It can be jarring to wake up with unexpected pain and soreness, like a muscle ache or cramp. One MyLupusTeam member asked, “Has anyone just woken up with a sore calf muscle? I haven’t hurt myself. Any thoughts on what this could be?”

From the butterfly rash to kidney problems, systemic lupus erythematosus (SLE), the most common type of lupus, can cause symptoms that affect nearly every body part. If you’re experiencing muscle aches and pains, how do you know whether they’re related to your lupus diagnosis?

Here, we explore common causes of calf pain in people living with lupus.

Is Calf Pain a Symptom of Lupus?

Lupus is known to cause myalgia, or aches and pains in muscles. This muscle pain usually affects the neck, thighs, shoulders, and upper arms but can occur anywhere in the body. The common symptoms, such as pain and stiffness, may or may not include swelling. Like this member, you may find that your muscle pain gets worse during a flare: “I am in the middle of a flare-up — very fatigued and aching all over.”

Less commonly, myositis, or muscle inflammation, can occur with lupus. However, myositis usually involves the hips and shoulders rather than the calves. Lupus is also known to cause joint pain and bone problems.

Other Common Causes of Calf Pain

Calf pain can strike for a variety of reasons, including blood clots, cramps, drugs, injury, and narrowed arteries. Many of these causes are unrelated to lupus.

Blood Clots

One MyLupusTeam member asked, “Do you have any risk for blood clots in your legs?” Compared with the general population, people with lupus do have a higher risk of deep vein thrombosis — when a blood clot forms in a deep vein, such as in the leg, pelvis, or arm. This potentially life-threatening condition is still quite rare, but it’s important to rule it out if you have severe, one-sided calf pain. Other risk factors for deep vein thrombosis include taking oral contraceptives (birth control), undergoing surgery, and sitting for many hours at a time.

Cramping

Often called a charley horse, a cramp in the calf can be excruciating but goes away after a few minutes. These cramps commonly occur at night, so waking up with the pain is not uncommon. “I have been having major cramps in my legs and thighs,” one MyLupusTeam member said.

Cramping may be a symptom of heat exhaustion or physical exertion, but it can also be related to kidney problems, which can occur in people with lupus. When the body lacks crucial electrolytes because the kidneys aren’t working well, muscles in the calves and elsewhere may be likely to spasm and cramp. Dehydration can also cause low electrolytes.

Medications

Certain medications, such as cholesterol-lowering drugs, may cause injury to the muscle fibers and lead to calf pain. If you think your muscle pain might be related to a medication, discuss this possibility with your doctor.

Injury

The calf is prone to injury from walking, running, and other physical activity. This includes strains from overstretching the muscle, tendinitis, and contusions (direct blows that usually cause bruising).

Peripheral Artery Disease

Narrowing of the arteries in the legs from peripheral artery disease (fat buildup in the arteries) can keep the calf muscles from getting enough blood. One MyLupusTeam member shared, “I have what the doctor says is poor blood circulation.” Lupus is a risk factor for heart problems, including peripheral artery disease. This common condition, which also occurs in people who smoke and people who have diabetes, usually gets worse when walking and resolves at rest.

Managing Aching Muscles

To prevent muscle, bone, and joint problems associated with lupus, the Lupus Foundation of America recommends eating foods rich in calcium and vitamin D, getting regular physical activity (as your condition allows), quitting smoking, and — if you consume alcohol — drinking in moderation.

When calf muscle pain occurs, Cleveland Clinic suggests trying strategies such as these:

• Rest the sore muscle, staying off it if possible.
• Apply a cold compress for 20 minutes every 2 hours. Don’t apply ice right on your skin — wrap ice cubes, an ice pack, or a bag of frozen veggies in a towel.
• Place a compression sock, bandage, or wrap around your calf to reduce swelling.
• Raise your leg to the level of your heart. Use pillows or folded blankets to hold up your leg while you lie down.
• Take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) to relieve pain.
• Seek out physical therapy if you suspect you have an injury or if the pain persists.
• Stretch your muscles to increase mobility.

If you think your cramp stems from dehydration, be sure to get extra electrolytes (substances that help maintain your body’s fluid balance) from sports drinks, coconut water, and bananas, along with drinking enough water and eating a healthy diet. One member shared, “My calf cramps have always been due to low potassium, dehydration, or a glitch with my kidneys.”

Speak With Your Health Care Team

Typically, muscle pain that goes away on its own is not a major concern. However, it’s important to check with your health care provider if you have unbearable or worsening pain, swelling, color changes, shortness of breath, fever, or other concerning symptoms — your doctor can rule out other causes of muscle aches. In addition, if you have recurrent muscle pain or believe that your sore calves or other aches are related to lupus, talk to your rheumatologist about how to manage this symptom. When you’re living with an autoimmune disease like lupus, your health care team is there to help you feel your best and improve your quality of life.

Find Your Team

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you ever woken up with sore calves or other unexplained muscle pain? What strategies did you use to relieve the pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.