It's a story that's all too familiar for many people — you're finally settling into bed after a long day and are ready to drift off to sleep when a throbbing ache or shooting pain in your foot jolts you awake. Night after night, your foot discomfort intensifies, leaving you frustrated and exhausted. Fortunately, you don’t have to suffer in silence.
At The Foot Institute, we understand the impact chronic nighttime foot pain can have on your quality of life, and we want to help you find relief. Our experienced podiatrists are here to work with you to discover the underlying causes of your nocturnal foot pain and develop an effective treatment plan that will help you find relief. Below, we discuss potential causes and solutions.
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Medical Conditions That Can Cause Nocturnal Foot Pain
Several medical conditions can contribute to nighttime foot discomfort. Some of the most common causes of foot pain at night include:
Plantar Fasciitis
Plantar fasciitis condition occurs when the thick band of tissue that runs along the bottom of your foot becomes inflamed. The pain associated with this condition is often most severe after long periods of rest, like sleeping, so it is often described as getting worse overnight.
This pain occurs because the plantar fascia tightens up overnight. When you take those first few steps in the morning, the tissue is suddenly stretched, causing micro-tears and pain. Wearing a night splint can help keep the plantar fascia gently stretched while you sleep.
Peripheral Neuropathy
Peripheral neuropathy refers to damage or dysfunction of the nerves outside of the brain and spinal cord. This condition often causes burning, tingling, or shooting pain in the feet that can intensify at night.
For many people with peripheral neuropathy, the lack of distractions and the quiet of nighttime can make pain more noticeable. Additionally, some people find that their feet become hypersensitive to the weight of bedding. Using a bed cradle to keep sheets and blankets off your feet can help.
Arthritis
Both osteoarthritis and rheumatoid arthritis can cause joint pain and stiffness in the feet and ankles. Many people with arthritis report that their pain worsens at night.
One theory is that the body's natural anti-inflammatory hormone, cortisol, drops to its lowest level in the evening. With less cortisol to counteract inflammation, pain can intensify. Applying heat to sore joints before bed and sleeping with a supportive pillow between your knees can alleviate nighttime arthritis pain.
Restless Leg Syndrome
Restless leg syndrome (RLS) is a neurological condition that causes an uncontrollable urge to move your legs, often accompanied by uncomfortable sensations like tingling, burning, or throbbing. Symptoms are usually at their worst at night.
The exact cause of RLS is unknown, but it's thought to be related to an imbalance of dopamine in the brain. Regular exercise, massage, and heat therapy can help manage RLS symptoms. In some cases, prescription medications may be needed.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome occurs when the tibial nerve, which runs through a narrow space in the ankle called the tarsal tunnel, becomes compressed. This can cause burning, tingling, or shooting pain in the foot and ankle.
Pain from tarsal tunnel syndrome often worsens at night because the tibial nerve is compressed when you're lying down. Propping your foot up on a pillow to keep your ankle in a neutral position can help. Physical therapy to stretch and strengthen the affected area is also beneficial.
Lifestyle Factors That Contribute to Foot Pain at Night
In addition to underlying medical conditions, certain lifestyle factors can cause or exacerbate nocturnal foot pain:
Poor Sleep Posture
The position you sleep in can put extra pressure on your feet and ankles, leading to pain. Sleeping on your stomach with your feet pointing downward is particularly problematic, as it can cause the plantar fascia to contract.
Try sleeping on your back or side with a pillow between your knees to keep your spine aligned and alleviate pressure on your feet. If you must sleep on your stomach, hang your feet over the edge of the bed to keep them in a neutral position, minimizing the potential for foot pain related to your sleeping posture.
Overuse During the Day
If you're on your feet all day for work or if you engage in high-impact activities like running, your feet may be more prone to pain at night. The repeated stress on your feet can cause inflammation and micro-tears in the tissues that become more apparent when you're trying to rest.
To combat overuse injuries, wear supportive shoes and take regular breaks throughout the day to rest your feet. Icing your feet for 15-20 minutes after activity can also help reduce inflammation.
Dehydration
Believe it or not, dehydration can contribute to nocturnal foot pain. When your body is dehydrated, it can't flush out toxins and inflammation as effectively, leading to increased pain.
Aim to drink at least 64 ounces of water per day to prevent dehydration. If you're active or live in a hot climate like El Paso, you may need even more. Keep a water bottle with you throughout the day to stay hydrated.
Smoking
Smoking constricts blood vessels and decreases circulation, which can contribute to nocturnal foot pain. Not only that, but the chemicals in cigarettes also impede the body's natural healing processes.
If you currently smoke, quitting is one of the best things you can do for your overall health. Doing so may also help to alleviate your nighttime foot pain.
Ways to Help Relieve Nighttime Foot Pain
If nocturnal foot pain is keeping you from getting the restful sleep you need, our El Paso podiatrists can recommend appropriate solutions based on your individual needs. Depending on the cause of your nighttime foot discomfort, potential solutions may include:
Using Orthotics
Wearing orthotics designed for your specific foot issues can help prevent or reduce nighttime foot pain. Custom orthotics from a podiatrist offer the most precise support.
Wearing Supportive Footwear
If you frequently go barefoot or wear unsupportive shoes like flip-flops, your feet may be more prone to pain at night. It’s best to wear properly fitting shoes with good arch support and cushioning, even when you're just lounging at home.
Night Splints
A night splint holds your foot in a gentle stretch while you sleep, which can be especially helpful for plantar fasciitis. The splint keeps the plantar fascia from contracting overnight, so you don't experience that stabbing pain with your first steps in the morning.
There are many different types of night splints available, from simple sock-like devices to more rigid braces. Your podiatrist can help you choose the best option for your needs.
Pain Relief Medication
Over-the-counter pain relievers like ibuprofen or naproxen can help alleviate inflammation and discomfort so you can sleep more soundly. Just be sure not to rely on them for more than a few days without consulting a doctor.
Topical pain relievers like menthol or capsaicin creams can also provide localized relief. Simply massage the cream into your painful areas before bed.
Stretching and Massage
Gentle stretches and self-massage can help alleviate foot pain and promote relaxation before bed. For example, rolling a tennis ball or frozen water bottle under your foot can provide a soothing massage.
Gentle calf stretches can also be beneficial. Once your podiatrist knows the underlying cause of your nighttime foot pain, they can prescribe specific exercises or physical therapy options that may be appropriate for you.