Pain guide · Foot pain

Foot pain at night: nerve pain, gout, circulation, cramps, restless legs and the night pain to check

Foot pain that wakes you or is worst in bed has a handful of common causes: nerve pain (often from diabetes), gout, night cramps, restless legs and a trapped nerve at the ankle. Plantar fasciitis is mostly a pain of the first steps in the morning, not of the night. Night pain on its own is rarely a sign of something serious, but a few patterns are.

Call 999 or go to accident and emergency (A&E) for a foot that is suddenly cold, pale or blue with severe pain. Burning pain in the toes or foot at rest that eases when you hang your foot out of bed needs a general practitioner (GP) straight away, or the National Health Service's 111 line (NHS 111) if you can't reach one, and with diabetes, a hot, swollen foot or a wound that won't heal needs your foot team within 24 hours. This guide explains why pain is often worse at night, helps you work out the likely cause, and gives what to do tonight for each cause and a staged plan of foot, calf and balance work with 3D demos.

3-stage exercise plan When to get help 65 sourcesUpdated 25 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: a foot or leg that is suddenly cold, pale, numb, weak or very painful without an injury. A sudden loss of blood supply is a vascular emergency.
Contact a GP immediately (or NHS 111 if you can't): burning leg or foot pain that carries on at rest, pale skin, wounds on the feet or legs that do not heal, or toes that go cold, numb, then red or black. The Global Vascular Guidelines and the Circulation Foundation add that this rest pain is often worse lying down and at night, can wake you, and is often eased by hanging the foot down or getting out of bed.
Call 999 or go to A&E: you have diabetes and a foot ulcer with a fever or signs of sepsis, an ulcer with poor circulation, or gangrene. NICE asks for these to go straight to hospital.
Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
If you have diabetes, see your local foot team urgently, within 24 hours, for a change in the colour or shape of your foot (especially a red, hot, swollen toe, ankle or foot), part of your foot feeling much colder or hotter than usual, new blisters, cuts or wounds (especially ones you can see but don't feel), a cut or wound that smells bad or is leaking fluid or pus, or new or unexplained pain in your foot. Meanwhile sit or lie down, take the weight off it and raise it.
Same day: a sudden, very painful, hot, swollen, red joint, often the big toe but sometimes the middle of the foot (the midfoot) or the ankle, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Call 999 or go to A&E: a red, hot, swollen foot with a very high temperature, feeling hot, cold or shivery, a fast heartbeat or fast breathing, purple patches on the skin, dizziness or confusion.
Same day: skin on the foot that is painful, hot and swollen. It could be a skin infection (cellulitis).
Ask for an urgent GP appointment or contact NHS 111 if you have pain, swelling, redness and a warm feeling over a bone, or a very high temperature (or you feel hot, cold or shivery) and feel generally unwell. It could be a bone infection.
Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Same day (urgent GP appointment or NHS 111): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, or it feels very stiff. If you think it's broken, don't treat it yourself.
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. It could be a blood clot (DVT). Watch for it after an ankle injury or time in a cast or boot.
Call 999: calf or leg pain or swelling with breathlessness or chest pain. It could be a clot that has reached the lungs.
Get urgent medical help: you're pregnant or have given birth in the last few weeks and have symptoms of pre-eclampsia, such as pain below the ribs, a severe headache that does not go away with simple painkillers, vision problems such as blurred vision or seeing flashing lights, or sudden swelling of the face, hands or feet. If you're pregnant, call your maternity unit if you have the number; if you've recently given birth or cannot call your maternity unit, call 111.
Contact your GP practice urgently, or phone 111 if it's closed, if a leg cramp lasts longer than 10 minutes and doesn't get better when you start to move.

