp-like pain in the calf (also known as charley horse) and may extend to the ankle or foot. There may also be some discoloration of the skin of the legs – from paleness, to redness and a bluish tinge. DVT pain can occur when active or at rest. The risk of a pulmonary embolism is particularly high when sitting or sleeping for long periods.
Nerve Problems in the Legs
The nerves of the legs may be affected in many ways, like with injury (trauma), vitamin deficiencies and infectious causes like shingles. However, another common nerve problem leading to leg pain starts at the lower back and not in the leg. This is seen with conditions like sciatica, where the major nerve of the leg (sciatic nerve), becomes inflamed. Here the nerve may be compressed at the point where it emerges from the spinal cord (pinched nerve). The nerve can also be compressed elsewhere along it course. Collectively, these nerve problems are known as peripheral neuropathy. Symptoms may include pain, numbness, tingling and weakness of the leg muscles.
Diabetes and Leg Pain
Leg pain is one of the common symptoms of advanced diabetes mellitus. It is a symptom of complications associated with long term and often poorly managed diabetes. The blood supply to the leg is affected as well as the nerves of the leg and the condition is collectively referred to as diabetic foot. Pain is one of the early symptoms but as these complications progress, tingling and numbness become the main symptoms. Diabetic ulcers may also form on the lower leg and feet. Due to the numbness and impaired wound healing in diabetes, injuries of the lower leg and feet may become infected easily. The blood supply may also become almost completely obstruction. This can lead to gangrene which may require amputation of the limb.
Leg Pain and Menopause
Many women report leg pain during menopause. Burning of the feet may be a combination of hormonal factors and vitamin deficiencies. It is typically worse at night while sleeping and can be severe enough to even affect sleep. Some cases may also be associated with deep vein thrombosis and varicose veins. Despite burning feet and leg pain being commonly reported symptoms, the exact cause is not known in most instances. Various studies have been conducted but cannot conclusively link the change in hormone levels in menopause with any direct mechanism that causes pain in the leg. However, the risk of serious causes of leg pain is higher later in life therefore various diagnostic investigations should be conducted.
Growing Pains in the Legs
Leg pain in children is often attributed to growing pains when there is no other cause that can be identified. It tends to occur in both legs and children between to 3 to 12 years of age more commonly experience this phenomenon. The pain typically occurs at night and may even affect sleep. However, there is no evidence to suggest that it actually occurs due to growth spurts. Instead growing pains is believed to be due to overuse of the leg muscles. Children are naturally more active than adults and may overexert themselves while playing but only notice the symptoms when resting.