Differential Diagnosis for Pain on One Leg Only at Night During Rest
- Single Most Likely Diagnosis
- Restless Legs Syndrome (RLS): Characterized by an irresistible urge to move the legs, usually due to uncomfortable sensations such as pain, itching, or tingling. These symptoms are typically worse at night and during periods of rest or inactivity.
- Other Likely Diagnoses
- Peripheral Artery Disease (PAD): Pain in one leg at night, especially during rest, could be indicative of intermittent claudication, a symptom of PAD where blood flow to the muscles is insufficient, leading to pain.
- Muscle Cramps: Nocturnal leg cramps are common and can cause significant pain, often occurring in one leg and resolving with movement or stretching.
- Varicose Veins: While not typically painful at night, severe varicose veins can cause nocturnal pain due to increased venous pressure when lying down.
- Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less common, DVT can present with pain in one leg, especially if it occurs at night and is exacerbated by rest. It's crucial to consider DVT due to its potential for severe complications like pulmonary embolism.
- Osteonecrosis or Avascular Necrosis: Reduced blood flow to the bone can cause pain that worsens at night, and it's essential not to miss this diagnosis due to its potential for severe and irreversible damage.
- Compartment Syndrome: A condition where increased pressure within a muscle compartment leads to insufficient blood supply to the tissues inside the compartment. It can cause severe pain, especially at night, and is a medical emergency.
- Rare Diagnoses
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can be worse at night and may be alleviated by cooling or elevating the affected limb.
- Peripheral Neuropathy: Certain types can cause nocturnal pain in the legs, though this is less common and usually associated with other symptoms like numbness or tingling.
- Nighttime Leg Pain due to Inflammatory Conditions: Conditions like rheumatoid arthritis or other autoimmune diseases can cause leg pain at night, though this is typically part of a broader symptom complex.