See a doctor or physiotherapist if

Pain, tingling or loss of feeling in your feet, loss of balance or weakness, or a cut or ulcer on your foot that isn't getting better: see a GP. These can be early signs of nerve damage (peripheral neuropathy).
Any foot pain if you have diabetes: foot problems can be more serious.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
Cramps that disturb your sleep.
Cramps that last longer than 10 minutes.
Cramps with numbness or swelling in the leg.
Restless legs that stop you sleeping, affect your mental health, or haven't eased with the things you can do yourself: see a GP, who can check your iron levels and the medicines you take.
See a GP if you have symptoms of gout for the first time (sudden, severe pain in a joint with hot, swollen, red skin), or you have gout and your usual treatments aren't helping.
Feet that keep flaring up red, hot and burning, often with warmth or exercise: see a GP, who can refer you to a specialist.
Chilblains that haven't cleared up after 2 to 3 weeks, keep coming back, have pus in them, or come with a high temperature, or any chilblains if you have diabetes: see a GP.
Pain that is far worse than an injury explains and carries on, with skin so sensitive that a light touch, a bump or a change in temperature hurts: see a GP. Early treatment may help.
Foot pain keeps you awake most nights for weeks despite these changes, or poor sleep is affecting your days: see a GP. Treatment for the cause and for sleep, including talking therapy for insomnia, can both help.
A child with pain in one leg, or in one joint such as the ankle, pain that's there in the morning or while walking and playing, a limp, swelling, bruising or a rash, a high temperature, or tiredness and weight loss: see a GP. Growing pains affect both legs, in the evening or at night, and are gone by morning.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Both feet: burning, tingling, numbness or pins and needles, worse in the evening and in bed; even the bedclothes can hurt

Often nerve damage (peripheral neuropathy), most often from diabetes: see a GP.

The sole of one foot, burning or tingling into the toes, worse after standing and at night

Possibly tarsal tunnel syndrome, a squeezed nerve behind the inner ankle bone.

Read: Tarsal tunnel syndrome →Under the heel and arch, worst on the first steps in the morning and easing as you walk

Usually plantar fasciitis, which is a morning pain rather than a night pain.

Read: Plantar fasciitis (plantar heel pain) →The heel at night

Our heel pain guide maps it.

Read: Heel pain →The big toe joint, sometimes the midfoot or ankle: sudden, severe, hot, red and swollen, often starting in the night

Possibly gout. With a high temperature or feeling unwell it could be an infection: get help the same day.

Read: Big toe pain →

The toes and forefoot burning at rest, worse lying flat and waking you, eased by hanging the foot out of bed

The blood supply may be failing: contact a GP immediately, as the warning signs say.

A foot that is suddenly cold, pale or blue, with severe pain

A sudden loss of blood supply: call 999.

A sudden, hard tightening of the foot or calf, the toes curling, lasting seconds to 10 minutes

Cramp.

Read: Leg cramps →An urge to move your legs, and sometimes your feet, in the evening, easing when you move

Restless legs syndrome: our leg pain at night guide covers it.

Read: Leg pain at night →Between the third and fourth toes, like standing on a pebble, mostly when walking in tight or high-heeled shoes

Possibly Morton's neuroma, which rarely hurts at night.

Read: Morton's neuroma →The ball of the foot, aching under the joints at the base of the toes

Our ball of foot pain guide maps it.

Read: Ball of foot pain →

Feet that flare red, hot and burning with warmth or exercise

Possibly erythromelalgia, which is rare: see a GP.

Itchy, burning, red or purple toes, a few hours after being cold

Chilblains: warm your feet slowly.

One spot on a foot bone that hurt with every step and now aches at rest and at night

A possible stress fracture: stop running and get it checked.

Read: Stress fracture →A stiff, aching big toe joint, worse after rest and when you push off

Possibly big toe arthritis.

Read: Big toe arthritis →The top of the foot

Our top of foot pain guide maps it.

Read: Pain on top of the foot →Pain far beyond what an injury explains, with skin that can't bear a light touch, weeks after an injury or operation

Possibly complex regional pain syndrome (CRPS).

Read: Complex regional pain syndrome (CRPS) →From the back down the leg into the foot, with tingling

Possibly sciatica, a nerve irritated in the lower back.

Read: Sciatica →

A hot, swollen foot in someone with diabetes, even if it doesn't hurt

A possible Charcot foot or infection: your foot team within 24 hours.

The ankle rather than the foot at night

Our ankle pain at night guide maps it.

Read: Ankle pain at night →

Understand it

What usually causes itEmerging evidence

Foot pain at night has a handful of common causes. Nerve damage (peripheral neuropathy) affects almost 1 in 10 people aged 55 and over, the NHS says, and brings burning, sharp or stabbing pain, tingling and numbness, usually in both feet; diabetes is the commonest cause. Gout attacks often start overnight. Cramps mostly come at night or at rest and can affect the feet, and restless legs are usually worse in the evening and at night.

