Legs feel sore and swollen at night, making it impossible to fall asleep.

Generally, leg soreness and swelling at night that interfere with sleep may be related to physiological factors such as overexertion, prolonged sitting or standing. They could also result from pathological conditions such as ligament injury or piriformis syndrome. Once the cause is identified, medical consultation is recommended to determine appropriate treatment, including medication or surgery. Specific analyses are as follows:

I. Physiological Factors

Engaging in heavy physical labor, intense exercise, prolonged sitting, or standing during the day can strain and stretch leg muscles, leading to excessive lactic acid buildup. During sleep, this may cause muscle swelling, resulting in sensations of soreness, swelling, and pain. These symptoms typically resolve spontaneously with adequate rest and do not require specific treatment.

II. Pathological Factors

1. Ligament Injury

Injuries or exposure to cold can damage leg muscles and fascia, causing muscle spasms and ischemia. In severe cases, patients may experience significant leg pain along with soreness and swelling. It is recommended to maintain warmth and avoid excessive fatigue. For severe cases, medications such as diclofenac sodium sustained-release tablets, indomethacin enteric-coated tablets, or piroxicam tablets may be taken under medical guidance to achieve pain relief.

2. Piriformis Syndrome

This condition occurs when the sciatic nerve is compressed in the buttock area, causing sciatica. As it worsens, it may pull on the leg muscles, producing a sensation of swelling. Mild cases may be treated under medical supervision with aspirin enteric-coated tablets, acetaminophen tablets, or phenylbutazone tablets. If no significant improvement is observed after medication, surgical intervention such as piriformis tendon release may need to be considered.

Besides the above causes, lumbar disc herniation may also be responsible. During an episode, it is important to get sufficient rest and avoid strenuous physical activity.