Plantar fasciitis, the commonest cause of heel pain, is different: the NHS says it's worse when you start walking and better when resting, and the American Academy of Orthopaedic Surgeons (AAOS) says it's worst on the first steps in the morning. Pain that wakes you points elsewhere.

Sources 1, 2, 3, 4, 5, 6, 7

Nerve pain and diabetesEmerging evidence

The NHS says up to 1 in 4 people with diabetes have some pain from nerve damage. In a community study of 15,692 people with diabetes in north-west England, 34% had painful nerve symptoms on a questionnaire and 21% had painful neuropathy on examination as well; painful symptoms were twice as likely with type 2 diabetes as type 1, and 50% more likely in women. Even a light touch can hurt, NHS inform says. Other causes include alcohol, low vitamin B12, an underactive thyroid, chemotherapy, kidney or liver disease and some medicines.

Sources 8, 9, 2

Why pain can be worse at night: what's known and what isn'tEmerging evidence

Diabetes UK says nerve pain may be worse at night, perhaps from cooler evenings, stress at the end of the day and fewer distractions. Drug trial data back the pattern: pain rose through the day in diabetic nerve pain and after shingles, by about a third between 8am and 8pm, and all 8 human studies in a review found nerve pain peaking late in the evening and early in the night. No study we found measured foot pain in bed itself.

Other causes have their own rhythms. Gout attacks were 2.36 times as likely between midnight and 8am as in the daytime, in 724 people followed for a year. Rest pain from badly narrowed arteries is worse lying down and eased by hanging the foot down, guidelines say. Erythromelalgia flares with warmth, and the NHS lists warm clothes, shoes and temperatures among its triggers; a warm bed being one is our inference.

In a laboratory study of healthy volunteers kept awake under controlled conditions, pain sensitivity peaked in the middle of the night, and in studies that follow people over time, poor sleep predicted worse pain more strongly than pain predicted poor sleep. Neither was in people with foot pain, so applying them here is our inference.

Sources 10, 11, 12, 13, 3, 14, 15, 16, 17, 18

Circulation: rest pain is a warning signStrong evidence

When the arteries in the leg are badly narrowed (chronic limb-threatening ischaemia), a constant burning pain in the toes and forefoot can come on at rest, often waking you at night, and is eased by hanging the foot down or getting out of bed. Guidelines want it present for 2 weeks or more, with tests showing poor blood flow, and say everyone with suspected rest pain should be referred urgently to a vascular specialist; the NHS says contact a GP immediately. It develops in 1 to 2 in every 100 people with peripheral arterial disease a year, and in 5% to 10% of people with calf pain on walking (claudication).

Claudication itself is calf pain on walking that eases with rest, not a night pain: 75% of people with it stay the same or improve, and the National Institute for Health and Care Excellence (NICE) recommends supervised exercise. A foot that is suddenly cold, pale and very painful is different again: a vascular emergency that needs immediate care.

Sources 14, 15, 19, 20, 21

Gout, cramps and restless legsStrong evidence

Gout causes sudden, severe pain with heat, redness and swelling, usually in the big toe joint, sometimes in the midfoot or ankle; NICE describes its rapid onset, often overnight; the NHS describes sudden or severe pain when anything touches the foot, and Arthritis UK says even the weight of a bedsheet can be unbearable. An untreated attack lasts about 1 to 2 weeks, the NHS says, or usually 5 to 7 days, Arthritis UK says.

Night cramps affect up to 60% of adults, a review says: most often the calf, less often the feet, lasting seconds to 10 minutes. Restless legs bring an urge to move the legs with unpleasant feelings, worse at rest in the evening and at night and eased by moving: in a survey of 15,391 adults, 7.2% reported symptoms and 2.7% had them often and badly enough to need treatment.

Sources 3, 22, 23, 24, 57, 4, 25, 5, 26, 27

Nerves at the ankle and the ball of the footEmerging evidence

Tarsal tunnel syndrome, a squeezed nerve behind the inner ankle bone, causes burning and tingling into the sole and toes. One single-author review says it's typically worse at night and with activity, and another says night symptoms can disturb sleep. Morton's neuroma causes burning or sharp pain between the third and fourth toes, mostly when you walk in tight or high-heeled shoes; the AAOS says night pain is rare.

Sources 28, 29, 30, 31, 58

Rarer causesEmerging evidence

Erythromelalgia is rare: burning pain, redness and heat, mainly in the feet (88% of 168 people in one series), usually in flares; over about 9 years, a third got worse, a third improved and 1 in 10 recovered fully. Chilblains are itchy, burning, red or purple toes a few hours after the cold.

A stress fracture starts as pain in one spot with activity and can become a constant dull ache, even at night, Health New Zealand says. Bone pain that's worse at night, especially with a lump or weight loss, needs a GP. Complex regional pain syndrome (CRPS) can follow an injury, with skin so sensitive that a light touch or a change in temperature hurts.

Sources 16, 32, 33, 34, 35, 36

Pregnancy and childrenStrong evidence

In pregnancy, night cramps are common later on, restless legs affect about 1 in 5 women, and feet swell by the end of the day. The NHS says restless legs in pregnancy usually go away after the birth, while RLS-UK says symptoms often continue. Sudden swelling of the face, hands or feet, with a bad headache, vision problems or pain below the ribs, can be pre-eclampsia and needs urgent help.

Growing pains affect both legs, in the evening or at night, in children aged 3 to 12, and are gone by morning, the NHS says; pain in one leg, a limp or a swollen joint needs a GP. RLS-UK says restless legs in children are often mistaken for growing pains.

Sources 4, 27, 5, 37, 38, 39

TestsEmerging evidence

A GP may arrange blood tests to find the cause of neuropathy, and NICE asks for the feet of people with diabetes to be checked at least once a year. Narrowed arteries are checked by comparing the blood pressure at the ankle and the arm (the ankle-brachial pressure index), and in diabetes toe pressures are preferred. Gout is confirmed with a urate blood test, repeated at least 2 weeks after a flare if it's normal during one, with fluid from the joint if infection is possible. An X-ray or other scan checks for a stress fracture or a Charcot foot, a GP can check iron levels for restless legs, and nerve tests help with tarsal tunnel syndrome.

Sources 1, 2, 40, 20, 14, 22, 34, 5, 28

How it usually goesEmerging evidence

Neuropathy may improve if its cause can be treated: well-controlled diabetes may stop it getting worse, NHS inform says, though some damage is permanent. An untreated gout attack settles within about 1 to 2 weeks, and urate-lowering treatment is offered if attacks keep coming. Most people with calf pain on walking stay the same or improve. Restless legs in pregnancy usually go after the birth, the NHS says, though not always. Stretching before bed reduced night cramps in a trial. No one can promise a timescale.

Sources 2, 24, 22, 15, 5, 27, 43

What helps, and how strong the evidence is

Nerve pain: medicines from a GP, because ordinary painkillers often don't helpStrong evidence

NICE recommends a choice of amitriptyline, duloxetine, gabapentin or pregabalin for nerve pain, and capsaicin cream for pain in one area if you'd rather avoid tablets. The NHS says nerve pain doesn't usually get better with paracetamol or ibuprofen, and NHS inform adds menthol cream and lidocaine plasters. No trial we opened tested anything for night-time nerve pain in particular.

Sources 41, 42, 2

Gout: treat the attack early, and keep the covers offStrong evidence

NICE recommends an anti-inflammatory, colchicine or a short course of steroid tablets for an attack, with ice packs as an add-on, and urate-lowering treatment for repeated attacks. The NHS says take medicine as soon as an attack starts, rest and raise the joint, and keep bedclothes off it at night; Arthritis UK suggests a bed cage and keeping a supply of medicine ready. Because attacks often start overnight, keeping your medicine by the bed makes sense (our suggestion).

Sources 22, 24, 23, 3

Night cramps: stretching before bed may help; magnesium doesn'tMixed evidence

In 80 adults over 55, calf and hamstring stretches every night before bed for 6 weeks cut night cramps by 1.2 a night and their pain by 1.3 cm on a 10 cm scale. A Cochrane review rated that low-certainty evidence, and calf stretching alone for 12 weeks did no better than a pretend stretch in 94 people over 60. Magnesium made no meaningful difference in older adults (11 trials, 735 people; moderate certainty). Quinine cut cramps by about 28%, but it has rare, sometimes fatal side effects, and the NHS mentions it only for cramps that exercise hasn't helped.

Sources 43, 44, 45, 46, 4

Rest pain from narrowed arteries: urgent vascular care, not exerciseStrong evidence

Guidelines say everyone with suspected rest pain should be referred urgently to a vascular specialist and given painkillers strong enough to control it until the blood flow can be restored. Walking exercise is for calf pain on walking (claudication): NICE recommends a supervised programme of 2 hours a week for 3 months, walking to the point of maximal pain.

Sources 14, 21, 15

Plantar fasciitis: stretching for the first steps; night splints are mixedMixed evidence

Across 51 trials (4,351 people), plantar fascia stretching (standardised mean difference 1.21) and taping (0.47) eased first-step pain in the short term. Night splints are mixed: in 32 people, all 16 feet treated with one were cured against 6 of 17 without; in 116 people a splint added nothing over 12 weeks; and in 40 people with long-standing pain it added little and didn't change sleep quality. The AAOS calls them very effective.

Sources 47, 7, 48, 49, 50

Sleep habits: health-service adviceEmerging evidence

The NHS's sleep advice is regular times, a dark, quiet room, no caffeine or alcohol in the 6 hours before bed and no exercise in the 4 hours before bed, with talking therapy for insomnia that lasts for months. Poor sleep predicts worse pain, a review found, so working on the sleep side may help too (our inference).

Sources 51, 18

How much pain is OK while you exercise?

The foot rule by day, earlier in the day; a few causes have their own rulesEmerging evidence

Exercise for the feet and calves follows the site's foot and ankle rule: pain no more than about 5 out of 10, settling within an hour and no worse the next morning, as NHS inform's foot exercises also say (0 to 3 minimal, 4 to 5 acceptable, 6 to 10 too much). If your feet are numb, pain won't warn you, so check your feet and skin after exercise, as Diabetes UK advises, and keep a hand on a counter for balance work. If you sleep badly, finish exercise at least 4 hours before bed, as the NHS advises.

Calf pain on walking from narrowed arteries is the one exception: NICE's programme asks people to walk to the point of maximal pain, rest, and go again. That's only for walking pain; rest pain needs a GP immediately. During a gout flare, rest and raise the joint and use the plan between attacks (the NHS). A cramp that lasts more than 10 minutes and doesn't ease when you move needs your GP practice urgently (NHS inform).

Sources 52, 53, 21, 24, 54, 51

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Tonight: an evening routine for your feet

From the first night, once the warning signs are ruled out. Do these in the evening, with the calf stretch last thing before bed if cramps wake you, and set up the bed by the written steps below. With a gout flare, rest the joint and use this plan between attacks.

Wall calf stretch (gastrocnemius) demonstrated on the 3D figure

3D demoWall calf stretch (gastrocnemius)Beginner · A wall

The NHS routine: lean for 2 to 3 s and repeat for 5 minutes, 3 times a day, the last just before bed · The NHS leg cramps page, as in our ankle pain at night guide

Easier: Seated calf stretch with a towel · Harder: Heel-on-step calf and hamstring stretch

Seated calf stretch with a towel demonstrated on the 3D figure

3D demoSeated calf stretch with a towelBeginner · Other / check instructions

3 holds of 30 s; in bed during a cramp, pull your toes towards you with a towel and hold until it eases · As in our ankle pain at night and leg cramps guides; the NHS says stretch and massage the muscle

Harder: Wall calf stretch (gastrocnemius)

Plantar fascia stretch (seated) demonstrated on the 3D figure

3D demoPlantar fascia stretch (seated)Beginner · A bench or box

3 to 5 holds of 10 to 30 s, 2 to 3 times a day, starting before your first steps in the morning · The move page's dose, for heel and arch pain on the first steps

Harder: Toes-tucked kneeling (toe squat)

Ankle circles demonstrated on the 3D figure

3D demoAnkle circlesBeginner · No equipment

With swollen feet or in pregnancy: bend and stretch each foot up and down 30 times, then circle each foot 8 times each way · The NHS's foot exercises for swelling in pregnancy; the move page's own dose is 10 slow circles each way (editorial)

Harder: Ankle CARs (controlled articular rotations)

Lying sciatic nerve slider (nerve glide) demonstrated on the 3D figure

3D demoLying sciatic nerve slider (nerve glide)Beginner · No equipment

Optional, for burning or tingling from a nerve in the back or at the ankle: 10 repetitions with a 1-second pause, 2 to 3 times a day · The move page's dose, from an NHS musculoskeletal service; keep it only if it helps after 2 weeks, as the page says

Harder: Seated sciatic nerve slider (nerve glide)

Move on when: Nights are settling, or you've had the cause checked (our suggestion).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

By day: strength, balance and circulation

About weeks 2 to 8, on most days and earlier in the day. Keep the evening routine going.

Seated bent-knee calf raise (soleus raise) demonstrated on the 3D figure

3D demoSeated bent-knee calf raise (soleus raise)Beginner · A bench or box

Sets of 8, 2 to 3 times a day, building to 2 sets of 15 · NHS inform's seated heel raise and pacing

Harder: Slow calf raise

Towel toe curl demonstrated on the 3D figure

3D demoTowel toe curlBeginner · Other / check instructions + A bench or box

Sets of 8, building to 2 sets of 15 · NHS inform's toe curl and pacing, done with a towel (our swap)

Easier: Big toe press (seated toe-flexor hold) · Harder: Short foot + toe splay

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 20 to 30 s each leg, with a hand on a counter · Editorial, as in our leg pain guide; with numb feet, keep the hand there, as the move page says

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Tandem stance and heel-to-toe walk demonstrated on the 3D figure

3D demoTandem stance and heel-to-toe walkBeginner · A wall

3 to 5 lengths, beside a wall or rail · Editorial, as in our ankle pain at night guide

Easier: Semi-tandem stance · Harder: Single-leg stand

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

10 to 30 minutes, earlier in the day; with calf pain on walking, walk to the point of strong pain, rest and repeat, building towards 2 hours a week · NICE's supervised exercise programme for claudication (2 hours a week for 3 months); not for rest pain, which needs a GP first

Harder: Treadmill jogging

Move on when: You can walk comfortably and balance steadily, and most nights are settled (our suggestion).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Keep it going: daily activity and the full night back

From about week 8: walking or cycling on most days and strength 2 days a week, earlier in the day, while the full night comes back by the written steps below.

3D demoTreadmill walkingBeginner · Cardio machine

Build towards 150 minutes a week, earlier in the day · As in our ankle pain at night guide; walking outdoors counts the same

Harder: Treadmill jogging

Recumbent exercise bike demonstrated on the 3D figure

3D demoRecumbent exercise bikeBeginner · Cardio machine

10 to 20 minutes at a moderate effort, building towards 30 · The move page's dose, an editorial starting point; a seated, low-impact option for sore or numb feet. Finish at least 4 hours before bed if you sleep badly, as the NHS advises

Harder: Stationary cycling

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

3 sets of 10 · As in our ankle arthritis guide (editorial)

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

3D demoStep-upBeginner · A step

3 sets of 8 each side, holding a rail · As in our ankle pain at night guide

Easier: Low step-up · Harder: Dumbbell step-up

Move on when: Our suggestion: most nights are settled and your usual activities don't flare your feet. If nights flare after a busy day, go back to the stage 1 routine for a week rather than stopping.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Tonight, by cause (written steps)

Our 3D figure can't show these changes. No trial has tested a sleeping position for foot pain, so each step names its source or is our suggestion.

1. Gout: take the medicine you've been prescribed as soon as an attack starts, raise the foot, cool it with an ice pack wrapped in a towel for up to 20 minutes, and keep the bedclothes off it (the NHS); a bed cage holds the sheets off your feet (Arthritis UK).
2. Cramps: in bed, keep your toes pointing up with a pillow on its side at the end of the bed to prop your soles against, or let your feet hang over the end if you lie on your front, and keep the sheets and blankets loose (NHS inform). During a cramp, stretch and massage the muscle, or stand and put your weight on that leg (the NHS).
3. Restless legs: a warm bath or heat pads before bed, and walking, stretching or massaging your legs when it starts (the NHS).
4. Feet that flare red, hot and burning (erythromelalgia): loose socks and shoes, a fan or a cool (not cold) gel pack for a short time, and your feet raised; no ice or cold water, which can damage the skin (the NHS). Keep the cooling for erythromelalgia: Diabetes UK says cooler evenings may make nerve pain more noticeable.
5. Burning nerve pain: if the bedclothes hurt your feet, holding the sheets off them with a bed cage, as Arthritis UK suggests for gout, may help (our suggestion).
6. Chilblains: warm your feet slowly, not on a radiator or in hot water, and don't use ice packs (the NHS).
7. Swollen feet in pregnancy: rest with your feet up, and bend and stretch each foot up and down 30 times and circle it 8 times each way (the NHS).
8. Burning toes that ease when you hang your foot out of bed: that's a reason to contact a GP immediately, not a fix (the NHS and the vascular guidelines).

Sources 24, 23, 54, 4, 5, 16, 10, 33, 55, 37, 20, 14

Foot care with numb feet or diabetes (written steps)

These come from Diabetes UK and NICE.

1. Check your feet every day, before you put your socks on and before bed, using a mirror or asking someone to help if you need to (Diabetes UK).
2. Test the bath water with your wrist or elbow, and don't soak your feet (Diabetes UK).
3. Wear socks and shoes that aren't tight, and check inside your shoes before you put them on (Diabetes UK).
4. Have your feet checked at least once a year (NICE).
5. A new wound, a change in colour or shape, part of the foot much hotter or colder, or new pain: your foot team within 24 hours (Diabetes UK).

Sources 53, 40, 56

Sleep habits, and the full night back (written steps)

These come from the NHS, with our suggestions marked.

1. Keep the same wake-up time every day, relax for an hour before bed, and keep the room dark and quiet (the NHS).
2. No caffeine or alcohol in the 6 hours before bed and no exercise in the 4 hours before bed; with restless legs, no caffeine after midday and no alcohol in the 2 hours before bed (the NHS).
3. Keep a short note of each night and what you did that day, and change one thing at a time (our suggestion).
4. If poor sleep carries on for months, see a GP: talking therapy for insomnia comes first, and sleeping pills are rarely used (the NHS).

Sources 51, 5

Positions to swap, and why

Habit or position	Why it matters	Instead
Heavy bedclothes on a painful foot	With gout, the NHS says keep bedclothes off the joint at night.	A bed cage or loose sheets.
Ice or cold water on feet that flare red, hot and burning	The NHS says ice and cold water can damage the skin in erythromelalgia.	A fan or a cool (not cold) gel pack for a short time.
Warming cold toes on a radiator or in hot water	It can harm chilblains, and numb feet can burn without you feeling it.	Warm up slowly, and test bath water with your wrist or elbow.
Hanging your foot out of bed night after night to ease burning toes	It's a sign the blood supply may be failing, not a treatment.	Contact a GP immediately.
Caffeine late in the day and alcohol near bedtime	The NHS advises against both with restless legs and poor sleep.	Decaffeinated drinks after midday, and no alcohol in the hours before bed.
Hard exercise late in the evening	The NHS advises against exercise in the 4 hours before bed if you sleep badly.	Walk or cycle earlier in the day.Try: Recumbent exercise bike
Magnesium tablets for typical night cramps	A Cochrane review found no meaningful benefit in older adults.	Calf stretches before bed.Try: Wall calf stretch (gastrocnemius)
Tight socks, shoes or straps	The NHS's swelling and erythromelalgia advice is to avoid them.	Loose socks and wide shoes.
Walking barefoot with numb feet	Cuts and blisters can go unnoticed, Diabetes UK warns.	Shoes or slippers, and a daily foot check.
Balancing on one leg without support if your feet are numb	Numb feet make balance harder, as the move page says.	Keep a hand on a counter or wall, or practise the heel-to-toe stand beside a wall.Try: Tandem stance and heel-to-toe walk

Routines to follow

Bedtime stretch routine

A slow, 10-minute floor routine to unwind before sleep: child's pose, twists, happy baby and slow breathing.

10 minBeginner7 movesFirm cushion, A wall

Exercises for peripheral neuropathy: balance and leg strength in shoes

A 35-minute home routine for numb feet: seated ankle work, leg strength and balance at a counter, then a walk, with shoes on and a foot check before and after.

35 minBeginner13 movesA bench or box, Something with weight

Restless legs exercises: a daytime walk and leg strength

A 45-minute daytime session for restless legs, our editorial home version of the one exercise trial: a 30-minute walk, six leg strength moves and three stretches.

45 minBeginner10 movesCardio machine, A bench or box

Claudication walking workout: walk-rest-walk

The walk-rest-walk session for leg pain from narrowed arteries: walk until the pain is close to the most you can bear, rest until it goes, repeat to 30 minutes.

45 minBeginner8 movesA wall, Cardio machine

Foot and ankle strengthening routine: toes, arches, calves and balance

A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.

15 minBeginner11 movesA wall, Other / check instructions

Plantar fascia routine

Plantar fascia and calf stretches, a gentle foot roll and the towel heel raise: the exercises the 2023 heel pain guideline supports.

8 minBeginner7 movesA bench or box, A massage ball

More moves for this area

Questions people ask

Why do my feet hurt at night?

Common causes are nerve pain (often from diabetes), gout, night cramps, restless legs and a trapped nerve at the ankle. Rest pain from narrowed arteries is less common but urgent. Plantar fasciitis is mostly a pain of the first steps in the morning, not of the night.

Why do my feet burn at night?

Burning, tingling or numbness in both feet is often nerve damage (peripheral neuropathy), most often from diabetes, and it can be worse at night. Burning in one sole can be tarsal tunnel syndrome. Burning toes at rest with pale or cold skin, or wounds that won't heal, need a GP immediately.

Why is foot pain worse at night?

Nerve pain tends to rise through the day, and there are fewer distractions at night; gout attacks often start overnight; and lying flat reduces blood flow when the arteries are badly narrowed. Poor sleep then makes pain worse. No study has measured foot pain in bed itself, so some of this is borrowed from other kinds of pain.

Is foot pain at night serious?

Usually not on its own. Call 999 for a sudden cold, pale foot, contact a GP immediately for burning pain at rest that eases when you hang your foot out of bed, and with diabetes see your foot team within 24 hours for a hot, swollen foot. Get help the same day for a hot, swollen joint with a fever, and see a GP for bone pain that is constant or worse at night with weight loss or a lump.

Is it plantar fasciitis?

Plantar fasciitis hurts most on your first steps in the morning or after sitting, and eases as you walk; it isn't typically a night pain. Stretching before your first steps helps, and night splints have mixed evidence.

Why do my feet hurt at night with diabetes?

Nerve pain is common with diabetes: the NHS says up to 1 in 4 people have some, and a UK study found painful symptoms in about a third. Diabetes UK says it may be worse at night. Check your feet every day, and see your foot team within 24 hours for a hot, swollen foot or a new wound, even if it doesn't hurt.

Could my foot pain at night be gout?

Yes: gout attacks were 2.4 times as likely to start overnight as in the day, usually in the big toe joint, sometimes the midfoot or ankle. Take treatment early and keep the bedclothes off the joint. Get help the same day if you also have a fever or feel unwell.

What helps foot cramps at night?

During a cramp, stretch and massage the muscle, or stand on it. Stretching your calves before bed may reduce cramps, and keeping the sheets loose helps; magnesium is unlikely to help older adults. See a GP if cramps disturb your sleep or last more than 10 minutes.

Why do my feet hurt at night in pregnancy?

Night cramps, restless legs (about 1 in 5 pregnant women) and swelling by the end of the day are common. Sudden swelling of the face, hands or feet with a bad headache, vision problems or pain below the ribs needs urgent help.

Why does my child's foot hurt at night?

Growing pains affect both legs in the evening or at night in children aged 3 to 12, and are gone by morning. Pain in one leg or joint, a limp, a swollen joint or a fever needs a GP, and restless legs in children are often mistaken for growing pains.

How should I sleep with sore feet?

It depends on the cause: keep the bedclothes off a gouty joint (a bed cage helps), raise swollen feet, and use a fan or a cool (not icy) pack for feet that flare red and hot. Burning toes that you ease by hanging your foot out of bed need a GP, not a new sleeping position.

What can I take for nerve pain in my feet at night?

Ordinary painkillers often don't help nerve pain. A GP can offer amitriptyline, duloxetine, gabapentin or pregabalin, or capsaicin cream for pain in one area, and lidocaine plasters and menthol cream are other options.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.